TY  - JOUR
AB  - BACKGROUND: Cardiovascular risk management is beneficial, but stringent glycemic control does not prevent the progression of distal sensorimotor polyneuropathy (DSPN). Persistent hyperglycemia-induced alterations and cardiovascular factors may contribute to diabetes-associated nerve damage. This study aimed to evaluate the correlation between skin auto-fluorescence (sAF), an indicator of dermal advanced glycation end-product (AGE) accumulations, cardiovascular risk, and changes in peripheral nerve integrity. METHODS: Sixty-two individuals with type 2 diabetes (T2D) (20 women and 42 men), including 29 diagnosed with DSPN (7 women and 22 men), and 10 healthy controls (HC) underwent diffusion tensor MR imaging of the sciatic nerve to assess fractional anisotropy (FA), an indicator of nerve structural integrity. sAF measurements were combined with clinical, serological, and electrophysiological evaluations. Arterial stiffness was assessed via pulse wave velocity (PWV). RESULTS: sAF (HC 2.1 ± 0.25 AU, nDSPN 2.3 ± 0.47, DSPN 2.6 ± 0.43; p = 0.005) was higher in individuals with DSPN compared to HC (p = 0.010) and individuals without DSPN (p = 0.035). Within the group of T2D FA correlated negatively with sAF (r = -0.49, p < 0.001), PWV (r = -0.40, p = 0.009) and high-sensitivity troponin T (hsTNT), a marker of microvascular damage (r = -0.39, p < 0.001). In DSPN, sAF correlated positively with hsTNT (r = 0.58, p = 0.005) and with PWV (r = 0.52, p = 0.007), the sciatic nerve's FA correlated negatively with PWV (r = -0.47, p = 0.010). CONCLUSIONS: This study is the first to show close correlations between reduced peripheral nerve integrity and both intradermal AGE deposition and arterial stiffness in individuals with T2D. These findings highlight a mechanistic link between glycation-related vascular injury and neuronal damage emphasizing the importance of cardiovascular risk management in preventing DSPN.
AU  - Mooshage, C.M.*
AU  - Tsilingiris, D.
AU  - Schimpfle, L.
AU  - Fleming, T.
AU  - Herzig, S.
AU  - Szendroedi, J.
AU  - Heiland, S.*
AU  - Bendszus, M.*
AU  - Kopf, S.
AU  - Kurz, F.*
AU  - Jende, J.*
AU  - Kender, Z.
C1  - 73232
C2  - 56966
CY  - Tiergartenstrasse 17, D-69121 Heidelberg, Germany
TI  - Intradermal advanced glycation end-products relate to reduced sciatic nerve structural integrity in type 2 diabetes.
JO  - Clin. Neuroradiol.
PB  - Springer Heidelberg
PY  - 2025
SN  - 1869-1439
ER  - 

TY  - JOUR
AB  - INTRODUCTION/AIMS: Diabetic small fiber neuropathy (SFN) is caused by damage to thinly myelinated A‑fibers (δ) and unmyelinated C‑fibers. This study aimed to assess associations between quantitative sensory testing (QST) and parameters of peripheral nerve perfusion obtained from dynamic contrast enhanced (DCE) magnetic resonance neurography (MRN) in type 2 diabetes patients with and without SFN. METHODS: A total of 18 patients with type 2 diabetes (T2D, 8 with SFN, 10 without SFN) and 10 healthy controls (HC) took part in this cross-sectional single-center study and underwent QST of the right leg and DCE-MRN of the right thigh with subsequent calculation of the sciatic nerve constant of capillary permeability (Ktrans), extravascular extracellular volume fraction (Ve), and plasma volume fraction (Vp). RESULTS: The Ktrans (HC 0.031 min-1 ± 0.009, T2D 0.043 min-1 ± 0.015; p = 0.033) and Ve (HC 1.2% ± 1.5, T2D: 4.1% ± 5.1; p = 0.027) were lower in T2D patients compared to controls. In T2D patients, compound z‑scores of thermal and mechanical detection correlated with Ktrans (r = 0.73; p = 0.001, and r = 0.57; p = 0.018, respectively) and Ve (r = 0.67; p = 0.002, and r = 0.69; p = 0.003, respectively). Compound z‑scores of thermal pain and Vp (r = -0.57; p = 0.015) correlated negatively. DISCUSSION: The findings suggest that parameters of peripheral nerve microcirculation are related to different symptoms in SFN: A reduced capillary permeability may result in a loss of function related to insufficient nutritional supply, whereas increased capillary permeability may be accompanied by painful symptoms related to a gain of function.
AU  - Mooshage, C.M.*
AU  - Schimpfle, L.
AU  - Kender, Z.
AU  - Tsilingiris, D.*
AU  - Aziz-Safaie, T.*
AU  - Hohmann, A.*
AU  - Szendroedi, J.*
AU  - Nawroth, P.*
AU  - Sturm, V.*
AU  - Heiland, S.*
AU  - Bendszus, M.*
AU  - Kopf, S.
AU  - Kurz, F.T.*
AU  - Jende, J.M.E.*
C1  - 68027
C2  - 54505
CY  - Tiergartenstrasse 17, D-69121 Heidelberg, Germany
SP  - 12
TI  - Association of Small Fiber Function with Microvascular Perfusion of Peripheral Nerves in Patients with Type 2 Diabetes : Study using Quantitative Sensory Testing and Magnetic Resonance Neurography.
JO  - Clin. Neuroradiol.
PB  - Springer Heidelberg
PY  - 2023
SN  - 1869-1439
ER  - 

TY  - JOUR
AB  - Purpose: Thrombus composition has been suggested to have a decisive impact on the outcome of patients treated by mechanical thrombectomy because of embolic stroke. The recent development of stent retrievers allows collection and, hence, histopathological analysis of fresh thrombus material. Against this background, the aim of this prospective study was to assess the impact of thrombus composition on mechanical recanalization, clinical outcome and stroke etiology. Methods: Thirty-four patients suffering from acute ischemic stroke due to occlusion of the distal internal carotid artery/carotid-T, anterior cerebral artery, or middle cerebral arteries were mechanically recanalized, and thrombus material was obtained. Histological thrombus composition was compared with imaging, clinical, and neurointerventional data. Results: The main findings were that a higher percentage of white blood cells (WBCs) in the thrombus was associated with (i) cardioembolic etiology, (ii) extended mechanical recanalization time, and (iii) less favorable recanalization (Thrombolysis in Cerebral Infarction score) and clinical outcome (National Institute of Health Stroke Scale). Conclusion: Our results suggest that thrombi with a high WBC fraction are related to more organized thrombi of cardioembolic origin associated with less favorable recanalization and clinical outcome in acute ischemic anterior circulation stroke. WBC-mediated immunological and coagulatory processes may play a key role in thrombus formation and pathogenesis of stroke warranting further investigation.
AU  - Boeckh-Behrens, T.*
AU  - Schubert, M.I.*
AU  - Forschler, A.*
AU  - Prothmann, S.*
AU  - Kreiser, K.*
AU  - Zimmer, C.*
AU  - Riegger, J.*
AU  - Bauer, J.*
AU  - Neff, F.
AU  - Kehl, V.*
AU  - Pelisek, J.*
AU  - Schirmer, L.*
AU  - Mehr, M.*
AU  - Poppert, H.*
C1  - 32662
C2  - 35217
CY  - Heidelberg
SP  - 189-197
TI  - The impact of histological clot composition in embolic stroke.
JO  - Clin. Neuroradiol.
VL  - 26
IS  - 2
PB  - Springer Heidelberg
PY  - 2016
SN  - 1869-1439
ER  -