Feasibility of contact heat evoked potentials for detection of diabetic neuropathy

The involvement of small myelinated fibers in the early stages of diabetic neuropathy (DN) has been suggested, but few objective methods can identify minimal neuropathy. The purpose of this study was to determine whether there are differences in contact heat evoked potential (CHEP) parameters between healthy adults and diabetics with and without lower limb symptoms.

CHEP was recorded at the midline channels. A peak stimulating temperature of 51°C was applied to the dorsum of the foot and at a point 10 cm proximal to the lateral malleolus.

There was a significant difference in N1-P1 amplitude in the three groups after stimulation of the dorsum of the foot (P = 0.028) and the point 10 cm proximal to the lateral malleolus (P = 0.006).

CHEP can help to detect early A-delta fiber damage in diabetic patients with minimal neuropathy.