Clinical effects of ischemic preconditioning in polyneuropathy of various origins

Introduction. Polyneuropathies are widespread among the population. Diabetes mellitus and industrial vibration are common causes of polyneuropathy, having common links of pathogenesis involving the autonomic nervous system. The therapeutic effects of ischemic preconditioning are realized by influencing pathogenetic mechanisms, and therefore their study in polyneuropathies of various genesis is of scientific interest.

The aim of the study was to investigate the remote clinical effects of ischemic preconditioning in polyneuropathies of various genesis.

Materials and methods. Twenty-five patients divided into 2 groups with lower extremity polyneuropathy of vibration and diabetic genesis were examined. 

A clinical and electroneuromyographic study of the peripheral nerves of the lower extremities was performed. An analysis of heart rate variability before and after the treatment with ischemic preconditioning of the upper extremities was executed.

Results. In both groups of the patients with polyneuropathy a decrease in clinical manifestations in the form of pain syndrome and sensitive disorders (numbness and paresthesia), an improvement in vibration sensitivity, an increase in impulse conduction velocity, mainly along the peripheral sensory nerve fibers were revealed. The analysis of heart rate variability after performing of ischemic preconditioning showed a gaining of the power of very low frequency oscillations, which indicated to an increase in the compensatory capabilities of autonomic regulation.

Limitations. The investigation was limited by studying the clinical and electrophysiological characteristics of the peripheral nervous system in 25 patients with diabetes mellitus type 2 and vibration disease caused by the exposure to local and whole-body vibration.

Conclusion. After the course of treatment of the pain syndrome, sensitive and autonomic disorders decrease with an increase in the compensatory possibilities of autonomic regulation, the functions of conducting along sensory nerves improve. Positive distant effects of ischemic preconditioning in the correction of manifestations of vibration and diabetic polyneuropathies indicate to a systemic effect on the mechanisms of autonomic regulation. The distance is manifested in the remoteness of the appearance of effects from the place of application of the technique.

Compliance with ethical standards. The study was performed by non-invasive methods and complies with the ethical standards of the Bioethical Committee of the Research Institute for Complex Problems of Hygiene and Occupational Diseases, elaborated in accordance with the Declaration of Helsinki by the World Medical Association “Ethical Principles for Conducting Scientific Research Involving Humans” as amended in 2013 and “Rules of Clinical Practice in the Russian Federation” approved by the Order of the Ministry of Health of the Russian Federation No. 266 dated June 19, 2003.

Contribution:
Yamshchikova A.V. — the concept and design of the study, collection and processing of material, collection of literature data, statistical processing, writing a text;
Fleishman A.N. — the concept and design of the study, editing;
Martynov I.D. — editing;
Bychkovskaya T.A. — collection and processing of material;
Kungurova A.A. — collection and processing of material;
Maklakova T.P. — collection and processing of material, editing. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Conflict of interest. The authors declare no conflict of interest.

Acknowledgement. The study had no sponsorship.

Received: February 8, 2023 / Accepted: March 24, 2023 / Published: May 29, 2023