Yıl: 2018 Cilt: 35 Sayı: 3 Sayfa Aralığı: 132 - 137 Metin Dili: İngilizce DOI: 10.5152/NSN.2018.11095 İndeks Tarihi: 16-05-2019

Nerve excitability in iron deficiency anemia: a prospective study

Öz:
Objective: The aim of this study was to evaluate the effects of iron deficiency anemia (IDA) on peripheral nervous system vianerve excitability tests (threshold tracking).Methods: The study was performed on 32 patients (22 patients (69%) with moderate, and 10 patients (31%) with severe IDA.Parenteral iron treatment was administered based on the calculated iron deficiency. Three nerve excitability tests were performed; Test 1: During the pre-treatment period, Test 2: On the 7th day of the post-treatment period, and Test 3: Three monthsafter the correction of anemia. The strength-duration/time constant (tSD), rheobase and supernormality values of motor andsensory axons of the median nerve were recorded.Results: A statistically significant stepwise increase in the supernormality periods of the sensory axons of the median nervewas detected between the tests conducted in three separate times (p<0.01). This increase significantly correlated with hemoglobin levels but not with iron levels. However, there was no significant difference in tSD and rheobase values between the testson both motor and sensory axons. A significant correlation observed between the increase of sensorial supernormality andhemoglobin levels.Conclusion: The significant increase of supernormality in sensory axons of the peripheral nerves may suggest that chronicischemia occurring in IDA may have some impacts on fast acting K channels. The causes of the decrease in supernormality ofsensory axons can make contribution to the pathogenesis of the patients’ complaints, such as abnormal sensation and dysesthesia in their extremities.
Anahtar Kelime:

Konular: Nörolojik Bilimler
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • Andrews NC. Iron Deficiency and Related Disorders. Greer JP, Foerster J, Lukens JN, Rodgers GM, Paraskevas F, Glader B (editors): Wintrobe’s Clinical Hematology 11th ed. Philadelphia Lippincott Williams & Wilkins, 2004: 979-1009.
  • Mehta BC, Thatte S. Mental alertness improves with iron therapy in iron deficiency anemia before hemoglobin rise. Indian J Hematol 1989; 7: 7-9.
  • Mann SK, Kaur S, Bains K. Iron and energy supplementation improves physical work capacity of female college students. Food Nutr Bull 2002; 23: 57-64. [CrossRef]
  • Ghosh K. Non haematological effects of iron deficiency - A perspective. Indian J Med Sci 2006; 60: 30-37. [CrossRef]
  • Beard JL. Iron biology in immune function, muscle metabolism and neuronal functioning. J Nutr 2001; 131: 568-580. [CrossRef]
  • Prasad AN, Prasad C. Iron deficiency; non- hematological manifestations. Prog Food Nutr Sci 1991; 15: 255–283.
  • Earley CJ, Connor JR, Beard JL, Malecki EA, Epstein DK, Allen RP. Abnormalities in CSF concentrations of ferritin and transferrin in restless legs syndrome. Neurology 2000; 54: 1698-700. [CrossRef ]
  • Toy P, Feiner J, Viele MK, Watson J, Yeap H, Weiskopf RB. Fatigue during acute isovolemic anaemia in healthy, resting humans. Transfusion 2000; 40; 457- 460. [CrossRef]
  • Agarwal S, Akhtar N, Babbar R. Spinal motoneuron excitability in iron deficiency anaemia. Indian J Physiol Pharmacol 2005; 49: 193-198.
  • Akyol A, Kiylioglu N, Kadikoylu G, Bolaman AZ, Ozgel N. Iron deficiency anemia and restless legs syndrome: is there an electrophysiological abnormality? Clin Neurol Neurosurg 2003; 106: 23-27. [CrossRef]
  • Nodera H, Kaji R. Nerve excitability testing and its clinical application to neuromuscular diseases. Clin Neurophysiol 2006; 117: 1902-1916. [CrossRef]
  • Kaji R, Nodera H. Puffer fish poisoning, Guillain-Barre syndrome and persistent sodium channels. Ann Neurol 2005; 57: 309. [CrossRef]
  • Burke D, Kiernan MC, Bostock H. Exitability of human axons. Clin Neurophysiol 2001; 112: 1575-1585. [CrossRef]
  • Bostock H, Cikurel K, Burke D. Threshold tracking tecniques in the study of human peripheral nevre. Muscle Nevre 1998; 21: 137-158. [CrossRef]
  • Kiernan MC, Burke D, Andersen KV, Bostock H. Multiple measures of axonal excitability: a new approach in clinical testing. Muscle Nerve 2000; 23: 399-409. [CrossRef]
  • Mogyoros I, Kiernan MC, Burke D. Strength-duration properties of human peripheral nerve. Brain 1996; 119: 439-447. [CrossRef]
  • Kuwabara S, Cappelen-Smith C, Lin CS-Y, Mogyoros I, Bostock H, Burke D. Excitability properties of median and peroneal motor axons. Muscle Nerve 2000; 23: 1365-1373. [CrossRef]
  • Bostock H, Baker M, Grafe P, Reid G. Changes in excitability and accommodation of human motor axons following brief periods of ischaemia. J Physiol 1991; 441: 513-535. [CrossRef]
  • Baker M, Bostock H. Depolarization changes the mechanism of accommodation in rat and human motor axons. J Physiol. 1989; 411: 545-561. [CrossRef]
  • Yerdelen D, Koc F, Uysal H. Strength-duration properties of sensory and motor axons in alcoholic polyneuropathy. Neurol Res 2008; 30: 746-750. [CrossRef]
  • Vucic S, Kiernan MC. Abnormalities in cortical and peripheral excitability in flail arm variant amyotrophic lateral sclerosis. J Neurol Neurosurg Psychiatry 2007; 78: 849-582. [CrossRef]
  • Krishnan AV, Phoon RK, Pussell BA, Charlesworth JA, Bostock H, Kiernan MC. Neuropathy, axonal Na+/K+ pump function and activity-dependent excitability changes in end-stage kidney disease. Clin Neurophysiol 2006; 117: 992-999. [CrossRef]
  • Misawa S, Kuwabara S, Ogawara K, Kitano Y, Hattori T. Strength-duration properties and glycemic control in human diabetic motor nerves. Clin Neurophysiol 2005; 116: 254-258. [CrossRef]
  • Mogyoros I, Kiernan MC, Burke D. Strength–duration properties of sensory and motor axons in amyotrophic lateral sclerosis. Brain 1998; 121: 851–859. [CrossRef]
  • Mogyoros I, Kiernan MC, Burke D. Strength-duration properties of sensory and motor axons in carpal tunnel syndrome. Muscle Nerve 1997; 20: 508–510. [CrossRef]
  • Panizza M, Nilsson J, Roth BJ, Grill SE, Demirci M, Hallett M. Differences between the time constant of sensory and motor peripheral nerve fibers: further studies and considerations. Muscle Nerve 1998; 21: 48-54. [CrossRef]
  • Kane RC. Intravenous iron replacement with sodium ferric gluconate complex in sucrose for iron deficiency anemia in adults. Curr Ther Res Clin Exp 2003; 64: 263-268. [CrossRef]
  • Kiernan MC, Mogyoros I, Burke D. Differences in the recovery of excitability in sensory and motor axons of human median nerve. Brain 1996; 119: 1099-1105. [CrossRef]
  • Weigl P, Bostock H, Franz P, Martius P, Miiller W, Grafe P. Threshold tracking provides a rapid indication of ischaemic resistance in motor axons of diabetic subjects. Electroencephalogr Clin Neurophysiol 1989; 73: 369-371. [CrossRef]
  • Grosskreutz J, Lin C, Mogyoros I, Burke D. Changes in excitability indices of cutaneous afferents produced by ischaemia in human subjects. J Physiol 1999; 518: 301-314. [CrossRef]
  • Mogyoros I, Kiernan MC, Burke D, et al. Excitability changes in human sensory and motor axons during hyperventilation and ischaemia. Brain 1997; 120: 317-325. [CrossRef]
  • Weiss G. Sur la possibilite de rendre comparables entre eux les appareils servant a l’excitation electrique. Arch Ital Biol 1901; 35: 413-46.
  • Leis AA, Stokie DS, Sheperd JM. Depression of spinal spinal motoneurons may underlie weakness associated with severe anemia. Muscle Nerve 2003; 27: 108-112. [CrossRef]
  • Bostock H, Rothwell JC. Latent addition in motor and sensory fibres of human peripheral nerve. J Physiol 1997; 498: 277-94. [CrossRef]
  • de Schutter E, Bower JM. An active membrane model of the cerebellar Purkinje cell. I. Simulation of current clamps in slice. J Neurophysiol 1994; 71: 375-400. [CrossRef]
  • Alzheimer C, Schwindt P, Crill WE. Modal gating of Na1 channels as a mechanism of persistent Na1 current in pyramidal neurons from rat and cat sensorimotor cortex. J Neurosci 1993; 13: 660- 673. [CrossRef]
  • Hille B. Charges and potentials at the nerve surface: divalent ions and pH. J Gen Physiol 1968; 51: 221-236. [CrossRef]
  • Brown EB. Physiological effects of hyperventilation. Physiol Rev 1953; 33: 445-471. [CrossRef]
  • Baker M, Bostock H. Depolarization changes the mechanism of accommodation in rat and human motor axons. J Physiol 1989; 411: 545-561. [CrossRef]
  • Baker M, Bostock H, Grafe P, Martius P. Function and distribution of three types of rectifying channel in rat spinal root myelinated axons. J Physiol 1987; 383: 45-67. [CrossRef]
  • Lin CS, Grosskreutz J, Burke D. Sodium channel function and the excitability of human cutaneous afferents during ischaemia. J Physiol 2002; 538: 435-446. [CrossRef]
APA TAHTACI M, YILDIZ N, OKUTAN H, YILDIZ S (2018). Nerve excitability in iron deficiency anemia: a prospective study. , 132 - 137. 10.5152/NSN.2018.11095
Chicago TAHTACI Mustafa,YILDIZ Nebil,OKUTAN Harika,YILDIZ Serpil Kuyucu Nerve excitability in iron deficiency anemia: a prospective study. (2018): 132 - 137. 10.5152/NSN.2018.11095
MLA TAHTACI Mustafa,YILDIZ Nebil,OKUTAN Harika,YILDIZ Serpil Kuyucu Nerve excitability in iron deficiency anemia: a prospective study. , 2018, ss.132 - 137. 10.5152/NSN.2018.11095
AMA TAHTACI M,YILDIZ N,OKUTAN H,YILDIZ S Nerve excitability in iron deficiency anemia: a prospective study. . 2018; 132 - 137. 10.5152/NSN.2018.11095
Vancouver TAHTACI M,YILDIZ N,OKUTAN H,YILDIZ S Nerve excitability in iron deficiency anemia: a prospective study. . 2018; 132 - 137. 10.5152/NSN.2018.11095
IEEE TAHTACI M,YILDIZ N,OKUTAN H,YILDIZ S "Nerve excitability in iron deficiency anemia: a prospective study." , ss.132 - 137, 2018. 10.5152/NSN.2018.11095
ISNAD TAHTACI, Mustafa vd. "Nerve excitability in iron deficiency anemia: a prospective study". (2018), 132-137. https://doi.org/10.5152/NSN.2018.11095
APA TAHTACI M, YILDIZ N, OKUTAN H, YILDIZ S (2018). Nerve excitability in iron deficiency anemia: a prospective study. Neurological sciences and neurophysiology (Online), 35(3), 132 - 137. 10.5152/NSN.2018.11095
Chicago TAHTACI Mustafa,YILDIZ Nebil,OKUTAN Harika,YILDIZ Serpil Kuyucu Nerve excitability in iron deficiency anemia: a prospective study. Neurological sciences and neurophysiology (Online) 35, no.3 (2018): 132 - 137. 10.5152/NSN.2018.11095
MLA TAHTACI Mustafa,YILDIZ Nebil,OKUTAN Harika,YILDIZ Serpil Kuyucu Nerve excitability in iron deficiency anemia: a prospective study. Neurological sciences and neurophysiology (Online), vol.35, no.3, 2018, ss.132 - 137. 10.5152/NSN.2018.11095
AMA TAHTACI M,YILDIZ N,OKUTAN H,YILDIZ S Nerve excitability in iron deficiency anemia: a prospective study. Neurological sciences and neurophysiology (Online). 2018; 35(3): 132 - 137. 10.5152/NSN.2018.11095
Vancouver TAHTACI M,YILDIZ N,OKUTAN H,YILDIZ S Nerve excitability in iron deficiency anemia: a prospective study. Neurological sciences and neurophysiology (Online). 2018; 35(3): 132 - 137. 10.5152/NSN.2018.11095
IEEE TAHTACI M,YILDIZ N,OKUTAN H,YILDIZ S "Nerve excitability in iron deficiency anemia: a prospective study." Neurological sciences and neurophysiology (Online), 35, ss.132 - 137, 2018. 10.5152/NSN.2018.11095
ISNAD TAHTACI, Mustafa vd. "Nerve excitability in iron deficiency anemia: a prospective study". Neurological sciences and neurophysiology (Online) 35/3 (2018), 132-137. https://doi.org/10.5152/NSN.2018.11095