• Georgios Ponirakis, Maria N Odriozola, Samantha Odriozola, Ioannis N Petropoulos, Shazli Azmi, Maryam Ferdousi, Hassan Fadavi, Uazman Alam, Andrew Marshall, Maria Jeziorska, Anthony Miro, Ahmad Kheyami, Mitra Tavakoli, Ahmed Al-Ahmar, Maria B Odriozola, Ariel Odriozola, and Rayaz A Malik.
• 1 Research Division, Weill Cornell Medicine-Qatar , Qatar Foundation, Education City, Doha, Qatar .

BackgroundAccurate and economic detection of nerve damage in diabetes is key to more widespread diagnosis of patients with diabetic peripheral neuropathy (DPN) and painful diabetic neuropathy. This study examined the diagnostic performance of NerveCheck, an inexpensive ($500) quantitative sensory testing (QST) device.MethodsOne hundred forty-four subjects (74 with and 70 without diabetes) underwent assessment with NerveCheck, neuropathy disability score (NDS), nerve conduction studies (NCS), intraepidermal and corneal nerve fiber density (IENFD and CNFD), and McGill questionnaire for neuropathic pain.ResultsOf the 74 subjects with diabetes, 41 were diagnosed with DPN based on the NDS. The NerveCheck scores for vibration perception threshold (VPT), cold perception threshold (CPT), and warm perception threshold (WPT) were significantly lower (P ≤ 0.0001) in diabetic patients with DPN compared to patients without DPN. The diagnostic accuracy of VPT was high with reference to NCS (area under the curve [AUC]: 82%-84%) and moderate for IENFD, CNFD, and neuropathic pain (AUC: 60%-76%). The diagnostic accuracy of CPT and WPT was moderate with reference to NCS, IENFD, and CNFD (AUC: 69%-78%) and low for neuropathic pain (AUC: 63%-65%).ConclusionsNerveCheck is a low-cost QST device with good diagnostic utility for identifying sensory deficits, comparable to established tests of large and small fiber neuropathy and for the severity of neuropathic pain.

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