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Jende, J.M.E.* ; Kender, Z.* ; Rother, C.* ; Alvarez-Ramos, L.* ; Groener, J.B.* ; Pham, M.* ; Morgenstern, J.* ; Oikonomou, D.* ; Hahn, A.* ; Juerchott, A.* ; Kollmer, J.* ; Heiland, S.* ; Kopf, S.* ; Nawroth, P.P. ; Bendszus, M.* ; Kurz, F.T.*

Diabetic polyneuropathy is associated with pathomorphological changes in human dorsal root ganglia: A study using 3T MR neurography.

Front. Neurosci. 14:570744 (2020)
Verlagsversion DOI
Open Access Gold
Creative Commons Lizenzvertrag
Diabetic neuropathy (DPN) is one of the most severe and yet most poorly understood complications of diabetes mellitus.In vivoimaging of dorsal root ganglia (DRG), a key structure for the understanding of DPN, has been restricted to animal studies. These have shown a correlation of decreased DRG volume with neuropathic symptom severity. Our objective was to investigate correlations of DRG morphology and signal characteristics at 3 Tesla (3T) magnetic resonance neurography (MRN) with clinical and serological data in diabetic patients with and without DPN. In this cross-sectional study, participants underwent 3T MRN of both L5 DRG using an isotropic 3D T2-weighted, fat-suppressed sequence with subsequent segmentation of DRG volume and analysis of normalized signal properties. Overall, 55 diabetes patients (66 +/- 9 years; 32 men; 30 with DPN) took part in this study. DRG volume was smaller in patients with severe DPN when compared to patients with mild or moderate DPN (134.7 +/- 21.86 vs 170.1 +/- 49.22;p= 0.040). In DPN patients, DRG volume was negatively correlated with the neuropathy disability score (r= -0.43; 95%CI = -0.66 to -0.14;p= 0.02), a measure of neuropathy severity. DRG volume showed negative correlations with triglycerides (r= -0.40; 95%CI = -0.57 to -0.19;p= 0.006), and LDL cholesterol (r= -0.33; 95%CI = -0.51 to -0.11;p= 0.04). There was a strong positive correlation of normalized MR signal intensity (SI) with the neuropathy symptom score in the subgroup of patients with painful DPN (r= 0.80; 95%CI = 0.46 to 0.93;p= 0.005). DRG SI was positively correlated with HbA1c levels (r= 0.30; 95%CI = 0.09 to 0.50;p= 0.03) and the triglyceride/HDL ratio (r= 0.40; 95%CI = 0.19 to 0.57;p= 0.007). In this firstin vivostudy, we found DRG morphological degeneration and signal increase in correlation with neuropathy severity. This elucidates the potential importance of MR-based DRG assessments in studying structural and functional changes in DPN.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Schlagwörter Diabetic Polyneuropathy ; Dorsal Root Ganglion ; Magnetic Resonance Neurography ; Neuropathic Pain ; Peripheral Nervous System; Peripheral Neuropathy; Risk-factors; Nerve; Lipids; Volume
ISSN (print) / ISBN 1662-453X
Quellenangaben Band: 14, Heft: , Seiten: , Artikelnummer: 570744 Supplement: ,
Verlag Frontiers
Verlagsort Avenue Du Tribunal Federal 34, Lausanne, Ch-1015, Switzerland
Förderungen International Foundation for Research in Paraplegia
Hoffmann-Klose foundation of Heidelberg University Hospital
German Research Foundation
German Research Council (DFG)
European Union
Dietmar Hopp foundation