Diagnostic Accuracy of Perception Threshold Tracking in the Detection of Small Fiber Damage in Type 1 Diabetes
Authors' conclusion
Perception threshold tracking had a very high diagnostic agreement with corneal confocal microscopy for detecting small nerve fiber loss and may have clinical utility for assessing small nerve fiber damage and hence early DPN.
Study context
- Population
- Participants with T1D without DPN, with DPN, with painful DPN, and healthy controls
- Participants
- 20 / 20 / 20 / 20
- Comparison
- Perception threshold tracking vs corneal confocal microscopy
- T1DM without DPNn = 20
- DPNn = 20
- Painful DPNn = 20
- Healthy controls (HCs)n = 20reference
- Outcome
- Diagnostic accuracy of perception threshold tracking on the foot vs corneal confocal microscopy for small nerve fiber damage
Performance
As reported in the abstract
Diagnostic accuracy of rheobase for small nerve fiber damage defined by CNFL
| Test or model | Sensitivity | Specificity | PPV | NPV |
|---|---|---|---|---|
| Perception threshold tracking (rheobase) | 94% | 94% | 97% | 89% |
Perception threshold tracking (rheobase)
Sensitivity94%
Specificity94%
PPV97%
NPV89%
Further findings
Between-group differences in rheobase, corneal nerve fiber density (CNFD), corneal nerve branch density (CNBD) and corneal nerve fiber length (CNFL)
- Rheobase, CNFD, CNBD and CNFL differed between groups
- all P < .001
Correlation of rheobase with CNFD, CNBD, CNFL and Michigan Neuropathy Screening Instrument
- Significant correlation of rheobase with CNFD, CNBD, CNFL and MNSI
- all P < .001
Original publication
Diagnostic Accuracy of Perception Threshold Tracking in the Detection of Small Fiber Damage in Type 1 Diabetes. J Diabetes Sci Technol. Published 24 February 2023. doi:10.
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