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Lower extremity nerve function in patients with lower extremity ischemia.

Mary M McDermott¹, Robert Sufit, Takashi Nishida

¹Department of Medicine, Northwestern University Feinberg School of Medicine, 676 N St Clair, Suite 200, Chicago, IL 60611, USA. mdm608@northwestern.edu

Archives of Internal Medicine

|October 13, 2006

Summary

Lower extremity ischemia, measured by ankle-brachial index (ABI), impairs peroneal nerve function, especially in non-diabetic individuals. Screening for peripheral arterial disease (PAD) is recommended for unexplained peroneal nerve dysfunction.

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Published on: September 22, 2020

Area of Science:

Neurology
Vascular Medicine
Peripheral Nerve Disorders

Background:

Peripheral arterial disease (PAD) is a condition affecting blood flow in the legs.
The ankle-brachial index (ABI) is a key diagnostic measure for PAD.
The relationship between lower extremity ischemia and nerve function requires further investigation.

Purpose of the Study:

To determine if lower extremity ischemia, indicated by ABI, is linked to impaired nerve function.
To investigate this association in individuals with and without diabetes.

Main Methods:

A study involving 478 individuals with PAD and 292 without.
Peripheral arterial disease was defined by ABI values (<0.90).
Electrophysiologic tests measured peroneal, sural, and ulnar nerve function.

Main Results:

In non-diabetic participants, PAD was associated with poorer peroneal nerve conduction velocity, particularly in severe PAD.
In participants with diabetes, PAD correlated with reduced peroneal and ulnar nerve conduction velocity and sural nerve amplitude.
Adjusting for confounders revealed significant associations between severe PAD and impaired peroneal nerve conduction velocity in non-diabetics.

Conclusions:

Leg ischemia, a hallmark of PAD, demonstrably impairs peroneal nerve function.
The association between PAD and nerve dysfunction is less pronounced in diabetic patients due to diabetes's significant impact on nerves.
Clinicians should consider PAD screening for patients with idiopathic peroneal nerve issues.