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Mooshage, C.M.* ; Schimpfle, L. ; Kender, Z. ; Tsilingiris, D.* ; Aziz-Safaie, T.* ; Hohmann, A.* ; Szendroedi, J.* ; Nawroth, P.* ; Sturm, V.* ; Heiland, S.* ; Bendszus, M.* ; Kopf, S. ; Kurz, F.T.* ; Jende, J.M.E.*

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.

Clin. Neuroradiol., 12 (2023)
Verlagsversion DOI PMC
Open Access Gold (Paid Option)
Creative Commons Lizenzvertrag
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.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Korrespondenzautor
Schlagwörter Diabetic Neuropathy ; Dynamic Contrast Enhanced Imaging ; Microangiopathy ; Nerve Perfusion ; Small Fiber Neuropathy; German Research Network; Neuropathic Pain Dfns; Sural Nerve; Polyneuropathy; Parameters; Protocol
ISSN (print) / ISBN 1869-1439
e-ISSN 1869-1447
Zeitschrift Clinical Neuroradiology
Quellenangaben Band: , Heft: , Seiten: 12 Artikelnummer: , Supplement: ,
Verlag Springer
Verlagsort Berlin ; Heidelberg
Nichtpatentliteratur Publikationen
Begutachtungsstatus Peer reviewed
Institut(e) Institute of Diabetes and Cancer (IDC)
Förderungen Bayer
Guerbet
Codman
Dietmar Hopp Foundation
Novo Nordisk
Else Kroner-Fresenius-Stiftung (EKFS)
Helmholtz Association (Helmholtz International Research School for Diabetes)
Ministry of Science, Research and the Arts
DFG
Boehringer Ingelheim Pharma
Ministry of Science, Research and the Arts of the State of Baden-Wurttemberg
DZD
German Research Foundation (DFG)
German Center of Diabetes Research (DZD)
Edith-Haberland-Wagner (EHW) Foundation

Else Kroner-Fresenius Stiftung (EKFS)
German Research Foundation (Deutsche Forschungsgesellschaft, DFG)
International Foundation for Research in Paraplegia (IRP)
Novartis
Stryker
Siemens
European Union
German Research Foundation