Methods of Early Detection and Grading Of Diabetic Peripheral Neuropathy (MEDON)

NCT ID: NCT04078516

Last Updated: 2021-11-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

80 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-08-12

Study Completion Date

2021-08-31

Brief Summary

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MEDON aims to examine new methods for early detection and grading of diabetic peripheral neuropathy focusing on both small- and large nerve fibers. Furthermore, MEDON aims to describe differences between people with classic diabetic peripheral neuropathy and those with painful diabetic neuropathy.

Detailed Description

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Conditions

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Neuropathy, Diabetic Neuropathy, Painful

Keywords

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diabetes neuropathy early detection small nerve fibers

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Type 1 diabetes and painful neuropathy

No interventions. A series of observationel/expirimental methods for detecting and grading neuropathy will be applied.

Perception Threshold Tracking (PTT)

Intervention Type DIAGNOSTIC_TEST

low-current electrical stimulation of both large- and small nerve fibers.

Axon-flair mediated respons

Intervention Type DIAGNOSTIC_TEST

Laser-doppler examination of small blood vessels in the peripheral skin.

Heart rate variability

Intervention Type DIAGNOSTIC_TEST

4 measurements of heart rate.

Quantitative Sensory Testing (QST)

Intervention Type DIAGNOSTIC_TEST

Seven tests measuring 13 parameters including heat- and cold-detection and pain thresholds, mechanical pain treshold, mechanical detection threshold, pressure pain treshold and vibration threshold.

Peripheral blood pressure and transcutaneous oxygen tension

Intervention Type DIAGNOSTIC_TEST

Ankle/brachial index, toe/brachial index, TcpO2.

Magnetic Resonance Imaging (MRI)

Intervention Type DIAGNOSTIC_TEST

MRI-scans of peripheral nerves and the central nervous system. Blood oxygen level dependent (BOLD) MRI.

Questionnaires

Intervention Type DIAGNOSTIC_TEST

Questionnaires for detecting painful neuropathy

Corneal Confocal Microscopy /CCM)

Intervention Type DIAGNOSTIC_TEST

Confocal microscopy of the cornea measuring NBD, NFD, NFL

Type 1 diabetes and non-painful neuropathy

No interventions. A series of observationel/expirimental methods for detecting and grading neuropathy will be applied.

Perception Threshold Tracking (PTT)

Intervention Type DIAGNOSTIC_TEST

low-current electrical stimulation of both large- and small nerve fibers.

Axon-flair mediated respons

Intervention Type DIAGNOSTIC_TEST

Laser-doppler examination of small blood vessels in the peripheral skin.

Heart rate variability

Intervention Type DIAGNOSTIC_TEST

4 measurements of heart rate.

Quantitative Sensory Testing (QST)

Intervention Type DIAGNOSTIC_TEST

Seven tests measuring 13 parameters including heat- and cold-detection and pain thresholds, mechanical pain treshold, mechanical detection threshold, pressure pain treshold and vibration threshold.

Peripheral blood pressure and transcutaneous oxygen tension

Intervention Type DIAGNOSTIC_TEST

Ankle/brachial index, toe/brachial index, TcpO2.

Magnetic Resonance Imaging (MRI)

Intervention Type DIAGNOSTIC_TEST

MRI-scans of peripheral nerves and the central nervous system. Blood oxygen level dependent (BOLD) MRI.

Questionnaires

Intervention Type DIAGNOSTIC_TEST

Questionnaires for detecting painful neuropathy

Corneal Confocal Microscopy /CCM)

Intervention Type DIAGNOSTIC_TEST

Confocal microscopy of the cornea measuring NBD, NFD, NFL

Type 1 diabetes and no neuropathy

No interventions. A series of observationel/expirimental methods for detecting and grading neuropathy will be applied.

Perception Threshold Tracking (PTT)

Intervention Type DIAGNOSTIC_TEST

low-current electrical stimulation of both large- and small nerve fibers.

Axon-flair mediated respons

Intervention Type DIAGNOSTIC_TEST

Laser-doppler examination of small blood vessels in the peripheral skin.

Heart rate variability

Intervention Type DIAGNOSTIC_TEST

4 measurements of heart rate.

Quantitative Sensory Testing (QST)

Intervention Type DIAGNOSTIC_TEST

Seven tests measuring 13 parameters including heat- and cold-detection and pain thresholds, mechanical pain treshold, mechanical detection threshold, pressure pain treshold and vibration threshold.

Peripheral blood pressure and transcutaneous oxygen tension

Intervention Type DIAGNOSTIC_TEST

Ankle/brachial index, toe/brachial index, TcpO2.

Magnetic Resonance Imaging (MRI)

Intervention Type DIAGNOSTIC_TEST

MRI-scans of peripheral nerves and the central nervous system. Blood oxygen level dependent (BOLD) MRI.

Questionnaires

Intervention Type DIAGNOSTIC_TEST

Questionnaires for detecting painful neuropathy

Corneal Confocal Microscopy /CCM)

Intervention Type DIAGNOSTIC_TEST

Confocal microscopy of the cornea measuring NBD, NFD, NFL

Matched controls without diabetes

No interventions. A series of observationel/expirimental methods for detecting and grading neuropathy will be applied.

Perception Threshold Tracking (PTT)

Intervention Type DIAGNOSTIC_TEST

low-current electrical stimulation of both large- and small nerve fibers.

Axon-flair mediated respons

Intervention Type DIAGNOSTIC_TEST

Laser-doppler examination of small blood vessels in the peripheral skin.

Heart rate variability

Intervention Type DIAGNOSTIC_TEST

4 measurements of heart rate.

Quantitative Sensory Testing (QST)

Intervention Type DIAGNOSTIC_TEST

Seven tests measuring 13 parameters including heat- and cold-detection and pain thresholds, mechanical pain treshold, mechanical detection threshold, pressure pain treshold and vibration threshold.

Peripheral blood pressure and transcutaneous oxygen tension

Intervention Type DIAGNOSTIC_TEST

Ankle/brachial index, toe/brachial index, TcpO2.

Magnetic Resonance Imaging (MRI)

Intervention Type DIAGNOSTIC_TEST

MRI-scans of peripheral nerves and the central nervous system. Blood oxygen level dependent (BOLD) MRI.

Questionnaires

Intervention Type DIAGNOSTIC_TEST

Questionnaires for detecting painful neuropathy

Corneal Confocal Microscopy /CCM)

Intervention Type DIAGNOSTIC_TEST

Confocal microscopy of the cornea measuring NBD, NFD, NFL

Interventions

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Perception Threshold Tracking (PTT)

low-current electrical stimulation of both large- and small nerve fibers.

Intervention Type DIAGNOSTIC_TEST

Axon-flair mediated respons

Laser-doppler examination of small blood vessels in the peripheral skin.

Intervention Type DIAGNOSTIC_TEST

Heart rate variability

4 measurements of heart rate.

Intervention Type DIAGNOSTIC_TEST

Quantitative Sensory Testing (QST)

Seven tests measuring 13 parameters including heat- and cold-detection and pain thresholds, mechanical pain treshold, mechanical detection threshold, pressure pain treshold and vibration threshold.

Intervention Type DIAGNOSTIC_TEST

Peripheral blood pressure and transcutaneous oxygen tension

Ankle/brachial index, toe/brachial index, TcpO2.

Intervention Type DIAGNOSTIC_TEST

Magnetic Resonance Imaging (MRI)

MRI-scans of peripheral nerves and the central nervous system. Blood oxygen level dependent (BOLD) MRI.

Intervention Type DIAGNOSTIC_TEST

Questionnaires

Questionnaires for detecting painful neuropathy

Intervention Type DIAGNOSTIC_TEST

Corneal Confocal Microscopy /CCM)

Confocal microscopy of the cornea measuring NBD, NFD, NFL

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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Laser-doppler Vagus TM German Research Network on Neuropathic Pain (DFNS) standard protocol Perimed 6000 PainDETECT, Douleur Neuropathique 4

Eligibility Criteria

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Inclusion Criteria

1. Men and women minimum 18 years of age and maximum 75 years of age
2. Signed informed consent form
3. Diagnosed with diabetes type I (for group 1-3)
4. Diagnosed with DPN defined as a threshold above 25-volt biothesiometry or absent feeling on the big toe using 10g-monofilament. (for group 1-2)
5. Answered questionnaire: PainDETECT
6. Nothing abnormal on initial tests (group 4)
7. Accepted initial screening blood samples
8. MRI-compatible participant

Exclusion Criteria

* 1\. Current or previous alcohol- or drug abuse 2. Abnormal screening blood samples 3. Not being able to understand Danish written and/or verbally 4. Not being able to corporate to examination (e.g. not being able to speak, suffering from senile dementia etc.) 5. Previous chemotherapy or intake of experimental medicine 6. Active HSV- or VZV-infection or known HIV 7. Known severe skin disease 8. Known neural damage or disease in the neural system (e.g. MS, Guillain-Barre etc.) 9. Critical limb ischemia defined as in current clinical consensus 10. Allergy or intolerance to histamine or inability to make do without for one day 11. Pregnancy 12. Active cancer-disease
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Aalborg University

OTHER

Sponsor Role collaborator

Aalborg University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Niels Ejskjær

Professor of Endocrinology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Niels Ejskjær, Professor

Role: PRINCIPAL_INVESTIGATOR

Steno Diabtes Center North Denmark, Aalborg University Hospital

Locations

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Aalborg University Hospital

Aalborg, North Denmark, Denmark

Site Status

Countries

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Denmark

References

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Roikjer J, Croosu SS, Sejergaard BF, Hansen TM, Frokjaer JB, Sondergaard CB, Petropoulos IN, Malik RA, Nielsen E, Morch CD, Ejskjaer N. Diagnostic Accuracy of Perception Threshold Tracking in the Detection of Small Fiber Damage in Type 1 Diabetes. J Diabetes Sci Technol. 2024 Sep;18(5):1157-1164. doi: 10.1177/19322968231157431. Epub 2023 Feb 24.

Reference Type DERIVED
PMID: 36825610 (View on PubMed)

Roikjer J, Croosu SS, Frokjaer JB, Hansen TM, Arendt-Nielsen L, Ejskjaer N, Morch CD. Perception threshold tracking: validating a novel method for assessing function of large and small sensory nerve fibers in diabetic peripheral neuropathy with and without pain. Pain. 2023 Apr 1;164(4):886-894. doi: 10.1097/j.pain.0000000000002780. Epub 2022 Sep 19.

Reference Type DERIVED
PMID: 36130086 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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N-20190003

Identifier Type: -

Identifier Source: org_study_id