A Magnetic Resonance Imaging Volumetry Study of Regional Brain Atrophy in Diabetic Peripheral Neuropathy

Selvarajah, Dinesh; Heiberg-Gibbons, Francesca; Wilkinson, Iain D.; Gandhi, Rajiv; Tesfaye, Solomon

doi:10.2337/db18-550-p

Cited by 6 publications

(4 citation statements)

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“…Several factors contribute to the development of neu-ropathic pain in diabetic neuropathy. AGE advanced glycation end products, HIF-1α hypoxia-induced factor 1α, PKC protein kinase C, TRPA1 transient receptor potential ankyrin 1, VGSC voltage-gated sodium channel, vWF von Willebrand factor are also described in patients with pDN: cortical atrophy within the somatomotor cortex and insula (Selvarajah et al 2018b;Shillo et al 2016), abnormal cortical interactions within the somatomotor network (Selvarajah et al 2018a), and increased cerebral blood flow in the anterior cingulate cortex (Watanabe et al 2018). It is still unknown whether the described CNS changes are only a response to afferent input of the peripheral nervous system or a primary mechanism responsible for the maintenance of pDN.…”

Section: Central Mechanisms Of Painful Diabetic Neuropathymentioning

confidence: 99%

Challenges of neuropathic pain: focus on diabetic neuropathy

et al. 2020

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Neuropathic pain is a frequent condition caused by a lesion or disease of the central or peripheral somatosensory nervous system. A frequent cause of peripheral neuropathic pain is diabetic neuropathy. Its complex pathophysiology is not yet fully elucidated, which contributes to underassessment and undertreatment. A mechanism-based treatment of painful diabetic neuropathy is challenging but phenotype-based stratification might be a way to develop individualized therapeutic concepts. Our goal is to review current knowledge of the pathophysiology of peripheral neuropathic pain, particularly painful diabetic neuropathy. We discuss state-of-the-art clinical assessment, validity of diagnostic and screening tools, and recommendations for the management of diabetic neuropathic pain including approaches towards personalized pain management. We also propose a research agenda for translational research including patient stratification for clinical trials and improved preclinical models in relation to current knowledge of underlying mechanisms.

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Section: Central Mechanisms Of Painful Diabetic Neuropathymentioning

confidence: 99%

Challenges of neuropathic pain: focus on diabetic neuropathy

et al. 2020

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“…Using a technique known as voxel-based morphometry, we calculated the brain volumes in subjects with DPN and identified total brain volume reduction which was localized to the somatosensory regions [144, 145]. Furthermore, our group has performed the largest cohort study of brain volume changes in DPN and painful-DPN to date [146]. In painful-DPN, cortical atrophy is localized within the somatomotor cortex and insula.…”

Section: Pathogenesis Of Painful-dpnmentioning

confidence: 99%

Painful and Painless Diabetic Neuropathies: What Is the Difference?

et al. 2019

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Purpose of Review The prevalence of diabetes mellitus and its chronic complications are increasing to epidemic proportions. This will unfortunately result in massive increases in diabetic distal symmetrical polyneuropathy (DPN) and its troublesome sequelae, including disabling neuropathic pain (painful-DPN), which affects around 25% of patients with diabetes. Why these patients develop neuropathic pain, while others with a similar degree of neuropathy do not, is not clearly understood. This review will look at recent advances that may shed some light on the differences between painful and painless-DPN. Recent Findings Gender, clinical pain phenotyping, serum biomarkers, brain imaging, genetics, and skin biopsy findings have been reported to differentiate painful- from painless-DPN. Summary Painful-DPN seems to be associated with female gender and small fiber dysfunction. Moreover, recent brain imaging studies have found neuropathic pain signatures within the central nervous system; however, whether this is the cause or effect of the pain is yet to be determined. Further research is urgently required to develop our understanding of the pathogenesis of pain in DPN in order to develop new and effective mechanistic treatments for painful-DPN.

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“…Так, найдены структурные и функциональные изменения в спинномозговой, соматомоторной, лимбической и таламической системе при БДПН [20]. Также описаны изменения в высших центрах головного мозга: атрофия коры прецентральной извилины и островка у пациентов с БДПН, увеличение мозгового кровотока в передней поясной извилине головного мозга у пациентов, страдающих невропатической болью [21,22]. До сих пор неизвестно, являются ли описанные изменения ЦНС только ответом на афферентную импульсацию со стороны ПНС или первичным механизмом, ответственным за поддержание болевого синдрома при БДПН.…”

Section: центральные механизмы развития болевой диабетической полинев...unclassified

Painful diabetic polyneuropathy: modern approaches to diagnosis and treatment

Ахмеджанова

Mandra

2023

Medicinskij sovet

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Diabetes mellitus is one of the most common chronic diseases, the incidence of which is steadily increasing. Approximately 1 in 11 adults in the world today has diabetes. Diabetic polyneuropathy is a common complication of diabetes mellitus and leads to a decrease in the quality and life expectancy of patients, increases the risk of disability. The pain form of diabetic polyneuropathy has a particularly negative effect on the quality of life. It includes both acute (Ellenberg’s neuropathy and acute insulin-induced neuropathy) and chronic forms. The article discusses modern ideas about the pathogenesis of pain diabetic polyneuropathy, as well as risk factors, clinical symptoms and diagnostic methods (electroneuromyography, quantitative sensory testing, sudomotor function, skin biopsy, confocal biopsy of the cornea) of the disease. In most patients, the pain form of diabetic polyneuropathy is accompanied by autonomic disorders. Treatment of painful diabetic polyneuropathy is a difficult task, including the correction of risk factors (glycemia level, patient lifestyle), as well as pathogenetic and symptomatic therapy. As symptomatic therapy, adjuvant analgesics are used, namely drugs from the group of anticonvulsants (gabapentin, pregabalin) and antidepressants (duloxetine). The use of alpha-lipoic acid is the basis of pathogenetic therapy. As a universal antioxidant, alpha-lipoic acid is an absolutely safe drug with a proven effect in the treatment of painful diabetic polyneuropathy and can be recommended for use in clinical practice.

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A Magnetic Resonance Imaging Volumetry Study of Regional Brain Atrophy in Diabetic Peripheral Neuropathy

Cited by 6 publications

References 0 publications

Challenges of neuropathic pain: focus on diabetic neuropathy

Challenges of neuropathic pain: focus on diabetic neuropathy

Painful and Painless Diabetic Neuropathies: What Is the Difference?

Painful diabetic polyneuropathy: modern approaches to diagnosis and treatment

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