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Revising two-point discrimination assessment in normal aging and in patients with polyneuropathies
  1. Sonja I. van Nes (s.vannes{at}erasmusmc.nl)
  1. Erasmus Medical Centre Rotterdam, Netherlands
    1. Catharina G. Faber (c.faber{at}neurologie.azm.nl)
    1. University hospital Maastricht, Netherlands
      1. Rinske M.T.P. Hamers (rmpt.hamers{at}student.unimaas.nl)
      1. University hospital Maastricht, Netherlands
        1. Oliver Harschnitz (o.harschnitz{at}student.unimaas.nl)
        1. University hospital Maastricht, Netherlands
          1. Mayienne Bakkers (m.bakkers{at}neurologie.azm.nl)
          1. University hospital Maastricht, Netherlands
            1. Mieke C.E. Hermans (mher{at}sneu.azm.nl)
            1. University hospital Maastricht, Netherlands
              1. Ron J. Meijer (rmeijer{at}spaarneziekenhuis.nl)
              1. Spaarne Hospital, Netherlands
                1. Pieter A. van Doorn (p.a.vandoorn{at}erasmusmc.nl)
                1. Erasmus Medical Centre Rotterdam, Netherlands
                  1. Ingemar S.J. Merkies (isjmerkies{at}planet.nl)
                  1. Spaarne Hospital, Netherlands

                    Abstract

                    Objectives: To revise the static and dynamic normative values for the two-point discrimination test and to examine its applicability and validity in patients with a polyneuropathy.

                    Methods: Two-point discrimination threshold values were assessed in 427 healthy controls and 99 patients mildly affected by a polyneuropathy. The controls were divided into seven age groups ranging from 20-29, 30-39,…, up to 80 years and older; each group consisted of at least 30 men and 30 women. Two-point discrimination examination took place under standardised conditions on the index finger. Correlation studies were performed between the obtained scores and the values derived from the Weinstein-Enhanced-Sensory-Test (WEST) and the arm-grade of the Overall Disability SumScore (ODSS) in the patients group (validity studies). Finally, the sensitivity to detect patients mildly affected by a polyneuropathy was evaluated for static and dynamic assessments.

                    Results: There was a significant age dependent increase of the two-point discrimination values. No significant gender difference was found. The dynamic threshold values were lower compared with the static scores. The obtained two-point discrimination values were significantly correlated with the arm-grade of the ODSS (static values: r=0.33, p=0.04; dynamic values: r=0.37, p=0.02) and the scores of the WEST in patients (static values: r=0.58, p=0.0001; dynamic values: r=0.55, p=0.0002). The sensitivity for the static and dynamic threshold values was 28% and 33%, respectively.

                    Conclusion: This study provides age-related normative two-point discrimination threshold values using a two-point discriminator (an aesthesiometer). This easily applicable instrument could be used as part of a more extensive neurological sensory evaluation.

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