4.7 Article

Rate-Dependent Depression: A Predictor of the Therapeutic Efficacy in Treating Painful Diabetic Peripheral Neuropathy

Journal

DIABETES
Volume 71, Issue 6, Pages 1272-1281

Publisher

AMER DIABETES ASSOC
DOI: 10.2337/db21-0960

Keywords

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Funding

  1. Shanghai Municipal Health Commission [ZHYY-ZXJHZX-1-201701]

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This study found that gabapentin treatment can restore rate-dependent depression in patients with painful diabetic peripheral neuropathy, and rate-dependent depression may be helpful in predicting the initial efficacy of gabapentin therapy.
We investigated the application of rate-dependent depression (RDD) of the Hoffmann (H) wave as a predictor of treatment efficacy in patients with painful diabetic peripheral neuropathy (DPN). General medical information, scales, and nerve conduction data were collected from 73 healthy subjects, 50 subjects with type 2 diabetes and painless DPN, and 71 subjects with type 2 diabetes and painful DPN. The left tibial nerve was stimulated, and RDD was calculated by the decline in amplitude of the third H wave relative to the first one. Gabapentin treatment was initiated after baseline evaluation, and the RDD and visual analog scale (VAS) score were both evaluated regularly during the 2-week study period. At baseline, the painful DPN group exhibited significant RDD impairment across all stimulation frequencies. Gabapentin treatment significantly reduced the VAS score and restored RDD during the 2-week observation period. RDD was found to be an independent factor of minimal VAS score improvement, such that the benefit increased by 1.27 times per 1% decrease in the RDD value. In conclusion, this study demonstrates that diabetes-induced loss of RDD can be modified by gabapentin and suggests that RDD may be valuable for predicting the initial efficacy of gabapentin therapy in patients with painful DPN.

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