SUDOSCAN applications

SUDOSCAN applications

Sudomotor dysfunction is a common finding, and one of the earliest detectable abnormalities in several peripheral and autonomic neuropathies. Small fiber neuropathies have been tested with SUDOSCAN in different diseases and compared to reference diagnosis tests:

• Neurology
• Diabetes
• Oncology
• Follow-up

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Picto-Neurology

NEUROLOGY

- AMYLOIDOSIS
- SJÖRGEN’S SYNDROME
- FABRY DISEASE
- PARKINSON’S DISEASE
- FIBROMYALGIA

DIABETES

- DIABETES COMPLICATIONS

Picto-Oncology

ONCOLOGY

- CHEMO INDUCED PERIPHERAL NEUROPATHY

Picto-Follow-up

FOLLOW-UP

- TREATMENT FOLLOW-UP
- LIFESTYLE IMPACT

Change over time in feet ESC values, sural amplitude and NIS (neuropathy impairment scale) score of tafamidis-treated patients, carriers and controls [1]

Schema-Sudoscan-Neurology

  SUDOSCAN IN NEUROLOGY

Amyloidosis disease example

ln the fatal hereditary amyloidosis related to transthyretin (hATTR amyloidosis), autonomic peripheral neuropathy is one of the earliest symptoms. ln a study by CASTRO et al. published in “Amyloid”, SUDOSCAN has been shown to be a compelling tool to assess the effect of tafamidis in Amyloidosis.
The usual neurological techniques are not as sensitive as SUDOSCAN to follow the effect of tafamidis treatment on small nerve fibers.

Mean Neuropathy lmpairment Score within the Lower Limbs (NIS-LL) in diabetes patients with normal vs abnormal feet Electrochemical Skin Conductance (ESC) [2]

Schema-Sudoscan-Diabetology

  SUDOSCAN IN DIABETES

Prevent and manage diabetes complications

Diabetes is shown to be the primary cause of small fiber neuropathy. The American Diabetes Association recommends including sudomotor function assessment of small fiber in the current panel of diagnostic tests for the detection of peripheral neuropathies. Early identification of these complications, which may be asymptomatic in up to 50% of diabetes patients, has the potential to reduce or delay their complications with timely preventative treatment.

SUDOSCAN has shown to be a sensitive tool to detect neuropathy in patients with Diabetes Mellitus.

SUDOSCAN scores correlates to TNSc extreme values [3] 

Schema-Sudoscan-Oncology

  SUDOSCAN IN ONCOLOGY

Chemotherapy induced Polyneuropathy

SUDOSCAN can easily be performed in the Oncology department, before and after treatment for an optimal follow-up of patients to detect Chemotherapy lnduced Polyneuropathy (CIPN). SUDOSCAN results are correlated to the Total Neuropathy Score (TNSc) clinical evaluation: reduced for TNSc > 6 population.

lmprovements of V02-max and ESC in individuals undergoing a 12 months lifestyle intervention program [4] 

Schema-Sudoscan-Fllow-up

  FOLLOW-UP WITH SUDOSCAN

Lifestyle interventions

Another key application of SUDOSCAN is patient management and longitudinal treatment follow-up. SUDOSCAN was used to evaluate the effect of physical activity on cardiovascular risk and metabolic diseases. ln patients with the highest level of weekly physical activity (as measured with a pedometer), improvement in sudomotor function – a surrogate measure of the regeneration of small nerve fibers – was the most significant change over 1 year.

New area development

SUDOSCAN is involved in the European project e-PREDICE (Early PRevention of Dlabetes Complications in people with hyperglycaemia in Europe). e-PREDICE aims at testing the long term efficacy of different therapeutic schemes for the early prevention of diabetic complications in people with hyperglycaemia currently under lifestyle intervention. This project involving 15 centers in Europe was developed in cooperation with Pr. Jaakko TUOMILEHTO.

References:

[1]  J. Castro et al. Electrochemical skin conductance in hereditary amyloidosis related to transthyretin V30M a promising tool to assess treatment efficacy?. Amyloid 2018, 25:4, 267 268.
[2]  C.M. Casellini et al (A.I. Vinik ). SUDOSCAN, a non invasive tool for detecting diabetic small fiber neuropathy and autonomic dysfunction. Diabetes technology and therapeutics. 2013;15(11).
[3]  M. Saad et al (D. Ricard). Quick, non invasive and quantitative assessment of small fiber neuropathy in patients receiving chemotherapy. Journal of Neuro Oncology. 2016;127(2):373 380.

[4]  A. Raisanen et al (J. Tuomilehto). Sudomotor Function as a Tool for Cardiorespiratory Fitness Level Evaluation: Comparison with Maximal Exercise Capacity. Int J Environ Res Public Health. 2014 May 30;11(6):5839 48.

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