​Hand-held instrument diagnoses nerve damage earlier and more securely

Lara Diagnostics has developed a portable instrument that makes it easier to discover and follow peripheral nerve damage, something that is particularly common among diabetic patients. One particular advantage is that the equipment can detect gradual nerve deterioration before obvious damage occurs. This allows preventive measures to be taken. Lara Diagnostics is one of the companies granted funding in the BIO-X call ‘New diagnostic solutions for disease monitoring’.

“What we can achieve with our instrument is new in three ways”, explains Louise Warme, physician and president of LARA Diagnostics. Firstly, it provides graded information about how the nerve fibres are functioning. This enables us to detect damage earlier and monitor developments over time. Secondly, it measures the condition of two types of nerve fibre – both the coarse and the fine, the latter of which is often subject to early damage. Furthermore, it is an e-health compatible solution, which lets it dock into other similar solutions as well as journal systems.

Peripheral nerve injuries are a major source of human suffering, particularly among people with diabetes where almost half of the individuals are affected. The condition manifests itself primarily as loss of sensation or numbness and tingling in the hands and feet. These problems contribute to complications such as intractable (difficult to heal) wounds, infections and, at worst, widespread tissue death that requires amputation. Today, nerve function is normally measured with a tuning fork. This in itself is a robust method, but it suffers the great disadvantage that it can only detect nerve damage when far advanced, and that it is difficult to track the progress of the damage in a comparative manner. In addition, it only measures coarse fibres.

The idea for the LARA instrument was born during a so-called Clinical Innovations Fellowship project carried out as a collaboration between the Royal Institute of Technology Stockholm, the Karolinska Institute and Stockholm County Council in 2013.

“We who participated were divided into multidisciplinary teams and assigned a clinic, which in our case was Radiumhemmet”, continues Louise Warme. “Our challenge was that many cancer patients undergoing chemotherapy experience problems with sensations such as touch”.

The group took on the task by converting the expensive and inaccessible QST technology (Quantitative Sensory Testing) to a portable concept. This method is similar in many ways to a hearing test, but it is the sensations that patients feel rather than their ability to hear that are reported.

LARA Diagnostics has received much attention for its project. Among other things, the company won the Inission Innovation Award 2014.

“Right now, we are testing the instrument in practice and are continuing its development”, says Louise, who estimates that a first product can be on the market within two years. “The BIO-X coaches have been extremely helpful and given us good feedback. A large workshop held at the end of the coaching was especially appreciated. Overall, the Uppsala BIO staff are both pleasant to work with and dedicated to their jobs – they represent a high level of expertise all gathered in one place”.

High blood sugar levels harm sensory nerves

The nerve fibres (axons) mentioned above are long outgrowths from so-called sensory nerve cells (neurons). Their job is to convey information from sensory receptors – for touch, heat or pain, for example – to the central nervous system (brain and spinal cord). In the long term, high, uncontrolled blood sugar concentrations, which are often found in diabetes, are very harmful to those nerve fibres, especially in the hands and feet. Up to two-thirds of those who suffer from diabetes have developed some form of injury to their nerves, generally referred to as neuropathy.