Summary
In order to assess the possible progression of neurological abnormalities over time and the value of visual evoked potential alterations in predicting stability and severity of diabetes-related optic pathway disease, a longitudinal study in non-insulin-dependent diabetic patients was performed. Neurological examination, visual evoked potentials with pattern reversal, motor and sensory nerve conduction velocities and metabolic control were studied in 18 non-insulin-dependent diabetic patients and in 35 normal control subjects at baseline and again after 4.6±0.8 years (range 4–6). At the first recording the peak P100 wave latencies were significantly delayed in the diabetic patients compared with the control subjects; signs of peripheral neuropathy were detected in five patients, clinical in three and in two there was only neurophysiological alteration without clinical signs. The second recording revealed no significant alterations of P100 latencies in patients compared with baseline, but the number with clinical signs and/or neurophysiological alterations with no clinical signs of peripheral neurological disease was increased to seven. In conclusion, we observed that visual evoked potential alterations were stable over time whereas peripheral neurological disease progressed and correlated positively with metabolic control.
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Abbreviations
- VEP-PR:
-
Visual evoked potentials with pattern reversal
- NCV:
-
nerve conduction velocities
- LP100:
-
peak latencies of P100 wave
- ILD:
-
interocular latencies difference
- NIDDM:
-
non-insulin-dependent diabetes mellitus
- ARI:
-
aldose reductase inhibitor
References
Puvanendran K, Devathasan G, Wong PK (1983) Visual evoked responses in diabetes. J Neurosurg Psychiatry 46:643–647
Khardori R, Soler NG, Good DC, Devlesc Howard AB, Broughton D, Walbert J (1986) Brainstem auditory and visual evoked potentials in type 1 (insulin dependent) diabetic patients. Diabetologia 29:362–365
Anastasi M, Lauricella M, Giordano C, Galluzzo A (1985) Visual evoked potentials in insulin dependent diabetics. Acta Diabetol Lat 22:343–349
Comi G, Martinelli V, Galardi G et al. (1987) Evaluation of central nervous conduction by visual evoked potentials in insulin-dependent diabetic children. Acta Diabetol Lat 24:157–162
Cirillo D, Gonfiantini E, De Grandis D, Bongiovanni L, Robert JJ, Pinelli L (1984) Visual evoked potentials in diabetic children and adolescents. Diabetes Care 7:273–275
Mariani E, Moreo G, Colucci GB (1990) Study of visual evoked potentials in diabetics without retinopathy: correlations with clinical findings and polyneuropathy. Acta Neurol Scand 81:337–340
National Diabetes Data Group (1979) Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes 28:1039–1057
Chatrian GE (1984) Guidelines for clinical evoked potentials studies. J Clin Neurophysiol 1:3–53
Chiappa KH (1990) Pattern-shift visual evoked potentials: interpretation. In: Chiappa KH (ed) Evoked potentials in clinical medicine. Raven Press, New York, pp 111–153
Kimura J (1985) Electrodiagnosis in disease of nerve and muscle. In: Kimura J, Davies FA (eds) Principles of nerve conduction studies. Saunders, Philadelphia, pp 83–141
Pozzessere G, Rizzo PA, Valle E et al.(1988) Early detection of neurological involvement in IDDM and NIDDM. Multinodal evoked potentials versus metabolic control. Diabetes Care 11:473–480
Algan M, Ziegler O, Gehin P et al. (1989) Visual evoked potentials in diabetic patients. Diabetes Care 12:227–229
Reske-Nielsen E, Lundbaek K, Rafaelsen OJ (1965) Pathological changes in the central and peripheral nervous system of young long-term diabetics. Diabetologia 1: 233–241
De Jong RN (1977) CNS manifestations in diabetes mellitus. Postgrad Med 61:101–107
Skenazy JA, Bigler ED (1984) Neuropsychological findings in diabetes mellitus. J Clin Psychol 40:246–258
Dyck PJ, Thomas PK (1993) Diabetic and hypoglycaemic neuropathy. In: Dyck PJ, Thomas PK (eds) Peripheral neuropathy. Saunders, Philadelphia, pp 1219–1241
Kamijo M, Cherian PV, Sima AAF (1993) The preventive effect of aldose reductase inhibition on diabetic optic neuropathy in the BB/W-rat. Diabetologia 36:893–898
Sima AAF, Nathaniel V, Bril V, McEwen TAJ, Greene DA (1988) Histopathological heterogeneity of neuropathy in insulin-dependent and non-insulin-dependent diabetes, and demonstration of axo-glial dysjunction in human diabetic neuropathy. J Clin Invest 81:349–364
Sima AAF, Prashar A, Zhang WX, Chakrabarti S, Greene DA (1990) Preventive effect of long term aldose reductase inhibition (Ponalrestat) on nerve conduction and sural nerve structure in the spontaneously diabetic BB-rat. J Clin Invest 85:1410–1420
Hogan MJ, Alvarados JA, Weddel JE (1971) Histology of the human eye. Saunders, Philadelphia
Halliday AM (1993) The visual evoked potential in the investigation of diseases of the optic nerve. In: Halliday AM (ed) Evoked potentials in clinical testing. Churchill, Livingstone, pp 195–278
Pozzessere G, Rizzo PA, Valle E et al. (1989) A longitudinal study of multimodal evoked potentials in diabetes mellitus. Diabetes Research 10:17–20
Martinelli V, Piatti PM, Filippi M et al. (1992) Effects of hyperglycaemia on visual evoked potentials in insulin-dependent diabetic patients. Acta Diabetol 29:34–37
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Moreo, G., Mariani, E., Pizzamiglio, G. et al. Visual evoked potentials in NIDDM: a longitudinal study. Diabetologia 38, 573–576 (1995). https://doi.org/10.1007/BF00400726
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DOI: https://doi.org/10.1007/BF00400726