ArticleDiagnostics (Basel, Switzerland)2021
Optimal Utility of H-Reflex RDD as a Biomarker of Spinal Disinhibition in Painful and Painless Diabetic Neuropathy.
Article in Diagnostics (Basel, Switzerland), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 16 citations in OpenAlex.
- Effect of Cocoa Supplementation on the Biochemical and Clinical Profile and the Somatosensory Processing of Diabetic Peripheral and Autonomic Neuropathy: A Randomized Clinical Trial.International journal of molecular sciences · 2025Trial
- The Hoffmann Reflex.NeuroSci · 2026Review
- Pain Modulation and Central Sensitization in Painful Diabetic Peripheral Neuropathy: Updated Narrative Review and Future Directions.Journal of diabetes · 2026Review
- Optimizing Hoffmann Reflex Rate-Dependent Depression: A Feasible Protocol for Assessing Spinal Inhibition in Upper and Lower Limbs.Medical sciences (Basel, Switzerland) · 2026Article
- Soleus H-reflex size versus stimulation rate in the presence of background muscle activity: a methodological study.Experimental brain research · 2025Article
- Evidence for spinal disinhibition as a pain-generating mechanism in fibromyalgia syndrome.Pain reports · 2025Article
- Transcranial magnetic stimulation measures of corticospinal excitability in Black and Hispanic/Latino people with painful peripheral neuropathy.Frontiers in human neuroscience · 2025Article
- Rate-Dependent Depression of the Hoffmann Reflex: Practical Applications in Painful Diabetic Neuropathy.Diabetes & metabolism journal · 2024Review
- Combined use of CLP290 and bumetanide alleviates neuropathic pain and its mechanism after spinal cord injury in rats.CNS neuroscience & therapeutics · 2024Article
- Feasibility of trancutaneous auricular vagus nerve stimulation in Black and Hispanic/Latino people with peripheral neuropathy.Frontiers in pain research (Lausanne, Switzerland) · 2024Article
- Development of KCC2 therapeutics to treat neurological disorders.Frontiers in molecular neuroscience · 2024Article
- Spinal disinhibition: evidence for a hyperpathia phenotype in painful diabetic neuropathy.Brain communications · 2023Article
- Post-activation depression of the Hoffman reflex is not altered by galvanic vestibular stimulation in healthy subjects.Frontiers in integrative neuroscience · 2023Article
- Evidence of impaired H-reflex and H-reflex rate-dependent depression in diabetes, prediabetes and obesity: a mini-review.Frontiers in endocrinology · 2023Review
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Authors and funding
11 authors at 5 institutions in 4 countries.
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Abstract
Impaired rate-dependent depression of the Hoffman reflex (HRDD) is a potential biomarker of impaired spinal inhibition in patients with painful diabetic neuropathy. However, the optimum stimulus-response parameters that identify patients with spinal disinhibition are currently unknown. We systematically compared HRDD, performed using trains of 10 stimuli at five stimulation frequencies (0.3, 0.5, 1, 2 and 3 Hz), in 42 subjects with painful and 62 subjects with painless diabetic neuropathy with comparable neuropathy severity, and 34 healthy controls. HRDD was calculated using individual and mean responses compared to the initial response. At stimulation frequencies of 1, 2 and 3 Hz, HRDD was significantly impaired in patients with painful diabetic neuropathy compared to patients with painless diabetic neuropathy for all parameters and for most parameters when compared to healthy controls. HRDD was significantly enhanced in patients with painless diabetic neuropathy compared to controls for responses towards the end of the 1 Hz stimulation train. Receiver operating characteristic curve analysis in patients with and without pain showed that the area under the curve was greatest for response averages of stimuli 2-4 and 2-5 at 1 Hz, AUC = 0.84 (95%CI 0.76-0.92). Trains of 5 stimuli delivered at 1 Hz can segregate patients with painful diabetic neuropathy and spinal disinhibition, whereas longer stimulus trains are required to segregate patients with painless diabetic neuropathy and enhanced spinal inhibition.
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