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Motor unit loss and weakness in association with diabetic neuropathy in humans

Authors

  • Matti D. Allen MSc,

    Corresponding author
    • School of Kinesiology, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
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  • In Ho Choi BA,

    1. School of Kinesiology, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
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  • Kurt Kimpinski MD, PhD,

    1. Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
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  • Timothy J. Doherty MD, PhD,

    1. School of Kinesiology, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
    2. Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
    3. Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
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  • Charles L. Rice PhD

    1. School of Kinesiology, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
    2. Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
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  • This work was funded by the Natural Sciences and Engineering Research Council (NSERC) of Canada. M.D.A. was supported by the Ontario Graduate Scholarship (OGS) program. The authors have no conflicts of interest to disclose. Supported by the National Science and Engineering Research Council of Canada.

Correspondence to: M. Allen; e-mail: mallen9@uwo.ca

ABSTRACT

Introduction

Diabetes mellitus can be associated with peripheral neuropathy which may affect numbers of functioning motor units (MUs) of limb muscles. Direct quantitative assessment of MU numbers and muscle strength have not been performed in humans. We compared the estimated number of MUs of individuals with diabetic polyneuropathy (DPN) versus controls.

Methods

Patients with signs/symptoms of DPN were studied using decomposition-enhanced quantitative electromyography of the tibialis anterior (TA). Motor unit number estimates were derived from this analysis.

Results

Dorsiflexion strength was ∼60% less in DPN than controls (P < 0.05). Additionally, the estimated number of functioning TA MUs was ∼60% fewer in patients with DM (∼46) versus controls (∼111) (P < 0.05).

Conclusions

These data directly measure MU loss associated with DPN in a proximal muscle in humans. It remains to be determined whether quantifying MU loss has clinical utility in monitoring the progression or management of DPN. Muscle Nerve, 48: 298–300, 2013

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