Reduced Thalamic γ-Aminobutyric Acid (GABA) in Painless but Not Painful Diabetic Peripheral Neuropathy.

Autor:	Shillo P; Diabetes Research Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, U.K., Sloan G; Diabetes Research Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, U.K.; Division of Clinical Medicine, University of Sheffield, Sheffield, U.K., Selvarajah D; Division of Clinical Medicine, University of Sheffield, Sheffield, U.K., Greig M; Diabetes Research Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, U.K., Gandhi R; Diabetes Research Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, U.K., Anand P; Peripheral Neuropathy Unit, Imperial College London, London, U.K., Edden RA; Department of Neuroradiology, Johns Hopkins University, Baltimore, MD., Wilkinson ID; Academic Unit of Radiology, University of Sheffield, Sheffield, U.K., Tesfaye S; Diabetes Research Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, U.K.
Jazyk:	angličtina
Zdroj:	Diabetes [Diabetes] 2024 Aug 01; Vol. 73 (8), pp. 1317-1324.
DOI:	10.2337/db23-0921
Abstrakt:	Alterations in the structure, function, and microcirculation of the thalamus, a key brain region involved in pain pathways, have previously been demonstrated in patients with painless and painful diabetic peripheral neuropathy (DPN). However, thalamic neurotransmitter levels including γ-aminobutyric acid (GABA) (inhibitory neurotransmitter) and glutamate (excitatory neurotransmitter) in different DPN phenotypes are not known. We performed a magnetic resonance spectroscopy study and quantified GABA and glutamate levels within the thalamus, in a carefully characterized cohort of participants with painless and painful DPN. Participants with DPN (painful and painless combined) had a significantly lower GABA:H2O ratio compared with those without DPN (healthy volunteers [HV] and participants with diabetes without DPN [no DPN]). Participants with painless DPN had the lowest GABA:H2O ratio, which reached significance compared with HV and no DPN, but not painful DPN. There was no difference in GABA:H2O in painful DPN compared with all other groups. A significant correlation with GABA:H2O and neuropathy severity was also seen. This study demonstrates that lower levels of thalamic GABA in participants with painless DPN may reflect neuroplasticity due to reduced afferent pain impulses, whereas partially preserved levels of GABA in painful DPN may indicate that central GABAergic pathways are involved in the mechanisms of neuropathic pain in diabetes. (© 2024 by the American Diabetes Association.)
Databáze:	MEDLINE
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