Table 3.
Neuropathy detection based on review.
| Type Instrument | Author | Number | Methods examination |
|---|---|---|---|
| Vibration perception threshold or Biothesimeter | (18), (23), (25), (27), (14), (20), (22) | 7 articles | VPT is a vibration activated under controlled pressure, there is pressure monitoring and the elasticity of the vibration is electrically controlled in both directions with five indicator lights. VPT adopted this new technology biothesiometer to assess VPT trends in subjects without sensorimotor distal symmetric polyneuropathy and identify age-specific normality thresholds. The voltage is given starting from 0.5 volts. Patients are considered to have neuropathy if they do not feel a voltage of ≥ 25 mV |
| Michigan Neuropathy Screening Instrument | (33), (15), (20), (22), (24), (28) | 6 | Interview with questions on the questionnaire with 15 questions about sensory perception. The result if the patient neuropathy, will answer ≥ 7 questions. |
| Toronto clinical neuropathy score (TCNS) | (30), (13), (17), (4), (22), (24), (30) | 7 | TCNS is to know level severity with check symptoms and sensitivity in the patient’s feet. The tool use Questionnaire Toronto, reflex examination and sensory test score. Questionnaire consist 6 symptoms: Pain, Numbness, tingling, weakness, ataxia, upper limb symptom. Ask patient about present (score 1) or absence (score 0) of symptom. After that reflex examination to knee and ankle reflex result Absence: score 2, Reduce: score 1, Normal: score 0). Sensory Test Score include pinprick, temp, light touch, vibration, position. The result sensory Abnormal (score 1), Normal (score 0). Conclusion TCNS: No neuropathy 0-5 points, Mild neuropathy 6-8 points, Moderate neuropathy 9-11 points, Severe neuropathy 12+ points. |
| tripartite questionnaire. | (11) | 1 | This questionnaire is divided into 3 parts: the first part contains participant data, the second part contains the neuropathy examination procedures, and the third part contains questions regarding the examination of pain, sensitivity, and temperature sensation. |
| 128Hz tuning fork, reflex hammer, and pinprick | (19) | 1 | Inspection done on the instep, Inspect Vibration with 128 Hz tuning fork, sensation temperature cold with tuning fork, sensation puncture needle with monofilament test, Achilles tendon reflex with use patellar hammer. |
| Electrode diagnostic | (21) | 1 | The examination uses an electrode with a current of <25 mA with a distance between the electrode and the stimulus depending on the size of the foot of 8-10 cm. Nerve action potential (NAP) was considered absent if it was not recorded at >20 mA indicating neuropathy |
| shear wave elastography (SWE | (4) | 1 | Shear wave elastography (SWE) detects neuropathy by looking at images of the nerves in the tibial area which indicates neuropathy if the results show nerve stiffness in the tibial area |
| 10 g semmes-weinstein monofilament | (15), (20), (22), (23) | 4 | Push monofilament 10 gr thread on point- point specifically on the feet. Ask the patient to close his eyes, The nurse explains that they will check the feet in several places, say “yes” if the patient feels it or if the patient does not feel it. Hold the monofilament to the skin perpendicularly, bending it, and then holding it back perpendicularly for about 1.5 seconds. Examine the plantar toes 1, 3, 5, metatarsal heads of toes 1, 3, 5, medial and lateral arches, heel and dorsum of the foot |
| Artificial intelligence (AI) | (26) | 1 | Neuropathy examination with AI using the Heidelberg Retina Tomograph III using the Rostock Corneal Module (RCM) to view the cornea in diabetes patients |
| electrochemical skin conductance (ESC) | (28) | 1 | Electrochemical skin conductance (ESC) detects neuropathy using electrodes connected to a computer. Electrodes are attached to the feet and hands, and then connected to a computer. This tool measures the response of skin conductance to electric current given through an electrode and then connects the results to a computer |
| Rostock Cornea Module (HRT-RCM) and EyeGuidance module (EG) | (29) | 1 | The examination includes patient demographic data, subsequent examination using an ophthalmological slit lamp and ophthalmoscopy to determine retinopathy, then examination using the Heidelberg Retina Tomograph II equipped with the Rostock Cornea Module (HRT-RCM) and Eye Guidance (EG) to result corneal confocal microscopy (CCM) in quantifying nerve fiber abnormalities in diabetic neuropathy |
| SUDOSCAN | (15) | 1 | SUDOSCAN is a test that provides an accurate evaluation of sweat function. The test focuses on small nerve fibers within the peripheral nervous system innervating the sweat glands. The device consists of a computer and 4 electrodes on which patients place their hands and bare feet. In less than 3 minutes, SUDOSCAN offers a stimulation of the sweat glands that assess nerve C fibers. |
| Neuropathy Total Score (TNS) | (17) | 1 | In the TNS examination, there are 8 parts: sensory and motor symptoms, pricking sensation, vibration sensation, strength examination, deep tendon reflexes, sural sensory amplitude, and tibial motor amplitude. TNS assessment score 1-4 with a total score of 32. Examination results are categorized into 4: level 0: 0-1, level 1: 2-8, level 2: 9-16, level 3: 17-24, level 4: 25- 32. |
| Neuropathy Disability Score | (23) | 1 | NDS examination of small nerve fibers uses pricking sensation and temperature sensation. This examination is considered positive neuropathy if there is damage to one of the 2 examination points in the lower extremity |
| DPN Check | (23) | 1 | DPN-Check is used for automatic sural nerve conduction examination. examination results show neuropathy if the amplitude is 4 or the conduction velocity is 40m/s in 1 of the 2 lower extremities |
| Ipswich touch | (23) | 1 | Ipswich touch examination of the feet with pressure using the index finger on the 1st, 3rd, and 5th toes of the lower extremities. The results show neuropathy if you don’t feel two touches |