Biothesiometry

Last updated
An analog biothesiometer kit Biothesiometer - Bioteziometer.jpg
An analog biothesiometer kit
A digital biothesiometer Digital Biothesiometer.png
A digital biothesiometer

Biothesiometry is a noninvasive medical test used to quantify the perception of vibration by measuring its threshold. [1] It is used in neurology and electrophysiology to diagnose a number of conditions, like diabetic neuropathy and erectile dysfunction, where the vibration perception threshold (VPT) would be higher than average. [1] [2] The numerical nature of the test can help stage the progression of disease or complications.

The test is done through a biothesiometer, which is composed of a handheld probe wired to a display unit. Both digital and analog types are commercially available, giving the reading on either a dial or a screen.

In a systematic review of screening methods for pediatric diabetic peripheral neuropathies, biothesiometry and fine microfilaments were shown to be the only diagnostic methods with high sensitivity and specificity. [3]

A systematic review showed that there is a strong co-relation between HbA1c values and Vibration Perception Test and could be a predictor for complications in the foot following Diabetic Peripheral Neuropathy. [4]

In a systemic review of modern devices available for the assessment and screening of peripheral neuropathy, digital devices were evaluated to measure tactile sensation, vibration perception, thermal perception and foot skin temperature. [5]

Related Research Articles

Erectile dysfunction (ED), also called impotence, is the type of sexual dysfunction in which the penis fails to become or stay erect during sexual activity. It is the most common sexual problem in men. Through its connection to self-image and to problems in sexual relationships, erectile dysfunction can cause psychological harm.

<span class="mw-page-title-main">C-peptide</span> Chemical compound

The connecting peptide, or C-peptide, is a short 31-amino-acid polypeptide that connects insulin's A-chain to its B-chain in the proinsulin molecule. In the context of diabetes or hypoglycemia, a measurement of C-peptide blood serum levels can be used to distinguish between different conditions with similar clinical features.

Diabetic neuropathy is various types of nerve damage associated with diabetes mellitus. Symptoms depend on the site of nerve damage and can include motor changes such as weakness; sensory symptoms such as numbness, tingling, or pain; or autonomic changes such as urinary symptoms. These changes are thought to result from a microvascular injury involving small blood vessels that supply nerves. Relatively common conditions which may be associated with diabetic neuropathy include distal symmetric polyneuropathy; third, fourth, or sixth cranial nerve palsy; mononeuropathy; mononeuropathy multiplex; diabetic amyotrophy; and autonomic neuropathy.

<span class="mw-page-title-main">Peripheral neuropathy</span> Nervous system disease affecting nerves beyond the brain and spinal cord

Peripheral neuropathy, often shortened to neuropathy, is a general term describing disease affecting the peripheral nerves, meaning nerves beyond the brain and spinal cord. Damage to peripheral nerves may impair sensation, movement, gland, or organ function depending on which nerves are affected; in other words, neuropathy affecting motor, sensory, or autonomic nerves result in different symptoms. More than one type of nerve may be affected simultaneously. Peripheral neuropathy may be acute or chronic, and may be reversible or permanent.

Neuropathic pain is pain caused by damage or disease affecting the somatosensory system. Neuropathic pain may be associated with abnormal sensations called dysesthesia or pain from normally non-painful stimuli (allodynia). It may have continuous and/or episodic (paroxysmal) components. The latter resemble stabbings or electric shocks. Common qualities include burning or coldness, "pins and needles" sensations, numbness and itching.

A complication in medicine, or medical complication, is an unfavorable result of a disease, health condition, or treatment. Complications may adversely affect the prognosis, or outcome, of a disease. Complications generally involve a worsening in severity of disease or the development of new signs, symptoms, or pathological changes which may become widespread throughout the body and affect other organ systems. Thus, complications may lead to the development of new diseases resulting from a previously existing disease. Complications may also arise as a result of various treatments.

<span class="mw-page-title-main">Pentoxifylline</span> Chemical compound

Pentoxifylline, also known as oxpentifylline, is a xanthine derivative used as a drug to treat muscle pain in people with peripheral artery disease. It is generic and sold under many brand names worldwide.

<span class="mw-page-title-main">Type 1 diabetes</span> Form of diabetes mellitus

Type 1 diabetes (T1D), formerly known as juvenile diabetes, is an autoimmune disease that originates when cells that make insulin are destroyed by the immune system. Insulin is a hormone required for the cells to use blood sugar for energy and it helps regulate glucose levels in the bloodstream. Before treatment this results in high blood sugar levels in the body. The common symptoms of this elevated blood sugar are frequent urination, increased thirst, increased hunger, weight loss, and other serious complications. Additional symptoms may include blurry vision, tiredness, and slow wound healing. Symptoms typically develop over a short period of time, often a matter of weeks.

The term diabetes includes several different metabolic disorders that all, if left untreated, result in abnormally high concentration of a sugar called glucose in the blood. Diabetes mellitus type 1 results when the pancreas no longer produces significant amounts of the hormone insulin, usually owing to the autoimmune destruction of the insulin-producing beta cells of the pancreas. Diabetes mellitus type 2, in contrast, is now thought to result from autoimmune attacks on the pancreas and/or insulin resistance. The pancreas of a person with type 2 diabetes may be producing normal or even abnormally large amounts of insulin. Other forms of diabetes mellitus, such as the various forms of maturity onset diabetes of the young, may represent some combination of insufficient insulin production and insulin resistance. Some degree of insulin resistance may also be present in a person with type 1 diabetes.

Diabetic angiopathy is a form of angiopathy associated with diabetic complications. While not exclusive, the two most common forms are diabetic retinopathy and diabetic nephropathy, whose pathophysiologies are largely identical. Other forms of diabetic angiopathy include diabetic neuropathy and diabetic cardiomyopathy.

<span class="mw-page-title-main">Epalrestat</span> Chemical compound

Epalrestat is a carboxylic acid derivative and a noncompetitive and reversible aldose reductase inhibitor used for the treatment of diabetic neuropathy, which is one of the most common long-term complications in patients with diabetes mellitus. It reduces the accumulation of intracellular sorbitol which is believed to be the cause of diabetic neuropathy, retinopathy and nephropathy It is well tolerated, with the most commonly reported adverse effects being gastrointestinal issues such as nausea and vomiting, as well as increases in certain liver enzymes. Chemically, epalrestat is unusual in that it is a drug that contains a rhodanine group. Aldose reductase is the key enzyme in the polyol pathway whose enhanced activity is the basis of diabetic neuropathy. Aldose reductase inhibitors (ARI) target this enzyme. Out of the many ARIs developed, ranirestat and fidarestat are in the trial stage. Others have been discarded due to unacceptable adverse effects or weak efficacy. Epalrestat is the only ARI commercially available. It is easily absorbed into the neural tissue and inhibits the enzyme with minimum side effects.

Sudomotor function refers to the autonomic nervous system control of sweat gland activity in response to various environmental and individual factors. Sweat production is a vital thermoregulatory mechanism used by the body to prevent heat-related illness as the evaporation of sweat is the body’s most effective method of heat reduction and the only cooling method available when the air temperature rises above skin temperature. In addition, sweat plays key roles in grip, microbial defense, and wound healing.

Pallesthesia, or vibratory sensation, is the ability to perceive vibration. This sensation, often conducted through skin and bone, is usually generated by mechanoreceptors such as Pacinian corpuscles, Merkel disk receptors, and tactile corpuscles. All of these receptors stimulate an action potential in afferent nerves found in various layers of the skin and body. The afferent neuron travels to the spinal column and then to the brain where the information is processed. Damage to the peripheral nervous system or central nervous system can result in a decline or loss of pallesthesia.

<span class="mw-page-title-main">Diabetic shoe</span> Shoes intended to reduce the risk of skin breakdown in diabetics

Diabetic shoes are specially designed shoes, or shoe inserts, intended to reduce the risk of skin breakdown in diabetics with existing foot disease and relieve pressure to prevent diabetic foot ulcers.

Complications of diabetes mellitus include problems that develop rapidly (acute) or over time (chronic) and may affect many organ systems. The complications of diabetes can dramatically impair quality of life and cause long-lasting disability. Overall, complications are far less common and less severe in people with well-controlled blood sugar levels. Some non-modifiable risk factors such as age at diabetes onset, type of diabetes, gender and genetics may influence risk. Other health problems compound the chronic complications of diabetes such as smoking, obesity, high blood pressure, elevated cholesterol levels, and lack of regular exercise. Complications of diabetes are a strong risk factor for severe COVID-19 illness.

<span class="mw-page-title-main">Diabetic foot</span> Medical condition

A diabetic foot is any pathology that results directly from peripheral artery disease (PAD) and/or sensory neuropathy affecting the feet in diabetes mellitus. Diabetic foot conditions can be acute or chronic complications of diabetes. Presence of several characteristic diabetic foot pathologies such as infection, diabetic foot ulcer and neuropathic osteoarthropathy is called diabetic foot syndrome. The resulting bone deformity is known as Charcot foot.

<span class="mw-page-title-main">Diabetic foot ulcer</span> Medical condition

Diabetic foot ulcer is a major complication of diabetes mellitus, and probably the major component of the diabetic foot.

Electrochemical skin conductance (ESC) is an objective, non-invasive and quantitative electrophysiological measure. It is based on reverse iontophoresis and (multiple) steady chronoamperometry.

<span class="mw-page-title-main">Diabetic foot infection</span> Medical condition

Diabetic foot infection is any infection of the foot in a diabetic person. The most frequent cause of hospitalization for diabetic patients is due to foot infections. Symptoms may include pus from a wound, redness, swelling, pain, warmth, tachycardia, or tachypnea. Complications can include infection of the bone, tissue death, amputation, or sepsis. They are common and occur equally frequently in males and females. Older people are more commonly affected.

Endocrine & Metabolism Research Institute (EMRI) is one of Tehran University of Medical Sciences research institute and a pioneering institute with a mission to combine clinical care, research, and education in diabetes, endocrine and metabolic diseases.

References

  1. 1 2 Mulhall, John P.; Jenkins, Lawrence C. (2017), Mulhall, John P.; Jenkins, Lawrence C. (eds.), "Biothesiometry", Atlas of Office Based Andrology Procedures, Cham: Springer International Publishing, pp. 9–14, doi:10.1007/978-3-319-42178-0_2, ISBN   978-3-319-42176-6 , retrieved 2022-02-27
  2. Davis, E. A.; Jones, T. W.; Walsh, P.; Byrne, G. C. (Sep 1997). "The use of biothesiometry to detect neuropathy in children and adolescents with IDDM". Diabetes Care. 20 (9): 1448–1453. doi:10.2337/diacare.20.9.1448. ISSN   0149-5992. PMID   9283795. S2CID   12199660.
  3. Hirschfeld, Gerrit; von Glischinski, Michael; Blankenburg, Markus; Zernikow, Boris (2014-05-01). "Screening for Peripheral Neuropathies in Children With Diabetes: A Systematic Review". Pediatrics. 133 (5): e1324–e1330. doi:10.1542/peds.2013-3645. ISSN   0031-4005. PMID   24709928. S2CID   1973886.
  4. Maiya, Arun G.; Parameshwar, Anche; Hande, Manjunath. "Relationship Between Glycated Hemoglobin and Vibration Perception Threshold in Diabetic Peripheral Neuropathy". The International Journal of Lower Extremity Wounds. 19 (2): 120–124. doi:10.1177/1534734619882173. ISSN   1552-6941. PMID   31838926.
  5. Riddhi, Dasgupta; Jebasingh, Felix; Thomas, Nihal; Kn, Maruthy; Sharma, Sanjay; Saravanan, Bharathi. "NEURO TOUCH: A novel digital device for assessment and screening of peripheral neuropathy". The Foot. 51: 101888. doi:10.1016/j.foot.2021.101888. ISSN   0958-2592.