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Three-dimensional Imaging of Nociceptive Intraepidermal Nerve Fibers in Human Skin Biopsies
Published on: April 29, 2013
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Exercise increases cutaneous nerve density in diabetic patients without neuropathy
John R Singleton1, Robin L Marcus2, Justin E Jackson2
1Department of Neurology, University of Utah Salt Lake City, Utah.
Annals of Clinical and Translational Neurology
|December 11, 2014
Summary
Structured exercise may reverse early nerve damage in type 2 diabetes patients. This study suggests exercise can improve intraepidermal nerve fiber density (IENFD), offering hope for neuropathy prevention.
Area of Science:
- Neurology
- Diabetology
- Clinical Trials
Background:
- Diabetic neuropathy involves unmyelinated axon loss, causing pain and reduced nerve fiber density.
- Early stages may be characterized by preclinical injury to unmyelinated axons.
Purpose of the Study:
- To investigate if lifestyle counseling or structured exercise can impact intraepidermal nerve fiber density (IENFD) in type 2 diabetes patients without neuropathy.
- To assess the potential reversibility of early nerve damage.
Main Methods:
- Patients with type 2 diabetes and no neuropathy were randomized into two groups.
- One group received quarterly lifestyle counseling (N=40), while the other underwent supervised weekly exercise (N=60) for one year.
- Intraepidermal nerve fiber density (IENFD) in the distal leg was measured.
Main Results:
- The exercise group showed a significant increase in distal leg IENFD.
- The lifestyle counseling group showed no significant change in IENFD.
- The difference in IENFD change between groups was statistically significant (P=0.03).
Conclusions:
- Preclinical injury to unmyelinated axons in early diabetic neuropathy may be reversible.
- Structured exercise appears to be a viable intervention to improve IENFD.
- IENFD may serve as a responsive biomarker in future clinical trials for neuropathy prevention.
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