Understanding diabetic neuropathy: from subclinical nerve lesions to severe nerve fiber deficits : a cross-sectional study in patients with type 2 diabetes and healthy control subjects
Studies on magnetic resonance neurography (MRN) in diabetic polyneuropathy (DPN) have found proximal sciatic nerve lesions. The aim of this study was to evaluate the functional relevance of sciatic nerve lesions in DPN, with the expectation of correlations with the impairment of large-fiber function...
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| Main Authors: | , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2020
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| In: |
Diabetes
Year: 2019, Volume: 69, Issue: 3, Pages: 436-447 |
| ISSN: | 1939-327X |
| DOI: | 10.2337/db19-0197 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.2337/db19-0197 Verlag, lizenzpflichtig, Volltext: https://diabetes.diabetesjournals.org/content/69/3/436 
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| Author Notes: | Jan B. Groener, Johann M. E. Jende, Felix T. Kurz, Zoltan Kender, Rolf-Detlef Treede, Sigrid Schuh-Hofer, Peter P. Nawroth, Martin Bendszus and Stefan Kopf |
| Summary: | Studies on magnetic resonance neurography (MRN) in diabetic polyneuropathy (DPN) have found proximal sciatic nerve lesions. The aim of this study was to evaluate the functional relevance of sciatic nerve lesions in DPN, with the expectation of correlations with the impairment of large-fiber function. Sixty-one patients with type 2 diabetes (48 with and 13 without DPN) and 12 control subjects were enrolled and underwent MRN, quantitative sensory testing, and electrophysiological examinations. There were differences in mechanical detection (Aβ fibers) and mechanical pain (Aδ fibers) but not in thermal pain and thermal detection clusters (C fibers) among the groups. Lesion load correlated with lower Aα-, Aβ-, and Aδ-fiber but not with C-fiber function in all participants. Patients with lower function showed a higher load of nerve lesions than patients with elevated function or no measurable deficit despite apparent DPN. Longer diabetes duration was associated with higher lesion load in patients with DPN, suggesting that nerve lesions in DPN may accumulate over time and become clinically relevant once a critical amount of nerve fascicles is affected. Moreover, MRN is an objective method for determining lower function mainly in medium and large fibers in DPN. |
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| Item Description: | Published online ahead of print December 11, 2019 Gesehen am 26.03.2020 |
| Physical Description: | Online Resource |
| ISSN: | 1939-327X |
| DOI: | 10.2337/db19-0197 |