, Volume 31, Issue 10, pp 762–765

Is resistance to ischaemic conduction failure induced by hypoxia?

  • E. A. Masson
  • S. E. Church
  • A. A. Woodcock
  • S. P. Hanley
  • A. J. M. Boulton


Resistance to ischaemic conduction failure is a recognised but unexplained property of diabetic peripheral nerve. We have studied matched groups of control, diabetic, and non-diabetic hypoxic subjects (hypoxia: arterial oxygen tension ⩽ 60 mm Hg (8 kPa) on at least one occasion and secondary to chronic lung disease). Similar resistance to ischaemia was seen in the hypoxic and diabetic groups compared with control subjects (p<0.001). The degree of resistance correlated with arterial oxygen tension at the time of testing (r = 0.72, p<0.01). In all individuals with acute exacerbations of hypoxia, the resistance to ischaemia was normalised with improvement of respiratory function (p<0.02). These results are compatible with the hypothesis that endoneurial hypoxia may be a factor in the pathogenesis of diabetic neuropathy.

Key words

Diabetes neuropathy hypoxia ischaemia ischaemia resistance 


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  1. 1.
    Caruso G, Labianca O, Ferrannini E (1973) Effect of ischaemia on sensory potentials of normal subjects of different ages. J Neurol Neurosurg Psychiatry 36: 455–466Google Scholar
  2. 2.
    Seneviratne KN, Peiris OA (1968) The effect of ischaemia on the excitability of human sensory nerve. J Neurol Neurosurg Psychiatry 31: 338–347Google Scholar
  3. 3.
    Low PA (1987) Recent advances in the pathogenesis of diabetic neuropathy. Muscle Nerve 10: 121–128Google Scholar
  4. 4.
    Steiness I (1959) Vibration perception in diabetics during arrested blood flow to the limb. Acta Med Scand 163: 195–205Google Scholar
  5. 5.
    Terkildsen AB, Christensen NJ (1971) Reversible nervous abnormalities in juvenile diabetics with recently diagnosed diabetes. Diabetologia 7: 113–117Google Scholar
  6. 6.
    Newrick PG, Boulton AJM, Ward JD (1987) Nerve ischaemia-resistance: an early abnormality in diabetes. Diab Med 4: 517–520Google Scholar
  7. 7.
    Steiness I (1961) Influence of diabetic status on vibratory perception during ischaemia. Acta Med Scand 170: 319–338Google Scholar
  8. 8.
    Low PA, Schmelzer JD, Ward KK Yao JK (1986) Experimental chronic hypoxic neuropathy: relevance to diabetic neuropathy. Am J Physiol 250: E94-E99Google Scholar
  9. 9.
    Seneviratne KN, Peiris OA (1969) The effects of hypoxia on the excitability of the isolated peripheral nerves of alloxan-diabetic rats. J Neurol Neurosurg Psychiatry 33: 462–469Google Scholar
  10. 10.
    Jaramillo J, Simard-Duquesne N, Dvornik D (1985) Resistance of the diabetic rat nerve to ischaemic inactivation. Can J Physiol Pharmacol 63: 773–777Google Scholar
  11. 11.
    Horowitz SH, Ginsberg-Fellner F (1979) Ischaemia and sensory nerve conduction in diabetes mellitus. Neurology 29: 695–704Google Scholar
  12. 12.
    Low PA, Tuck RR, Dyck PJ, Schmelzer JD, Yao JK (1984) Prevention of some electrophysiologic and biochemical abnormalities with oxygen supplementation in experimental diabetic neuropathy. Proc Natl Acad Sci USA 81: 6894–6898Google Scholar
  13. 13.
    Tuck RR, Schmelzer JD, Low PA (1984) Endoneurial blood flow and oxygen tension in the sciatic nerves of rats with experimental diabetic neuropathy. Brain 107: 935–950Google Scholar
  14. 14.
    Newrick PG, Wilson AJ, Jakubowski J, Boulton AJM, Ward JD (1986) Sural nerve oxygen tension in diabetes. Br Med J 293: 1053–1054Google Scholar
  15. 15.
    Dyck PJ, Karnes J, O'Brien PC (1987) Diagnosis, staging, and classification of diabetic neuropathy. In: Dyck PJ, Thomas PK, Asbury AK, Winegrad AI, Porte D (eds) Diabetic neuropathy. WB Saunders, Philadelphia, pp 36–44Google Scholar
  16. 16.
    Castaigne P, Cathala H-P, Beassart-Boulenge L, Petrover M (1972) Effect of ischaemia on peripheral nerve function in patients with chronic renal failure undergoing dialysis treatment. J Neurol Neurosurg Psychiatry 35: 631–637Google Scholar
  17. 17.
    Nielsen VK, Kardel T (1975) Delayed decrement of the nerve impulse propagation during induced limb ischaemia in chronic hepatic failure. J Neurol Neurosurg Psychiatry 38: 966–976Google Scholar
  18. 18.
    Ritchie JM (1985) A note on the mechanism of resistance to anoxia and ischaemia in pathophysiological mammalian myelinated nerve. J Neurol, Neurosurg, Psychiatry 48: 274–277Google Scholar
  19. 19.
    Hochachka PW, Dunn JF (1983) Metabolic arrest: the most effective means of protecting tissues against hypoxia. In: Sutton JR, Houston CS, Jones NL (eds) Hypoxia, Exercise, and Altitude: Proceedings of the Third Banff International Hypoxia Symposium, Alan R Liss Inc, New York, pp 279–309Google Scholar
  20. 20.
    Low PA, Ward K, Schmelzer JD, Brimijoin S (1985) Ischaemic conduction failure and energy metabolism in experimental diabetic neuropathy. Am J Physiol 248: E457–462Google Scholar
  21. 21.
    Wright EB (1946) A comparative study of the effects of oxygen lack on peripheral nerve. Am J Physiol 147: 78–89Google Scholar
  22. 22.
    Appenzeller O, Parks RD, MacGee J (1968) Peripheral neuropathy in chronic disease of the respiratory tract. Am J Med 44: 873–880Google Scholar
  23. 23.
    Paramelle B, Vila A, Pollak P, Muller P, Gavelle D, Reymond F, Brambilla C, Stoebner P (1986) Frequence des polyneuropathies dans les bronchopneumopathies chroniques obstructives. Presse Medicale 15: 563–567Google Scholar
  24. 24.
    Yasuda H, Dyck PJ (1987) Abnormalities of endoneurial microvessels and sural nerve pathology in diabetic neuropathy. Neurology 37: 20–28Google Scholar

Copyright information

© Springer-Verlag 1988

Authors and Affiliations

  • E. A. Masson
    • 1
  • S. E. Church
    • 1
  • A. A. Woodcock
    • 2
  • S. P. Hanley
    • 3
  • A. J. M. Boulton
    • 1
  1. 1.Manchester Royal InfirmaryUK
  2. 2.Wythenshawe HospitalUK
  3. 3.Monsall HospitalManchesterUK

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