AUTHOR=Cai Qiong , Aimair Guliqiemu , Xu Wen-Xiao , Xiao Pei-Yao , Liu Lie-Hua , Liang Yin-Xing , Wu Chao , Liao Song-Jie 

TITLE=The Physiological Significance of A-Waves in Early Diabetic Neuropathy: Assessment of Motor Nerve Fibers by Neurophysiological Techniques

JOURNAL=Frontiers in Systems Neuroscience

VOLUME=15

YEAR=2021

URL=https://www.frontiersin.org/journals/systems-neuroscience/articles/10.3389/fnsys.2021.633915

DOI=10.3389/fnsys.2021.633915

ISSN=1662-5137

ABSTRACT=<p><bold>Objective:</bold> This study aimed to investigate how early A-waves could occur in type II diabetes, and what it implied functionally.</p><p><bold>Methods:</bold> We performed conduction velocity distribution (CVD) test in peroneal nerves of 37 type II diabetic patients with normal nerve conduction study (NCS) and 22 age-matched controls. The electrophysiological data and clinical information were analyzed.</p><p><bold>Results:</bold> A-waves were observed in 45.9% of diabetic patients and only in 1 person in healthy controls, all detected in the tibial nerves. The diabetic patients with A-waves showed faster conduction velocity in all quartiles in the motor peroneal nerves compared to the patients without A-waves, and their CVD histograms were shifted to the right side, consisting of a significantly larger percentage of fast conducting fibers. There was no significant difference in the CVD values of the upper extremity nerves among the patients with and without A-waves and the healthy controls.</p><p><bold>Conclusion:</bold> A-waves could occur in type II diabetes as early as when NCS showed normal, and represented as a sign of neuropathy as well as a sign of rescued motor nerve function.</p>