Sural sensory action potential identifies diabetic peripheral neuropathy responders to therapy

Muscle Nerve. 2005 Nov;32(5):619-25. doi: 10.1002/mus.20423.


Identifying patients with diabetic peripheral neuropathy (DPN) amenable to therapy is a challenge. To determine whether the amplitude of the sural sensory nerve action potential (sural SNAP) reflects the severity of DPN, an analysis was performed on 205 patients with DPN, identified by an abnormal vibration detection threshold (VDT), who were enrolled in a multinational clinical trial investigating ruboxistaurin (RBX) mesylate. Nerve conduction velocity and response amplitude and latency were measured and compared. VDT was significantly lower in those with preserved sural SNAPs (n = 128) than in those in whom they were absent (n = 77; 21.5 vs. 22.7 JND units, P = 0.002). Thus, preserved sural SNAP denoted less severe DPN. Logistic regression analyses evaluating baseline characteristics, HbA(1c), and baseline symptom scores identified only DPN duration as a factor that might contribute to the presence of sural SNAP (P = 0.004; OR = 0.896). For patients with abnormal VDT, preserved sural SNAP identifies a patient population with less severe DPN who may respond to therapeutic intervention in clinical trials.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Action Potentials*
  • Adult
  • Diabetic Neuropathies / diagnosis*
  • Diabetic Neuropathies / drug therapy
  • Diabetic Neuropathies / physiopathology*
  • Double-Blind Method
  • Enzyme Inhibitors / therapeutic use
  • Female
  • Humans
  • Indoles / therapeutic use
  • Logistic Models
  • Male
  • Maleimides / therapeutic use
  • Middle Aged
  • Neural Conduction
  • Predictive Value of Tests
  • Sensory Thresholds*
  • Severity of Illness Index
  • Sural Nerve / physiopathology*
  • Vibration*


  • Enzyme Inhibitors
  • Indoles
  • Maleimides
  • ruboxistaurin