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Understanding diabetic neuropathy: From subclinical nerve lesions to severe nerve fiber deficits. A cross-sectional study in patients with type 2 diabetes and healthy controls.
Diabetes 69, 436-447 (2019)
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, expecting correlations with the impairment of large fiber function. 61 patients with diabetes mellitus type 2 (48 with, 13 without DPN) and 12 controls were enrolled, undergoing 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) between the groups. Lesion load correlated with lower Aα, Aβ, and Aδ fiber, but not 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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Publication type
Article: Journal article
Document type
Scientific Article
Language
english
Publication Year
2019
HGF-reported in Year
2019
ISSN (print) / ISBN
0012-1797
e-ISSN
1939-327X
Journal
Diabetes
Quellenangaben
Volume: 69,
Issue: 3,
Pages: 436-447
Publisher
American Diabetes Association
Publishing Place
Alexandria, VA.
Reviewing status
Peer reviewed
Institute(s)
Institute of Diabetes and Cancer (IDC)
POF-Topic(s)
90000 - German Center for Diabetes Research
Research field(s)
Helmholtz Diabetes Center
PSP Element(s)
G-501900-251
PubMed ID
31826867
Erfassungsdatum
2020-01-15