Case Control Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jan 15, 2019; 10(1): 47-56
Published online Jan 15, 2019. doi: 10.4239/wjd.v10.i1.47
Relationship between sonographically measured median nerve cross-sectional area and presence of peripheral neuropathy in diabetic subjects
Fredrick Andrew Attah, Christianah Mopelola Asaleye, Adeleye Dorcas Omisore, Babatope Ayodeji Kolawole, Adeniyi Sunday Aderibigbe, Mathew Alo
Fredrick Andrew Attah, Adeniyi Sunday Aderibigbe, Department of Radiology, Obafemi Awolowo University Teaching Hospitals Complex, Osun 220222, Nigeria
Christianah Mopelola Asaleye, Adeleye Dorcas Omisore, Department of Radiology, Obafemi Awolowo University/Obafemi Awolowo University Teaching Hospitals Complex, Osun 220222, Nigeria
Babatope Ayodeji Kolawole, Department of Internal Medicine, Obafemi Awolowo University/Obafemi Awolowo University Teaching Hospitals Complex, Osun 220222, Nigeria
Mathew Alo, Department of Orthopedics, Obafemi Awolowo University Teaching Hospitals Complex, Osun 220222, Nigeria
Author contributions: Attah FA suggested the concept, did the data collection and initial write-up of the manuscript; Asaleye CM was involved in study design, literature search and editing of the manuscript; Omisore AD was involved in study design, data analysis, writing of the final version of the manuscript; Kolawole BA did literature search and editing of the manuscript; Aderibigbe AS did data collation and was involved with analysis; Alo M was part of patient recruitment and manuscript editing.
Institutional review board statement: The study was approved by the Ethical committee of the Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife, Osun State, Nigeria, and a copy is uploaded with the submission.
Informed consent statement: Written informed consent was obtained from all study participants before their inclusion into the study.
Conflict-of-interest statement: The authors have no conflict of interest to report.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Adeleye Dorcas Omisore, MBBS, Attending Doctor, Lecturer, Department of Radiology, Obafemi Awolowo University/Obafemi Awolowo University Teaching Hospitals Complex, Ilesa road, Osun 220222, Nigeria. omisoreadeleye@yahoo.com
Telephone: +234-803-1538004
Received: September 1, 2018
Peer-review started: September 3, 2018
First decision: November 8, 2018
Revised: December 29, 2018
Accepted: January 3, 2019
Article in press: January 3, 2019
Published online: January 15, 2019
ARTICLE HIGHLIGHTS
Research background

Peripheral neuropathy (PN) is a common complication of diabetes mellitus. High-resolution ultrasonography gives good morphological detail in the peripheral nerves.

Research motivation

Sonographic measurement of the Median nerve cross-sectional area may be a valuable tool in addition to clinical examination in identifying subjects with peripheral neuropathy in regions where standard electrophysiological studies like nerve conduction test are not available.

Research objectives

We evaluated the relationship between median nerve cross-sectional area (CSA) and the presence of PN in a cohort of adult diabetic Nigerians.

Research methods

A one-year cross-sectional study carried out in diabetic subjects recruited in the endocrinology unit of a Nigerian tertiary hospital and age- and sex-matched controls.

Research results

This study demonstrates that the median nerve is thicker in CSA at the carpal tunnel (CATL) and 5 cm proximal to the carpal tunnel (5cmCATL) in diabetic subjects than in age- and sex-matched healthy controls. Further thickening in the median nerve CSA is seen in the presence of diabetic peripheral neuropathy at the carpal tunnel but not at a point 5 cm proximal to it. Median nerve size has no significant relationship with age, gender, severity of DPN, duration of DM or glycemic control in our diabetic subjects.

Research conclusions

This study done in Diabetics of Nigerian origin adds to the current literature that Diabetic subjects have thicker MN CSA compared to their age- and sex-matched controls. Median nerve CSA was also thicker at the CATL in Diabetics with PN than in those without PN.

Research perspectives

We suggest the need for longitudinal studies in diabetic subjects who have median nerve neuropathy confirmed with nerve conduction test to elucidate the progressive effect of diabetic peripheral neuropathy on MN CSA.