Ria Arnold

University of Wollongong | UOW · Faculty of Science Medicine

Peripheral nerve disorders are caused by a range of different aetiologies. The range of causes include metabolic conditions such as diabetes, obesity and chronic kidney disease. Diabetic neuropathy may be associated with severe weakness and the loss of sensation, leading to gangrene and amputation in advanced cases. Recent studies have indicated a...

Diabetic peripheral neuropathy (DPN) affects over half of type 2 diabetes mellitus (T2DM) patients, with an urgent need for effective pharmacotherapies. While many rat and mouse models of T2DM exist, the phenotyping of DPN has been challenging with inconsistencies across laboratories. To better characterize DPN in rodents, a consensus guideline was...

Introduction/aims: Sonographic alterations of peripheral nerves in pre-dialytic kidney disease are yet to be determined. We aimed to assess peripheral nerve cross-sectional area (CSA) and intraneural blood flow in patients with pre-dialytic chronic kidney disease (CKD) and diabetic kidney disease (DKD). Methods: Subjects with CKD (n = 20) or DKD...

Adolescence is a dynamic developmental period where unhealthy solid foods and sugar-sweetened beverages are routinely consumed. Regular consumption of solid ‘junk’ foods rich in fat and refined carbohydrate and sugar-sweetened beverages are independently associated with an increased risk of metabolic disease and altered gut microbiome composition....

Background and objectives: Neuropathy is a common complication of kidney disease that lacks proven disease-modifying treatments. Hemodiafiltration improves clearance of uremic toxins and is associated with better nerve function than hemodialysis. We aimed to determine whether hemodiafiltration reduces the progression of neuropathy in people receivi...

Objective To assess the effect of exenatide (a GLP-1 receptor agonist), dipeptidyl peptidase-IV (DPP-IV) inhibitors, and sodium-glucose co-transporter 2 (SGLT-2) inhibitors on measures of peripheral nerve excitability in patients with type 2 diabetes Methods Patients receiving either exenatide (n = 32), a DPP-IV inhibitor (n = 31), or a SGLT-2 inh...

Background There is a strong association between the metabolic syndrome in diabetes and the development of peripheral neuropathy, however the pathophysiological mechanisms remain unknown. Methods Participants with type 2 diabetes and metabolic syndrome (T2DM/MetS, n = 89) and type 2 diabetes alone (T2DM, n = 59) underwent median nerve ultrasound a...

Background: Impaired physical function drives adverse outcomes in chronic kidney disease (CKD). Peripheral neuropathy is highly prevalent in CKD, though its contribution to physical function in CKD patients is unknown. This study examined the relationships between neuropathy, walking speed and quality of life (QoL) in CKD. Methods: This was a pr...

Peripheral neuropathy (PN) is a debilitating complication of diabetes that affects >50% of patients. Recent evidence suggests that obesity and metabolic disease, which often precede diabetes diagnosis, may influence PN onset and severity. We examined this in a translationally relevant model of prediabetes induced by a cafeteria (CAF) diet in Spragu...

Diabetic peripheral neuropathy is a major complication of diabetes with complex and incompletely understood pathophysiology. We utilised a cafeteria-style diet (Caf) and low dose streptozotocin (STZ) to model varying degrees of hyperglycemia. Adult male Sprague-Dawley rats were divided into four groups: control (chow diet), prediabetic (Caf diet fo...

Aim To examine the associations between of continuous overlapping net glycaemic action (CONGA), percentage time in hyperglycaemia (%HG) or normoglycaemia (%NG) and peripheral nerve structure and function in type 1 diabetes. Methods Twenty‐seven participants with type 1 diabetes underwent continuous glucose monitoring followed by corneal confocal m...

Aim: The present study was undertaken to investigate mechanisms of peripheral nerve dysfunction in latent autoimmune diabetes in adults (LADA). Materials and methods: Participants with LADA (n = 15) underwent median nerve ultrasonography and nerve excitability to examine axonal structure and function, in comparison to cohorts of type 1 diabetes...

A sandwich immunosensor was successfully developed for monitoring of interleukin-1β (IL-1β) in rat whole blood. The substrate stainless steel (SS) was first coated with a polydopamine layer and subsequently grafted with poly(ethylene glycol) methacrylate brushes, onto which a sandwich immunosensor was modified for detection of IL-1β. The device has...

Objective: Chronic kidney disease (CKD) caused by diabetes is known as diabetic kidney disease (DKD). The present study aimed to examine the underlying mechanisms of axonal dysfunction and features of neuropathy in DKD compared to CKD and type 2 diabetes (T2DM) alone. Methods: Patients with DKD (n = 30), CKD (n = 28) or T2DM (n = 40) and healthy...

Objective: To demonstrate construct validity of the Total Neuropathy Score (TNS) in assessing peripheral neuropathy in subjects with chronic kidney disease (CKD). Methods: 113 subjects with CKD and 40 matched controls were assessed for peripheral neuropathy using the TNS. An exploratory factor analysis was conducted and internal consistency of t...

Electrophysiology enables the objective assessment of peripheral nerve function in vivo. Traditional nerve conduction measures such as amplitude and latency detect chronic axon loss and demyelination, respectively. Axonal excitability techniques "by threshold tracking" expand upon these measures by providing information regarding the activity of io...

Abstract Background and objectives Neuromuscular complications are almost universal in CKD by the time that a patient commences dialysis. Recent studies have indicated that chronic hyperkalemia may contribute to the development of neuropathy in CKD. This study was undertaken to determine whether dietary restriction of potassium intake may be a neur...

Introduction: We quantified intraneural blood flow (INBF) in 18 patients with end-stage kidney disease (ESKD) and examined its relationship with nerve size, neuropathy severity and nerve excitability parameters. Methods: Sonographic measurements of the median nerve were performed at the same site before and after haemodialysis. INBF was quantifi...

Diabetes may impair the capacity for neuroplasticity such that patients experience a slower and poorer recovery after stroke. The current study aimed to investigate changes in cortical function in stroke patients with diabetes to determine how this comorbidity may impact post-stroke cortical plasticity and thereby functional recovery. From a cohort...

Patients with chronic kidney disease (CKD) are frequently afflicted with neurological complications. These complications can potentially affect both the central and peripheral nervous systems. Common neurological complications in CKD include stroke, cognitive dysfunction, encephalopathy, peripheral and autonomic neuropathies. These conditions have...

Objective: We explored the nerve ultrasound (US) characteristics of 15 patients with end-stage kidney disease (ESKD) and correlated these findings with clinical severity and electrophysiological parameters of neuropathy. Methods: 15 ESKD patients on thrice-weekly high-flux haemodialysis and 15 healthy controls were enrolled. Sonographic and elec...

Background: Nerve excitability testing by threshold-tracking is the only available method to study axonal ion channel function and membrane potential in the clinical setting. The measures are, however, indirect and the interpretation of neuropathic changes remains challenging. The same multiple measures of axonal excitability were adapted to furth...

Introduction: Glycemic variability (GV) may be a novel factor in the pathogenesis of diabetic complications. However, the effect of GV on peripheral nerve function has not been explored systematically. Methods: The relationship between GV and acute glucose levels on motor and sensory nerve function in 17 patients with type 1 diabetes mellitus (T...

Introduction Peripheral neuropathy is highly prevalent in chronic kidney disease (CKD), occurring in 90–100% of patients receiving dialysis. Previous neurophysiological studies using nerve excitability techniques have demonstrated changes in axonal function following a single session of dialysis. The present study was undertaken to examine whether...

Introduction: There is no specific treatment for neuropathy in chronic kidney disease (CKD). We compared nerve function across hemodialysis (HD) and peritoneal dialysis (PD). Methods: Subjects underwent neurological assessment and neurophysiological testing using nerve excitability studies. Pre-and post-dialysis studies were undertaken in HD (n=...

Objectives: Diabetic neuropathy is a debilitating complication of diabetes. Animal models of type 1 diabetes (T1DM) suggest that functional and structural changes, specifically axo-glial dysjunction, may contribute to neuropathy development. The present study sought to examine and characterise early sensory axonal function in T1DM patients in the...

Ion channel dysfunction has been identified as a contributor to symptom development and neurodegeneration in multiple sclerosis (MS). The molecular insights have been translated into new lines of research, with ion channel modulation now representing a therapeutic approach in MS. Studies of Na+ channel function have demonstrated pathological blocka...

Background Diabetic peripheral neuropathy is a common and debilitating complication of diabetes mellitus (DM). Although strict glycemic control may reduce the risk of developing diabetic peripheral neuropathy, the neurological benefits of different insulin regimens remain relatively unknown.Methods In the present study,55 consecutive patients with...

Neurological complications are highly prevalent in patients with CKD. These complications can potentially affect all levels of the nervous system from central nervous system disorders, such as encephalopathy and cognitive dysfunction, to peripheral disorders such as myopathy and autonomic and peripheral neuropathies. These conditions have significa...

Background Diabetic neuropathy is a common complication of diabetes. While strict glycaemic control through multiple daily insulin injections (MDII) or continuous subcutaneous insulin infusion (CSII) may reduce risk of neuropathy development, the potential differences in axonal function between CSII and MDII treated patients have not been evaluated...

Objective Neuropathy has been considered as a complication that is limited to patients with severe chronic kidney disease (CKD). The prevalence and impact of neuropathy in moderate severity CKD have not been systematically evaluated. As such, this study aimed to examine the effect of neuropathy on physical function, quality of life and nerve excita...

Potassium (K(+)) has been implicated as a factor in the development of uraemic neuropathy. This study was undertaken to investigate whether hyperkalaemia plays a causal role in axonal dysfunction in end-stage kidney disease (ESKD). Median motor nerve excitability studies were undertaken in four haemodialysis patients during a modified dialysis sess...

Neurotoxicity is a significant clinical side effect of immunosuppressive treatment used in prophylaxis for rejection in solid organ transplants. This study aimed to provide insights into the mechanisms underlying neurotoxicity in patients receiving immunosuppressive treatment following renal transplantation. Clinical and neurophysiological assessme...

The global burden imposed by metabolic diseases and associated complications continue to escalate. Neurological complications, most commonly peripheral neuropathy, represent a significant cause of morbidity and disability in patients with diabetes and chronic kidney disease. Furthermore, health care costs are substantially increased by the presence...

Peripheral neuropathy is the most common neurological complication in end-stage kidney disease. While high flux hemodialysis (HFHD) and hemodiafiltration (HDF) have become the preferred options for extracorporeal dialysis therapy, the effects of these treatments on nerve excitability have not yet been examined. An observational proof-of-concept stu...

OBJECTIVES Pharmacological agents for diabetic peripheral neuropathy (DN) target a number of mechanisms, including sodium-channel function and γ-aminobutyric acid-minergic processes. At present, prescription is undertaken on a trial-and-error basis, leading to prolonged medication trials and greater healthcare costs. Nerve-excitability techniques a...

Background: The present study was undertaken to determine whether there were changes evident in axonal membrane function prior to the onset of neuropathy in patients with type 1 and type 2 diabetes. Methods: From a cohort of 110 consecutive referrals, nerve excitability was investigated in 40 diabetic patients without clinical evidence of neurop...

Introduction and Aims: Recent studies have implicated potassium (K+) as a major factor in the development of uremic neuropathy, with strong correlations noted between nerve dysfunction and serum K+ concentration. The present study utilized a K+ clamp strategy to investigate whether hyperkalaemia plays a causal role in nerve dysfunction in end-stage...

To evaluate the development of diabetic neuropathy, the current study examined changes in peripheral axonal function. Nerve excitability techniques were undertaken in 108 type 2 diabetic patients with nerve conduction studies (NCS), HbA(1c) levels, and total neuropathy score (TNS). Patients were categorized into two cohorts: patients with diabetes...

This study aimed to examine: 1) Swaymeter concurrent validity in discriminating between young and older adult populations; 2) Swaymeter convergent validity against a forceplate system; and 3) the immediate test-retest repeatability of postural sway measures obtained from the Swaymeter. Twenty-nine older adults aged 71 to 83 years and 11 young adult...