Data from: Clinician-rated measures for distal symmetrical axonal polyneuropathy: ACTTION systematic review

Distal symmetrical axonal polyneuropathy (DSP) is due to injury to
peripheral sensory, motor, and autonomic nerve fibers, resulting in distal
predominant sensory loss, pain, and gait instability. DSP occurs as a
complication of multiple medical conditions including diabetes or HIV, or
following exposure to various toxins such as chemotherapy. It affects at
least 10% of the United States population. Few treatments for DSP are
approved by regulatory agencies. Reliable and responsive outcome measures
are integral to developing new DSP treatments. Multiple clinician-rated
measures that incorporate neuropathy signs exist, however, it is not clear
which of these measures performs best for various DSP phenotypes. This
systematic review summarizes the content of 18 published measures of DSP
identified using PubMed and from personal archives of the authors. The
relative percentage of scoring dedicated to motor, reflex, large and small
fiber sensory, and autonomic domains varied considerably among measures.
The most common neurological examination items included in the scales were
(1) vibration perception (n=18, 100%), (2) reflexes (n=16, 89%), (3)
pin-prick perception (n=14, 78%), (4) muscle strength (n=11, 61%), (5)
touch-pressure perception (n=9, 50%) and (6) joint-position perception
(n=8, 44%). This review can be used to inform decisions regarding which of
the available clinician-rated sign outcome measures would be most
appropriate for use in a particular DSP population, based on the domains
most affected by that neuropathy or on the domains most likely to be
affected by a particular experimental therapy.