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Groener, J.B.* ; Jende, J.M.E.* ; Kurz, F.T.* ; Kender, Z.* ; Treede, R.D.* ; Schuh-Hofer, S.* ; Nawroth, P.P. ; Bendszus, M.* ; Kopf, S.*

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)
Verlagsversion Postprint DOI
Open Access Green
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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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
ISSN (print) / ISBN 0012-1797
e-ISSN 1939-327X
Zeitschrift Diabetes
Quellenangaben Band: 69, Heft: 3, Seiten: 436-447 Artikelnummer: , Supplement: ,
Verlag American Diabetes Association
Verlagsort Alexandria, VA.
Begutachtungsstatus Peer reviewed