Contribution of central neuropathy to postural instability in IDDM patients with peripheral neuropathy

Luigi Uccioli, Pier Giorgio Giacomini, Patrizio Pasqualetti, Stefano Di Girolamo, Paola Ferrigno, Giovanna Monticone, Ernesto Bruno, Paolo Boccasena, Antonio Magrini, Leoluca Parisi, Guido Menzinger, Paolo Maria Rossini

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE - To evaluate the contribution of central neuropathy on postural impairment observed in diabetic patients with peripheral neuropathy. RESEARCH DESIGN AND METHODS - Central sensory and motor nervous propagation, nerve conduction velocity, and static posturography were assessed in the following agematched subjects: 7 IDDM patients with peripheral neuropathy (group DN), 18 IDDM patients without peripheral neuropathy (group D), and 31 control subjects (group C). Somatosensory-evoked potentials (SEPs) during tibial nerve stimulation were recorded, and the spine-to-scalp sensory central conduction time (SCCT) was evaluated. Motor-evoked potentials (MEPs) were recorded from leg muscles during magnetic transcraniaI brain stimulation, and the scalp-to-spine motor central conduction time (MCCT) was evaluated. The following posturographic parameters were calculated from the statnkinesigram: trace length, trace surface, velocity of body sway with its standard deviation, and VFY (a parameter derived from the velocity variance and the anteroposterior mean position of the body). RESULTS - SCCT was significantly higher in the DN group than in the C and D groups (P <0.001). MCCT was similar in all groups. Posturographic parameters were all significantly impaired in the DN group (P <0.01). While posturographic parameters showed a direct relationship with some parameters of peripheral nerve conduction, no correlations were observed with SEP and MEP central conduction time. These results were also confirmed by logistic regression, which indicates peripheral neuropathy as the only implicating factor in postural instability (odds ratio 0.22, 95% CI 007-0.75) after data reduction by means of factor analysis. CONCLUSIONS - Although diabetic patients with peripheral neuropathy show a delay in central sensory conduction, postural instability may be fully explained by the presence of peripheral neuropathy.

Original languageEnglish
Pages (from-to)929-934
Number of pages6
JournalDiabetes Care
Volume20
Issue number6
Publication statusPublished - Jun 1997

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

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