Electrically evoked nociceptive potentials for early detection of diabetic small‐fiber neuropathy

Background and purpose: This study investigated the utility of pain‐related evoked potentials (PREP’s) elicited by a nociceptive electrical stimulation of the skin (= electrically evoked nociceptive potentials) in early detection of diabetic small‐fiber neuropathy. Methods: We studied 36 ‘young’ (19–35 years) and 24 ‘older’ (36–65 years) healthy subjects as well as 35 patients (35–64 years) with diabetes and neuropathic symptoms and 22 patients (34–64 years) with diabetes without neuropathic symptoms. Only patients with normal standard nerve conduction testing were included. Results: In patients with neuropathic symptoms, we found a significant increase in PREP latencies and decrease of amplitudes elicited from both, upper and lower limbs. In non‐symptomatic diabetic patients, we observed PREP abnormalities from lower limbs only. Conclusions: These data suggest that the method of pain‐related evoked potentials elicited by a nociceptive electrical stimulation of the skin may contribute to the early detection of diabetic sensory neuropathy.