ArticlePloS one2013
The rate of decline in small fibre function assessed using axon reflex-mediated neurogenic vasodilatation and the importance of age related centile values to improve the detection of clinical neuropathy.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02549534 (Early Detection of Taxane-Induced Neuropathy in Women With Breast Cancer), which is not on this map. Cited by 11 papers.
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Early Detection of Taxane-Induced Neuropathy in Women With Breast Cancer
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11 citing papers in PubMed, 27 citations in OpenAlex.
- Assessment of diabetic neuropathy using a point-of-care nerve conduction device shows significant associations with the LDIFLARE method and clinical neuropathy scoring.Journal of diabetes science and technology · 2015Trial
- Corneal Confocal Microscopy Identifies People with Type 1 Diabetes with More Rapid Corneal Nerve Fibre Loss and Progression of Neuropathy.Journal of clinical medicine · 2022Article
- Early Detection of Diabetic Peripheral Neuropathy: A Focus on Small Nerve Fibres.Diagnostics (Basel, Switzerland) · 2021Review
- A Synoptic Overview of Neurovascular Interactions in the Foot.Frontiers in endocrinology · 2020Review
- Axon reflex-mediated vasodilation is reduced in proportion to disease severity in TTR-FAP.Neurology. Genetics · 2018Article
- The influence of age, anthropometric and metabolic variables on LDIFLARE and corneal confocal microscopy in healthy individuals.PloS one · 2018Article
- Laser Doppler Flare Imaging and Quantitative Thermal Thresholds Testing Performance in Small and Mixed Fiber Neuropathies.PloS one · 2016Article
- Vasoregression: A Shared Vascular Pathology Underlying Macrovascular And Microvascular Pathologies?Omics : a journal of integrative biology · 2015Review
- Assessment of chemotherapy-induced peripheral neuropathy using the LDIFLARE technique: a novel technique to detect neural small fiber dysfunction.Brain and behavior · 2015Article
- Microvascular dysfunction in the context of diabetic neuropathy.Current diabetes reports · 2014Review
- Distal Sensorimotor Neuropathy: Improvements in Diagnosis.The review of diabetic studies : RDSReview
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2 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe LDIflare technique (LDIflare) is a simple non-invasive test of small fibre function in dorsal foot skin involving skin heating and measuring the size of the resulting axon reflex-mediated vasodilator (flare) response using a laser Doppler imager (LDI). This study establishes age-related normative reference ranges for the test and determines the rate of decline in small fibre function per decade. Additionally, the potential value of using age related centiles rather than Receiver Operator Curves (ROC) was explored by comparison of the sensitivity and specificity of each analytic technique in identifying clinical neuropathy.
methodsLDIflare areas were assessed in 94 healthy controls and 66 individuals with diabetes with (DN+, n = 31) and without clinical neuropathy (DN-, n = 35); neuropathy defined as a Neuropathy Disability Score ≥ 3. The age specific 5th centile values were used as the 'cut-offs' for the diagnosis of neuropathy from which sensitivity and specificity were calculated.
resultsThere was a significant age dependant decrease in LDIflare size (r = -0.42, p<0.0001) with no significant gender differences. The LDIflare size reduced 0.56 cm(2) per decade which gives a percentage reduction of approximately 5.5% per decade. Using the normative 5th centiles as the cut-offs, the technique had a sensitivity of 77%, specificity of 90%, positive predictive value of 82% and negative predictive value of 87%.The ROC analysis gave a threshold of <3.66 cm(2) for the cut-off, resulting in a sensitivity of 75%, specificity of 85%, positive predictive value of 74% and negative predictive value of 86%.
conclusionsThere is an age dependent decrease in small fibre function in the foot of 5.5% per decade. Both analytic techniques demonstrate good sensitivity and specificity for detecting clinical neuropathy but the technique based on age centiles offers better diagnostic accuracy and is therefore proposed as the method of choice.
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