Usefulness of a Point-of-Care Sural Nerve Conduction Device (DPNCheck™) for Evaluation of Diabetic Symmetric Sensorimotor Polyneuropathy in Japan
Authors: SHIBATA YUKA , KAMIYA HIDEKI , HIMENO TATSUHITO , MOTEGI MIKIO , SHIMODA HIROMI , KATO MAKOTO , YAMADA YUICHIRO , MIURA-YURA EMIRI , KONDO MASAKI , TSUNEKAWA SHIN , KATO YOSHIRO , NAKAMURA JIRO 
Published: June 2018

Nerve conduction study (NCS) is a reliable examination to diagnose and to evaluate diabetic symmetric sensorimotor polyneuropathy (DSPN). However, NCS is not feasible in daily medical practice, because it requires skilled laboratory technicians and an expensive equipment. A point-of-care device, DPNCheck™can measure sural nerve (SN) action potential amplitude (Amp) and conduction velocity (CV) in less than 5 minutes without special techniques. Here, we evaluated the accuracy and the usefulness of DPNCheck™ for diagnosis of DSPN in Japanese diabetic patients. We selected 207 diabetic patients. 1. We examined bilateral SN both by electromyography (EM) and DPNCheck™ and compared the differences. 2. To evaluate the reproducibility and inter-rater reliability of DPNCheck™, Amp and CV of SN were measured twice by an examiner and once by another examiner. 3. Based on the results of EM, we classified the severity of DSPN into 3 grades as follows; grade 0: Amp of SN (SNAP) 5μV or more and Amp of tibial nerve (CMAP) 5mV or more, grade 1: SNAP&lt;5μV and CMAP 5mV or more, and grade 2: SNAP&lt;5μV and CMAP&lt;5mV. Then, a formula to predict the grades of DSPN severity by using the Amp and CV from DPNCheck™ was created. For statisticalanalyses SPSS was used. 1. The correlation coefficient (R) for CV and Amp between DPNCheck™ and EM were R=0.7663 and 0.6178, respectively. 2. The reproducibility and inter-rater reliability of DPNCheckTM were “superior” and “acceptable”, respectively. 3. The formula to predict the severity of DSPN by DPNCheck™ was as follows; “grade = 2.235+0.009xAge-0.015xCV-0.041xAmp.” The grade calculated by this formula was relatively “acceptable” compared with the real grade determined by EM (correlation coefficient: R=0.645). These results indicate that DPNCheck™ is a useful device to measure SN functions in Japanese diabetic patients and should be used more frequently in the bedside to diagnose and evaluate DSPN.

Disclosure
Y. Shibata: None. H. Kamiya: Other Relationship; Self; MSD K.K., Ono Pharmaceutical Co., Ltd., Sanofi K.K., AstraZeneca, Astellas Pharma KK, Eli Lilly and Company, Novartis Pharma K.K., Dainippon Sumitomo Pharma Co., Ltd, Boehringer Ingelheim Pharmaceuticals, Inc., Takeda Pharmaceutical Co., Ltd, Ono Pharmaceutical Co., Ltd.. T. Himeno: None. M. Motegi: None. H. Shimoda: None. M. Kato: None. Y. Yamada: None. E. Miura-Yura: None. M. Kondo: None. S. Tsunekawa: None. Y. Kato: Speaker's Bureau; Self; Merck Sharp & Dohme Corp., Sanofi, Takeda Pharmaceutical Company, Eli Lilly Japan. J. Nakamura: Other Relationship; Self; Astellas Pharma US, Inc., AstraZeneca, Ono Pharmaceutical Co., Ltd., MSD K.K., Kyowa Hakko Kirin Co., Ltd., Kowa Pharmaceuticals America, Inc., Sanofi K.K., Taisho Pharmaceutical Co., Ltd., Takeda Development Center Asia, Pte. Ltd., Mitsubishi Tanabe Pharma Corporation, Eli Lilly and Company, Novartis Pharma K.K., Pfizer Inc..