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Updated: Mar 22, 2026
Three-dimensional Imaging of Nociceptive Intraepidermal Nerve Fibers in Human Skin Biopsies
Published on: April 29, 2013
Elevated pain threshold in patients with asymptomatic diabetic neuropathy: an intraepidermal electrical stimulation
Chieko Suzuki1, Tomoya Kon1, Yukihisa Funamizu1
1Department of Neurology, Aomori Prefectual Central Hospital, 2-1-1, Higashi-Tsukurimichi, Aomori, 030-8553, Japan.
Introduction:
The loss of epidermal nerve fibers is regarded as an early pathological change in human diabetes. We investigated epidermal Aδ nerve fiber function by examining pain threshold by means of intraepidermal electrical stimulation (IES) in early diabetic neuropathy.
Methods:
We recruited 20 asymptomatic diabetic patients. Eighteen age-matched, healthy subjects served as controls. We placed the IES electrode onto the skin of the foot dorsum and delivered weak electrical stimulation. We defined pain threshold as the minimum electrical intensity at which a subject felt a pricking sensation.
Results:
The mean pain thresholds in the patient group were significantly higher (0.053 ± 0.036 mA; P < 0.01) than in the control group (0.027 ± 0.006 mA).
Conclusion:
We confirmed that the pain threshold was elevated in early diabetic neuropathy. We conclude that the IES electrode is a useful tool to evaluate early diabetic polyneuropathy. Muscle Nerve 54: 146-149, 2016.
