下降的坐骨神经结构完整性与2型糖尿病患者的独特外周感官表型有关
Christoph M Mooshage1, Dimitrios Tsilingiris2,3,4, Lukas Schimpfle2,3
1Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
Diabetologia
|November 29, 2023
概括
糖尿病感觉运动性多神经病变 (DSPN) 通过感觉表型进展,严重的形式 (机械超痛和感觉丧失) 显示下降的坐骨神经完整性. 这表明2型糖尿病中神经损伤的级联,为预防提供了目标.
科学领域:
- 神经学 神经学
- 糖尿病学 糖尿病学
- 医疗成像医学成像
背景情况:
- 糖尿病感觉运动性多神经病变 (DSPN) 是2型糖尿病的常见并发症.
- 定量感官测试 (QST) 可以根据感官表型识别快速DSPN进展的个体.
- 了解感官表型和神经结构之间的关系对于管理DSPN至关重要.
研究的目的:
- 调查QST定义的感官表型与2型糖尿病患者的坐骨神经结构完整性之间的关联.
- 探索坐骨神经结构标志物作为DSPN进展指标的潜力.
主要方法:
- 一项涉及76名2型糖尿病患者的横截面研究.
- 足部的定量感官测试 (QST) 和高分辨率磁共振神经图 (MRN) 与坐骨神经的扩散张力成像 (DTI).
- 测量坐骨神经分数异构 (FA) 和横截面积 (CSA),作为结构完整性的标记.
- 将参与者分为四种感官表型:健康的感官特征 (HSP),热过敏症 (TH),机械过敏症 (MH) 和感官损失 (SL).
主要成果:
- 神经学缺陷在从HSP到SL的表型中增加.
- 在整个表型 (HSP,TH,MH,SL) 中,坐骨神经FA显著下降 (p=0.005),CSA显著增加 (p=0.011).
- MH和SL表型与较低的FA和较高的CSA有关,表明神经结构完整性降低.
- 坐骨髓FA与CSA和微血管损伤标志物负相关.
结论:
- 严重的DSPN表型 (MH和SL) 与坐骨神经结构完整性降低有关 (较低的FA,较高的CSA),表明渐进式轴突损失.
- 在2型糖尿病中存在潜在的神经纤维损伤级联,从健康到感官损失.
- 靠近性坐骨神经的结构变化先于周边感官损失,可能是预防终端阶段DSPN的目标.
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