TORONTO CLINICAL NEUROPATHY SCORE AND MODIFIED TORONTO CLINICAL NEUROPATHY SCORE DIAGNOSTIC TESTS IN DISTAL DIABETIC SENSORIMOTOR POLYNEUROPATHY PATIENTS

Background: Distal diabetic sensorimotor polyneuropathy is a common complication occurred in diabetes mellituspatients. Even though the number of diabetes mellitus patients has been increasing, the prevalence is still far from its actual numbers due to diagnostic and method criteria. Objectives:We aimed to determine Toronto Clinical Neuropathy (TCN) and modified Toronto clinical neuropathy (mTCN) scores in distal diabetic sensorimotor polyneuropathy patients. Methods: Cross-sectional study was carried out from October 29th, 2014-June 1st, 2015 in 77 diabetes mellitus patients who visited Outpatient Clinic. Polyneuropathy diagnosis was based on TCN and mTCN scores, with gold standard of peroneal and/or sural nerve conduction velocity examination. Results: Area under curvevalue of TCN score was 84.5% (95% CI: 74.7%-94.3%). TCN diagnostic score above 4 had sensitivity, specificity, and accuracy of 96%, 40%, 82%, respectively. On the other hand, TCN diagnostic score above 8 had sensitivity, specificity, accuracy of 72%, 80%, 74%, respectively. The AUC value of mTCN score was 81.9% (95% CI: 71.8%-92.1%). mTCN diagnostic score above 8 had sensitivity, specificity, accuracy of 63%, 75%, 66%, respectively. Conclusion: TNC score above 4 could be used as a screening test, while score above 8 could be used as a diagnostic test for distal DSP.