Division of Research, Weill Cornell Medicine Qatar, Doha, Qatar.
Copyright © 2018 Korean Diabetes Association
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DN4, Douleur Neuropathique en 4; LANSS, Leeds Assessment of Neuropathic Symptoms and Signs; NPQ, Neuropathic Pain Questionnaire; MNSI, Michigan Neuropathy Screening Instrument; DNS, Diabetic Neuropathy Symptom; TCNS, Toronto Clinical Neuropathy Score; NDS, neuropathy disability score; UENS, Utah Early Neuropathy Scale; QSART, Quantitative Sudomotor Axon Reflex Test; NCS, nerve conduction studies; IENFD, intra-epidermal nerve fiber density; HRT III RCM, Heidelberg Retina Tomograph III Rostock Corneal Module.
Examination name | Examination type | Advantages | Disadvantages |
---|---|---|---|
Clinical symptoms & signs | DN4, LANSS, NPQ, MNSI, DNS, TCNS, NDS, UENS | Relevant to the patient, easy to use, inexpensive | Limited sensitivity, high variability |
Quantitative sensory testing | CASE IV (WR Medical Electronics), Biothesiometer, Thermoaesthesiometer, TSA Neurosensory Analyser (Medoc Ltd.) | Easy to perform, rapid, non-invasive, evaluates large and small nerve fibers | Variable, subjective, requires special equipment |
Sudomotor function | Neuropad (Skyrocket Phytopharma), Sudoscan (Impeto Medical), QSART, sympathetic skin response | Fast, objective, easy to perform, simple, reproducible | Moderate sensitivity, uncertain interpretation |
Neurophysiology | NCS of motor and sensory nerves | Objective, widely available | Only assesses large fibers, moderate reproducibility, requires special equipment |
Skin punch biopsy | IENFD | Objective, gold standard to assess small fibers | Costly, time-consuming, risk of infections requires specialist equipment and personnel to quantify IENFD |
Corneal confocal microscopy | HRT III RCM | Objective, rapid, reproducible, assesses small fibers | Costly, requires specialist equipment |
DN4, Douleur Neuropathique en 4; LANSS, Leeds Assessment of Neuropathic Symptoms and Signs; NPQ, Neuropathic Pain Questionnaire; MNSI, Michigan Neuropathy Screening Instrument; DNS, Diabetic Neuropathy Symptom; TCNS, Toronto Clinical Neuropathy Score; NDS, neuropathy disability score; UENS, Utah Early Neuropathy Scale; QSART, Quantitative Sudomotor Axon Reflex Test; NCS, nerve conduction studies; IENFD, intra-epidermal nerve fiber density; HRT III RCM, Heidelberg Retina Tomograph III Rostock Corneal Module.