Reduced Thalamic Volume and Metabolites in Type 1 Diabetes with Polyneuropathy
| Autor: | Asbjørn Mohr Drewes, Poul Erik Jakobsen, Christina Brock, Birgitte Brock, Jens Brøndum Frøkjær, Solomon Tesfaye, Jesper Karmisholt, Anne Juhl, Tine Maria Hansen, Janusiya Anajan Muthulingam, Dinesh Selvarajah |
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| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Diabetic neuropathy Magnetic Resonance Spectroscopy Endocrinology Diabetes and Metabolism Thalamus Pain 030209 endocrinology & metabolism 03 medical and health sciences Polyneuropathies 0302 clinical medicine Endocrinology Atrophy Internal medicine Sensation Internal Medicine medicine Humans Type 1 diabetes business.industry Brain metabolites General Medicine medicine.disease Magnetic Resonance Imaging Peripheral neuropathy Cross-Sectional Studies Diabetes Mellitus Type 1 Central nervous system Cardiology Peripheral nervous system Tetanic stimulation business Polyneuropathy 030217 neurology & neurosurgery |
| Zdroj: | Hansen, T M, Frøkjær, J B, Selvarajah, D, Muthulingam, J A, Tesfaye, S, Juhl, A, Drewes, A M, Jakobsen, P E, Karmisholt, J, Brock, B & Brock, C 2022, ' Reduced Thalamic Volume and Metabolites in Type 1 Diabetes with Polyneuropathy ', Experimental and Clinical Endocrinology and Diabetes, vol. 130, no. 5, pp. 327-334 . https://doi.org/10.1055/a-1347-2579 |
| DOI: | 10.1055/a-1347-2579 |
| Popis: | Objective Thalamus is essential in processing of sensory information. This study explored the associations between thalamic volume and intra-thalamic metabolites and associations to clinical and experimental characteristics of sensory function in adults with diabetic polyneuropathy. Methods 48 adults with type 1 diabetes and confirmed distal symmetric peripheral neuropathy (DPSN) and 28 healthy controls participated in a cross-sectional study and underwent a brain magnetic resonance imaging scan. Estimates for thalamic volume were extracted using voxel-based morphometry and intra-thalamic N-acetylaspartate/creatine (NAA/cre) levels were assessed by magnetic resonance spectroscopy. Associations between thalamic volume and clinical measures, quantitative sensory testing and neuropathic phenotype were explored. Results In diabetes, reduced gray matter volume was identified including bilateral thalamus (all p≤0.001) in comparison to healthy participants. Thalamic volume estimates were positively associated to intra-thalamic NAA/cre (r=0.4; p=0.006), however not to diabetes duration (p=0.5), severity of DSPN (p=0.7), or presence of pain (p=0.3). Individuals with the lowest thalamic volume had greatest loss of protective sensation (light touch using von Frey-like filaments, p=0.037) and highest pain tolerance to electric stimulation (tetanic stimulation, p=0.008) compared to individuals with the highest thalamic volume. Conclusions In this cohort with type 1 diabetes and severe DSPN, thalamic atrophy was present and associated with reduced NAA/cre, indicating thalamic structural loss and dysfunction. Thalamic atrophy was associated to reduced sensory function involving large fiber neuropathy and sensation to tetanic stimulation that may reflect synaptic transmission. This may ultimately contribute to the current understanding of the pathophysiology behind the perception changes evident in DSPN. |
| Databáze: | OpenAIRE |
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