QUANTITATIVE MEASUREMENT OF CUTANEOUS PERCEPTION IN DIABETIC NEUROPATHY

To determine the diagnostic value of various cutaneous sensory modalit ies in diabetic neuropathy, we studied cutaneous perception at the dom inant hallux of 113 subjects (32 normal healthy controls and 81 diabet ic subjects). The cutaneous sensory perception tests included warm and cold thermal perception, vibration, touch-pressure sensation, and cur rent perception testing (CPT). The sensitivity of each modality when s pecificity is held greater than 90% was as follows: warm = 78%, cold = 77%, vibration = 88%, tactile-pressure = 77%, 5-Hz CPT = 52%, 250-Hz CPT = 48%, and 2000-Hz CPT = 56%. Combination thermal and vibratory ga ve optimum sensitivity (92-95%) and specificity (77-86%). We conclude that vibratory and thermal testing should be the primary screening tes ts for diabetic peripheral neuropathy. Other modalities may be of use only in specific situations, (C) 1995 John Wiley & Sons, Inc.