For somatosensory assessment, we recorded pressure perception thresholds with graded monofilaments.
Areas of callus should always be avoided when testing for pressure perception.
We assessed cutaneous pressure perception using a 10-g Semmes-Weinstein monofilament at four validated plantar sites.
The pressure perception threshold was assessed using the 10-g monofilament Touch-test Sensory Evaluator 5.07 (North Coast Medical, U.S).
The technique for testing pressure perception with the 10-g monofilament is illustrated in Fig. 2; patients should close their eyes while being tested.
Diabetic neuropathy evaluation was based on symptoms, quantitative sensory testing (temperature, vibration, and pressure perception), and quantitative motor testing (patellar and ankle reflexes).
Touch and pressure perception was tested in the plantar region, in the sensory distribution of the posterior tibial nerve (1st., 3rd. and 5th. metatarsal and 1st., 3rd. and 5th. toes).
The right foot was assessed using the Neuropen (Owen Mumford, Oxford, U.K ., which contains a 10-g monofilament to assess pressure perception and a Neurotip (Owen Mumford) for pinprick sensation (13, 14).
The succession of steps leading to PIV involves pressure perception in nociceptive sensory small fibers neurons mediated by Asic3, resulting in release of the vasodilator calcitonin gene-related peptide (CGRP) from afferent sensory nerve endings.
In multiple linear stepwise regression analysis, when measures of large and small fiber neuropathy, autonomic neuropathy, blood measures, BMD, and bone stiffness were entered into the model, 74.5% of group membership was predicted by vibration perception, pressure perception, and sRAGE (r = 0.745, P < 0.001).
