Measurement of Electrophysiology, Sexual Dysfunction, and Cognitive Impairment in Patients With Diabetes Referred for Neuropathy Symptoms: A Case-Control Study

Leila Simani, Muhanna Kazempour, Mahtab Ramezani, Faezeh Maghsudloo, Hasan Kazazi, Sahar Abedi, Zahra Fatehi, Fatemeh Ghorbani, Ehsan Karimialavijeh


Background: The association between diabetic neuropathy, cognitive impairment, and sexual dysfunction together in patients with diabetes mellites (DM) is not assessed in prior studies. This study aimed to investigate the association between all these microvascular complications of DM.

Methods: A cross-sectional study was conducted on 162 participants (110 diabetic patients and 52 non-diabetic subjects). Neuropathy was evaluated by neuropathy disability score (NDS) and neuropathy symptom score (NSS). Nerve conduction study (NCS), sural and radial sensory nerve action potential, sural/radial nerve amplitude ratio (SRAR), and tibial compound muscle action potential were measured. Participants underwent cognitive and sexual assessments by Montreal cognitive assessment (MoCA), Beck depression score, female sexual function index, and the male sexual function index questionnaires.

Results: Both groups showed a decline in cognitive functions; however, diabetic patients had a significantly lower score in MoCA compared to the non-diabetic group (mean ± standard deviation: 20.98 ± 5.07, 23.17 ± 4.47; P value < 0.001). No statistical difference was observed regarding sexual activity (P value = 0.12 and 0.39 for female and male sexual function index), and Beck score (mean ± standard deviation: 8.56 ± 6.47, 8.96 ± 4.74; P value = 0.451) between the two groups. The NCS parameters were notably different in both groups. There were no differences between NCS, NDS, and NSS findings and sexual function.

Conclusions: Our data suggest that NCS parameters, even SRAR, do not necessarily correlate with cognitive performance and sexual function. Sexual dysfunction was not correlated with diabetic neuropathy, but clinical findings of NDS and NSS showed a modestly negative correlation with cognitive function.

J Neurol Res. 2023;13(1):50-55


Diabetes mellitus; Neuropathy; Sexual dysfunction; Cognition; Nerve conduction study

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