Effect of glucose concentration on peripheral nerve and its response to anoxia


  • Disclosure: M.S. receives royalties for articles in UpToDate on status epilepticus and cardiac operations. He has been paid by ASET—the neurodiagnostic society—for an electronic course on intraoperative neurophysiologic monitoring and is also an invited lecturer for the American Society of Neurophysiologic Monitoring and ASET—the neurodiagnostic society—for which he receives compensation for travel and meeting expenses. M.S. is also on the board of the neurophysiology research and education consortium, which is a non-profit company that aims to establish databases for intraoperative neurophysiological monitoring, for which he is not compensated. He is also on the board of the non-profit American Board of Neurophysiologic Monitoring Programs, for which he is not compensated.


Introduction: Glucose has a significant effect on nerve function. Methods: The effects of glucose on the nerve action potential (NAP) were investigated for concentrations between 0 and 55.5 mmol/L in an in vitro system using rat sciatic nerve. The effects of glucose were investigated in nerves exposed to oxygenated perfusate and those subjected to anoxia. Multiple aspects of the NAP were analyzed. Results: Hypoglycemia produces immediate reductions in NAP amplitude and velocity, whereas hyperglycemia has the opposite effect in the short term. Over a 12-hour experiment, the amplitude of the NAP remained stable for glucose concentrations in the range 2.8–5.6 mmol/L, but, when the glucose concentration was <2.8 mmol/L or >27.8 mmol/L, the amplitude of the NAP declined. The deleterious effects of hyperglycemia (≥27.8 mmol/L) or hypoglycemia (<4.2 mmol/L) were more pronounced in nerves exposed to intermittent anoxia. Conclusions: This findings confirm the importance of glucose concentration for nerve function especially during anoxia. Muscle Nerve 49:370–377, 2014