Magnetic Resonance Neuroimaging Study of Brain Structural Differences in Diabetic Peripheral Neuropathy.

Diabetic peripheral neuropathy (DPN) has hitherto been considered a
disease of the peripheral nervous system only, with central nervous
system (CNS) involvement largely overlooked. The aim of this study was
to investigate any differences in brain structure in subjects with
DPN.RESEARCH DESIGN AND METHODSThirty-six subjects with type 1 diabetes
(No DPN [n = 18], Painful DPN [n = 9], Painless DPN [n = 9]) underwent
neurophysiological assessment to quantify the severity of DPN. All
subjects, including 18 healthy volunteers (HVs), underwent volumetric
brain magnetic resonance imaging at 3 Tesla.RESULTSAdjusted peripheral
gray matter volume was statistically significantly lower in subjects
with painless and painful DPN (mean 599.6 mL [SEM 9.8 mL] and 585.4 mL
[10.0 mL], respectively) compared with those with No DPN (626.5 mL [5.7
mL]) and HVs (639.9 mL [7.2 mL]; ANCOVA, P = 0.001). The difference in
adjusted peripheral gray matter volume between subjects with No DPN and
HVs, and those with Painful DPN and Painless DPN was not statistically
significant (P = 0.16 and 0.30, respectively). Voxel-based morphometry
analyses revealed greater localized volume loss in the primary
somatosensory cortex, supramarginal gyrus, and cingulate cortex
(corrected P < 0.05) in DPN subjects.CONCLUSIONSThis is the first
study to focus on structural changes in the brain associated with DPN.
Our findings suggest increased peripheral gray matter volume loss,
localized to regions involved with somatosensory perception in subjects
with DPN. This may have important implications for the long-term
prognosis of DPN.

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