Quantitative parameters of diffusion tensor imaging in the evaluation of carpal tunnel syndrome

Vo, Nhu Quynh; Hoang, Ngoc Thanh; Nguyen, Duy; Nguyen, Thi Hieu Dung; Le, Trong Binh; Le, Nghi Thanh Nhan; Nguyen, Thanh Thao

doi:10.21037/qims-21-910

Cited by 1 publication

(1 citation statement)

References 48 publications

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“…A greater peripheral (most prominently, sciatic or tibial) nerve CSA assessed by ultrasound or MRN has been also ascertained in DSPN compared with control individuals with HSP, albeit with considerable overlap of CSA values and without convincing evidence of an association between CSA and the severity of DSPN [ 33 – 35 ]. Moreover, in individuals with carpal tunnel syndrome, an inverse correlation of the nerve’s FA and CSA was found, with the FA being associated with a higher severity of neurological deficits [ 36 ]. However, our study is the first to show such correlation in individuals with polyneuropathy, underlining that an increased CSA is associated with a compromised nerve function in individuals with polyneuropathies such as DSPN.…”

Section: Discussionmentioning

confidence: 99%

A diminished sciatic nerve structural integrity is associated with distinct peripheral sensory phenotypes in individuals with type 2 diabetes

Mooshage,

Tsilingiris,

Schimpfle

et al. 2023

Diabetologia

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Aims/hypothesis Quantitative sensory testing (QST) allows the identification of individuals with rapid progression of diabetic sensorimotor polyneuropathy (DSPN) based on certain sensory phenotypes. Hence, the aim of this study was to investigate the relationship of these phenotypes with the structural integrity of the sciatic nerve among individuals with type 2 diabetes. Methods Seventy-six individuals with type 2 diabetes took part in this cross-sectional study and underwent QST of the right foot and high-resolution magnetic resonance neurography including diffusion tensor imaging of the right distal sciatic nerve to determine the sciatic nerve fractional anisotropy (FA) and cross-sectional area (CSA), both of which serve as markers of structural integrity of peripheral nerves. Participants were then assigned to four sensory phenotypes (participants with type 2 diabetes and healthy sensory profile [HSP], thermal hyperalgesia [TH], mechanical hyperalgesia [MH], sensory loss [SL]) by a standardised sorting algorithm based on QST. Results Objective neurological deficits showed a gradual increase across HSP, TH, MH and SL groups, being higher in MH compared with HSP and in SL compared with HSP and TH. The number of participants categorised as HSP, TH, MH and SL was 16, 24, 17 and 19, respectively. There was a gradual decrease of the sciatic nerve’s FA (HSP 0.444, TH 0.437, MH 0.395, SL 0.382; p=0.005) and increase of CSA (HSP 21.7, TH 21.5, MH 25.9, SL 25.8 mm2; p=0.011) across the four phenotypes. Further, MH and SL were associated with a lower sciatic FA (MH unstandardised regression coefficient [B]=−0.048 [95% CI −0.091, −0.006], p=0.027; SL B=−0.062 [95% CI −0.103, −0.020], p=0.004) and CSA (MH β=4.3 [95% CI 0.5, 8.0], p=0.028; SL B=4.0 [95% CI 0.4, 7.7], p=0.032) in a multivariable regression analysis. The sciatic FA correlated negatively with the sciatic CSA (r=−0.35, p=0.002) and markers of microvascular damage (high-sensitivity troponin T, urine albumin/creatinine ratio). Conclusions/interpretation The most severe sensory phenotypes of DSPN (MH and SL) showed diminishing sciatic nerve structural integrity indexed by lower FA, likely representing progressive axonal loss, as well as increasing CSA of the sciatic nerve, which cannot be detected in individuals with TH. Individuals with type 2 diabetes may experience a predefined cascade of nerve fibre damage in the course of the disease, from healthy to TH, to MH and finally SL, while structural changes in the proximal nerve seem to precede the sensory loss of peripheral nerves and indicate potential targets for the prevention of end-stage DSPN. Trial registration ClinicalTrials.gov NCT03022721 Graphical Abstract

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Section: Discussionmentioning

confidence: 99%

A diminished sciatic nerve structural integrity is associated with distinct peripheral sensory phenotypes in individuals with type 2 diabetes

Mooshage,

Tsilingiris,

Schimpfle

et al. 2023

Diabetologia

View full text Add to dashboard Cite

show abstract

Quantitative parameters of diffusion tensor imaging in the evaluation of carpal tunnel syndrome

Abstract: Contributions: (I) Conception and design: TT Nguyen; (II) Administrative support: NT Hoang; (III) Provision of study materials or patients: NT

Cited by 1 publication

References 48 publications

A diminished sciatic nerve structural integrity is associated with distinct peripheral sensory phenotypes in individuals with type 2 diabetes

A diminished sciatic nerve structural integrity is associated with distinct peripheral sensory phenotypes in individuals with type 2 diabetes

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