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Magnetic Resonance Neurography Reveals Smoking-Associated Decrease in Sciatic Nerve Structural Integrity in Type 2

Johann M E Jende1, Christoph Mooshage1, Zoltan Kender2

  • 1Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.

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|March 4, 2022
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Smoking significantly damages sciatic nerve integrity in type 2 diabetes (T2D) patients, worsening diabetic polyneuropathy (DPN). Quitting smoking may help slow DPN progression by reducing nerve damage and glycemic stress.

Keywords:
diabetic polyneuropathydiffusion tensor imagingmagnetic resonance neurography (MRN)smokingtype 2 diabetes

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Area of Science:

  • Neuroscience
  • Diabetology
  • Radiology

Background:

  • Diabetic polyneuropathy (DPN) is a common complication of type 2 diabetes (T2D).
  • The role of smoking in DPN development and progression remains debated.
  • Diffusion-weighted magnetic resonance neurography (MRN) offers objective assessment of nerve integrity.

Purpose of the Study:

  • To investigate the impact of cigarette smoking on sciatic nerve structural integrity in individuals with T2D.
  • To correlate nerve integrity markers with clinical, electrophysiological, and serological data.

Main Methods:

  • Cross-sectional study of T2D patients (smokers, never-smokers, ex-smokers) and healthy controls.
  • Utilized 3 Tesla diffusion tensor imaging MRN with semi-automated nerve fiber tracking.
  • Analyzed sciatic nerve fractional anisotropy (FA) and radial diffusivity.

Main Results:

  • Smokers with T2D exhibited significantly lower sciatic nerve FA compared to controls and never-smokers.
  • Increased radial diffusivity, indicative of myelin damage, was observed in smokers.
  • FA correlated negatively with DPN markers, arterial stiffness, and long-term glycemic stress.

Conclusions:

  • Smoking contributes to sciatic nerve damage in T2D, exacerbating DPN.
  • Glycemic stress and microangiopathy play roles in smoking-related nerve damage.
  • Smoking cessation is a potential strategy to mitigate DPN progression in T2D.