UNASSIGNED: Diabetic neuropathy (DN) is a very frequent microvascular complication of type 2 diabetes mellitus (T2DM). Obesity and physical inactivity are well-known risk factors for T2DM. Fibroblast growth factor 21 (FGF21) is a liver-secreted hormone with several beneficial effects on obesity-related metabolic disorders. We aimed to investigate the effect of short-term physical activity on the levels of FGF21, and its correlation with the severity of peripheral sensory polyneuropathy in T2DM patients.
UNASSIGNED: Thirty patients with DN were enrolled in the study, compared to age- and gender-matched controls. We conducted a six-week aerobic training program, which meant treadmill and cycle ergometers three times a week. Anthropometric and laboratory parameters were measured for each patient before and after intervention. Serum levels of FGF21, TNF-alpha, irisin, leptin and adiponectin were measured by ELISA. The sensory perception threshold (CPT) was quantitatively measured using Neurometer®.
UNASSIGNED: We found significant decreases in BMI, waist circumference, HbA1c and TNF-alpha levels. From baseline to six-week follow-up, FGF21 levels were significantly increased in DN patients. Significant negative correlations were shown between the changes in FGF21 levels and BMI, between changes in FGF21 and the improvement of CPT values, and between the changes in FGF21 and TNF-alpha levels. There was no difference in irisin, adiponectin and leptin levels in DN patients after aerobic training program.
UNASSIGNED: The physical activity may increase the level of FGF21 in T2DM patients with neuropathy. Our results highlight the importance of regular physical activity in the treatment of diabetic neuropathy.

UNASSIGNED:

The aim of this study is to comprehensively determine the types of affected fibers in Parkinson’s disease (PD) patients by employing nerve conduction studies (NCS), sympathetic skin response (SSR) examinations, and current perception threshold (CPT) testing and to analyze the correlation between levodopa use and nerve involvement.

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UNASSIGNED:

This retrospective study included 36 clinically diagnosed PD patients who were recruited between January 2018 and April 2019. All patients underwent NCS, SSR testing, and CPT sensory examinations. Additionally, the PD patients were assessed for disease staging using the Hoehn and Yahr (H-Y) scale. 

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UNASSIGNED:

Fifteen patients were included in the tremor-dominant subtype, ten patients in the rigid-dominant subtype, and eleven patients in the mixed subtype. Eleven patients were using levodopa, while twenty-five patients had never used any anti-Parkinson’s medication. Ten patients (28%) showed abnormal sympathetic skin responses (SSR). The CPT examination revealed sensory abnormalities in twenty-four patients (67%), with eighteen patients (75%) experiencing sensory hypersensitivity and six patients (25%) experiencing sensory hypoesthesia. Twelve patients (33%) had normal CPT results. Among the patients with abnormal CPT findings, seven cases (29%) involved large myelinated fiber damage, twenty-two cases (92%) involved small myelinated fiber damage, and nineteen cases (79%) involved unmyelinated fiber damage. The rate of sensory abnormalities was 64% (7/11) in the levodopa group and 68% (17/25) in the non-levodopa group, with no statistically significant difference between the two groups. 

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UNASSIGNED:

The incidence of abnormal CPT findings in PD patients was higher than that of abnormal SSR responses, suggesting that nerve fiber damage primarily affects small fiber nerves (SFN).

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UNASSIGNED:

E vizsgálat célja, hogy átfogóan meghatározza az érintett rostok típusait Parkinson-kóros (PD-) betegeknél idegvezetési vizsgálatok (NCS), szimpatikus bőrválasz- (SSR-) vizsgálatok és áramérzékelési küszöb- (CPT-) tesztek alkalmazásával, valamint hogy elemezze a levodopahasználat és az idegek érintettsége közötti összefüggést.

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UNASSIGNED:

Ebbe a retrospektív vizsgálatba 36 klinikailag diagnosztizált PD-beteget vontunk be, akiket 2018 januárja és 2019 áprilisa között vizsgáltak klinikánkon. Minden betegnél NCS-, SSR- és CPT szenzoros vizsgálatokat végeztek. A betegeket a Hoehn és Yahr (H-Y) skála segítségével betegségstá-diumba sorolták. 

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UNASSIGNED:

Tizenöt beteg tartozott a tremordomináns-altípusba, 10 beteg a rigiditásdomináns-altípusba és 11 beteg a kevert altípusba. Tizenegy beteg használt levodopát, míg 25 beteg soha nem alkalmazott semmilyen PD-ellenes gyógyszert. Tíz betegnél (28%) mutattak ki kóros szim-patikus bőrreakciót (SSR). A CPT-vizsgálat 24 betegnél (67%) mutatott ki szenzoros eltéréseket, közülük 18 betegnél (75%) szenzoros túlérzékenységet, hat betegnél (25%) pedig szenzoros hypoesthesiát. Tizenkét beteg (33%) CPT-eredményei normálisak voltak. A kóros CPT-leletet mutató betegek közül hét esetben (29%) a nagy myelinizált rostok károsodása, 22 esetben (92%) a kis myelinizált rostok károsodása, 19 esetben (79%) pedig a nem myelinizált rostok károsodása fordult elő. A szenzoros eltérések aránya 64% (7/11) volt a levodopacsoportban és 68% (17/25) a nem levodopacsoportban; a két csoport között nem volt statisztikailag szignifikáns különbség. 

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UNASSIGNED:

A kóros CPT-leletek előfordulási gyakorisága a PD-betegeknél magasabb volt, mint a kóros SSR-válaszoké. Ez arra utal, hogy az idegrostok károsodása elsősorban a kis idegrostokat (SFN) érinti.

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Although some studies have examined the impact of short-term dopamine agonist treatment on altered central sensory processing in patients with restless legs syndrome (RLS), there is a scarcity of research investigating the effect of long-term treatment with these drugs. The aim of this study is to investigate the long-term impact of dopamine agonist treatment on altered central sensory processing in RLS patients using current perception threshold (CPT) testing.
We conducted a study of 24 RLS patients, measuring their CPT values before and after dopamine agonist treatment for at least 2 months. Patients were classified as responders or non-responders based on their decrease in International Restless Legs Syndrome (IRLS) score. Clinical parameters were collected and compared pre- and post-treatment.
The mean duration of treatment with dopamine agonist was 13.6 ± 11.0 months. Our results showed that dopamine agonist treatment significantly improved clinical parameters, including the IRLS score, Visual Analogue Scale, and RLS Quality of Life questionnaire. However, CPT values did not show significant changes for all stimulus frequencies after treatment. Furthermore, we did not find any difference in CPT values before and after treatment in both responders and non-responders.
Our study demonstrated that long-term treatment with dopamine agonists effectively reduces RLS symptoms, but does not reverse the altered central sensory processing observed on CPT testing in RLS patients. These results support the notion that the pathophysiology of RLS is multifactorial and not solely driven by dopaminergic dysfunction.

BACKGROUND: The diagnosis of sensitive skin remains nonuniform, and the underlying mechanism is unclear. Previous studies were inconsistent in the current perception threshold (CPT) measurement for sensitive skin; thus, the neural sensitivity of sensitive skin needs to be clarified.
OBJECTIVE: This study aimed to compare the CPT measurement and the cowhage test for sensitive skin and to investigate the correlation between CPT values and cowhage-itch scores.
METHODS: Participants with and without sensitive skin (n = 30, 30) were included. The cowhage test and CPT measurement with its related sensations were performed.
RESULTS: No difference was found in CPT between the sensitive and nonsensitive groups at either the site of the face or the forearm (5, 250, or 2000 Hz). Once the CPT was reached, sensations (itch, stinging, and throbbing) were significantly different between the two groups. Cowhage provoked more intense itch with a longer duration in the face (visual analog scale [VAS] score 1.90 ± 1.47 vs. 0.52 ± 0.90, p < 0.001; duration 3.80 ± 3.31 vs. 0.87 ± 1.43 min, p < 0.001) and forearm (VAS 2.53 ± 2.60 vs. 0.72 ± 1.06, p < 0.001; duration 3.37 ± 3.46 vs. 1.33 ± 2.14 min, p < 0.01) of the sensitive group compared with the nonsensitive group. Cowhage-induced itch and CPT-related itch (5 Hz) showed moderate correlations in both the face (r = 0.441, p < 0.001) and forearm (r = 0.491 p < 0.001) and weak correlations in the forearm (r = 0.323 at 250 Hz, p = 0.012; r = 0.376 at 2000 Hz, p = 0.003).
CONCLUSIONS: Cowhage test showed better performance in assessing the neural sensitivity of sensitive skin in comparison with the CPT measurement. Evaluation of CPT-related sensations may add valuable information to sensitive skin assessment.

In this work, Coca-Cola® bottles were reused as a PET polymer (rPET) source to produce electrospun polymeric nanofibers. The nanofibers were electrospun from polymer solutions with different concentrations of reduced graphene oxide (rGO) incorporated for applications in somatosensory electrical stimulation. The rPET/rGO nanofiber mats were characterized by SEM, TEM, Raman, DSC, TGA, and DMA and the results showed that the incorporation of rGO in electrospun rPET fibers produced rPET/rGO composites. The rPET/rGO composites were then evaluated for possible application as dry electrodes. Moreover, with a preliminary test of numerous volunteers, the rPET/rGO dry electrode showed promising results. The rPET/rGO electrodes showed good performance and applicability to make dry electrodes, and these have applications as dry or wearable electrodes to produce electrochemical sensors.

BACKGROUND: Diabetic microvascular complications, including diabetic kidney disease (DKD), retinopathy (DR), and neuropathy (DN), were major causes of morbidity and mortality in diabetic patients worldwide. It has been suggested that urinary albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) were not the only indicators of renal function impairment in DKD and that they were also associated with diabetic peripheral neuropathy (DPN) which might affect nerve conduction velocity (NCV). As 30-40% of DPN patients had no subjective symptoms, while current perception threshold (CPT) could detect sensory nerve damage at an early stage. As a result, we aimed to investigate correlation between UACR, eGFR and CPT in DKD patients.
METHODS: A total of 273 DKD patients from the First Affiliated Hospital of Kunming Medical University from January 2018 to June 2020 were enrolled to complete the CPT test. CPT values of the bilateral median nerve and superficial and deep peroneal nerves at 2000 Hz, 250 Hz, and 5 Hz were collected.
RESULTS: In normoesthesia and hypaesthesia patients with DKD, MDRD-eGFR correlated negatively with TC (r = -0.135, P = 0.037), left superficial peroneal and deep peroneal nerve 2000 Hz CPT (r = -0.205, P = 0.001) and right superficial peroneal and deep peroneal nerve 2000 Hz CPT (r = -0.154, P = 0.017). Besides, left and right superficial peroneal and deep peroneal nerve 2000 Hz CPT correlated with CKD-EPI-eGFR and UACR. Multivariate logistic regression analysis found left superficial peroneal and deep peroneal nerve 2000 Hz CPT was independently associated with both MDRD-eGFR and CKD-EPI-eGFR.
CONCLUSIONS: Decreased MDRD-eGFR and CKD-EPI-eGFR were expected to be a predictor of peripheral nerve injury in normoesthesia and hypaesthesia patients with DKD.

To explore pharyngeal sensory function by current perception threshold (CPT) measurement in paresthetic pharynx. In total, 58 healthy participants and 66 patients with pharyngeal paresthetic symptoms underwent CPT evaluation. Pharyngeal paresthesia (n = 66) was classified into three categories based on aetiologies: six cases with pain in pharynx; 34 neuropathic patients with glossopharyngeal nerve and/or vagus nerve or recurrent laryngeal nerve injury; and 26 patients with globus pharyngeus. CPT measurements were obtained from bilateral palatoglossal arch and tongue base at 2000, 250 and 5 Hz stimulation frequencies. Ranked from high to low, the CPT values for the bilateral palatoglossal arches and tongue bases were: lower cranial neuropathic patients, globus pharyngeus, healthy participants and patients with pain. The CPT values for neuropathic patients on the injured side were significantly higher than those on the healthy side (P < 0.05). The CPT values for patients with pain in pharynx were significantly lower than those of healthy participants (P < 0.05) when the bilateral tongue bases were stimulated. The CPT measurement is a reliable method for quantitatively assessing pharyngeal sensory function and able to differentiate pharyngeal paresthesia between lower cranial neuropathic and subjective discomfort. Pharyngeal sensory function is more sensitive in patients with pain in pharynx. Pharyngeal sensory function is significantly reduced in lower cranial neuropathic patients, especially on the injured side. Patients with globus pharyngeus have pharyngeal hyposensitivity.

OBJECTIVE: To summarize the current literature on lower urinary tract electrical sensory assessment (LUTESA), with regard to current perception thresholds (CPTs) and sensory evoked potentials (SEPs), and to discuss the applied methods in terms of technical aspects, confounding factors, and potential for lower urinary tract (LUT) diagnostics.
METHODS: The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Medline (PubMed), Embase and Scopus were searched on 13 October 2020. Meta-analyses were performed and methodological qualities of the included studies were defined by assessing risk of bias (RoB) as well as confounding.
RESULTS: After screening 9925 articles, 80 studies (five randomized controlled trials [RCTs] and 75 non-RCTs) were included, comprising a total of 3732 patients and 692 healthy subjects (HS). Of these studies, 61 investigated CPTs exclusively and 19 reported on SEPs, with or without corresponding CPTs. The recording of LUTCPTs and SEPs was shown to represent a safe and reliable assessment of LUT afferent nerve function in HS and patients. LUTESA demonstrated significant differences in LUT sensitivity between HS and neurological patients, as well as after interventions such as pelvic surgery or drug treatments. Pooled analyses showed that several stimulation variables (e.g. stimulation frequency, location) as well as patient characteristics might affect the main outcome measures of LUTESA (CPTs, SEP latencies, peak-to-peak amplitudes, responder rate). RoB and confounding was high in most studies.
CONCLUSIONS: Preliminary data show that CPT and SEP recordings are valuable tools to more objectively assess LUT afferent nerve function. LUTESA complements already established diagnostics such as urodynamics, allowing a more comprehensive patient evaluation. The high RoB and confounding rate was related to inconsistency and inaccuracy in reporting rather than the technique itself. LUTESA standardization and well-designed RCTs are crucial to implement LUTESA as a clinical assessment tool.

BACKGROUND: Damage to sensory input is an underlying pathology of chronic ankle instability (CAI). Therefore, it is necessary to evaluate the sensory function of patients with CAI. The present study quantitatively evaluated sensory nerve function in patients with CAI and healthy controls using current perception threshold (CPT) measurements, as well as the influence of sex, age, and body mass index (BMI) on CPT values and the relations between CPT frequencies.
METHODS: Fifty-nine subjects with CAI and 30 healthy controls participated in this study. CPT values at the anterior talofibular ligament region were recorded on the injured and uninjured sides in CAI patients and on both sides in the healthy control group. Between group differences were compared. The influence of sex, age and BMI on CPT values was evaluated. Correlations between different frequencies were also studied.
RESULTS: There were no significant differences in age, sex, height, weight or BMI between the CAI and healthy control groups. The CPT values did not show a significant difference by sex. The CPT values did not significantly correlate with age or BMI. Compared to the control group, the CAI group had significantly higher CPT values on the injured and uninjured sides under 250-Hz and 5-Hz electrical stimuli; the difference between the groups was significant (p < 0.01), and the effect size were large. No significant difference was observed under 2000-Hz stimuli. There were correlations between CPT values at different frequencies (p < 0.01), especially 250 Hz and 5 Hz.
CONCLUSIONS: The present study revealed increased sensory thresholds in 250-Hz- and 5-Hz-related sensory nerve fibres in the injured and uninjured ankles of patients with CAI. This increase may indicate dysfunction of A-delta and C fibres. Sex, age and BMI did not significantly impact CPT values. There were correlations between CPT values at different frequencies, especially 250 Hz and 5 Hz.
METHODS: Level III, case-control study.

UNASSIGNED: Previous studies made controversial claims about the alleged effects of Kinesio taping (KT) on pain relief. To date, the mechanism by which KT relieves pain remains unclear. Moreover, pain evaluation lacks objective and quantitative parameters. This study compared the acute effects of different KT interventions on the local thresholds of pressure pain and current perception in healthy adults to determine the potential mechanisms by which KT relieves pain.
UNASSIGNED: Thirty healthy female subjects randomly received four KT interventions, namely, no taping (NT), placebo taping (PT), Y strips of KT (KY), and fan strips of KT (KF), on the waist. Current perception threshold (CPT), pressure pain threshold (PPT), soft tissue hardness, and the visual analog scale (VAS) scores of the subjects\' perceived pain were immediately measured after taping. Repeated-measures ANOVA was performed to determine significant differences in these parameters among the four interventions.
UNASSIGNED: Significant differences in CPT values among the interventions were observed at the frequency of 5 Hz (F = 3.499, p = 0.019, η p 2 = 0.111). Post hoc analysis revealed that CPT was significantly higher for KF than for NT (p = 0.008, 95% CI = 1.390-11.990). Significant differences in PPT values (F = 4.352, p = 0.012, η p 2 = 0.130) and soft tissue hardness (F = 2.957, p = 0.049, η p 2 = 0.093) were observed among the different taping conditions. Post hoc analysis revealed that PPT was significantly higher for KF than for PT (p = 0.011, 95% CI = 0.071-0.749), and soft tissue hardness was significantly higher for KF than for NT (p = 0.010, 95% CI = 0.461-4.586) and KY (p = 0.040, 95% CI = 0.059-3.800). No significant differences in self-perceived pain among the interventions were observed.
UNASSIGNED: The healthy adult females had higher PPT values, lower soft tissue hardness, and higher CPT values at 5 Hz under KF intervention applied on the waist than those under the other taping interventions. Moreover, the different taping conditions had no significant differences in terms of VAS of perceived pain. These results provide guidance for the application of KT on pain management.