Sural nerve fibre pathology in diabetic patients with mild neuropathy: relationship to pain, quantitative sensory testing and peripheral nerve electrophysiology

Malik, Rayaz A.; Veves, Aristidis; Walker, David; Siddique, Irfan; Lye, R. H.; Schady, W.; Boulton, Andrew J.M.

doi:10.1007/s004010000287

Cited by 138 publications

(61 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…From evaluation of sural nerve biopsies, myelinated nerve fibre density has proven a reliable indicator of neuropathy in patients with diabetes [25]. For the patients with diabetes and carpal tunnel syndrome in this study, we have previously demonstrated significant reduction in myelinated nerve fibre density in the non-compressed posterior interosseous nerve of the forearm, compared with the patients without diabetes with idiopathic carpal tunnel syndrome [26].…”

Section: Discussionmentioning

confidence: 51%

Vibrotactile sense in patients with diabetes and carpal tunnel syndrome

Thomsen

Cederlund

Speidel³

et al. 2011

Diabetic Medicine

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 51%

Vibrotactile sense in patients with diabetes and carpal tunnel syndrome

Thomsen

Cederlund

Speidel³

et al. 2011

Diabetic Medicine

View full text Add to dashboard Cite

show abstract

“…A reduction in myelinated fibre density is an indicator of mild neuropathy in diabetic patients [11]. A quantifiable association also exists between the magnitude of myelinated nerve fibre loss and a meaningful alteration in neurological and electrophysiological deficits [12].…”

Section: Discussionmentioning

confidence: 99%

Biopsy of the posterior interosseous nerve: a low morbidity method for assessment of peripheral nerve disorders

et al. 2009

Self Cite

View full text Add to dashboard Cite

Aims The sural nerve is the commonest peripheral nerve biopsied to help in the diagnosis of peripheral neuropathy of unknown cause. However, associated complications limit its use. The aim was, as an alternative, to asses biopsy of the terminal branch of the posterior interosseous nerve (PIN) in the forearm.Methods PIN pathology was morphometrically quantified in 10 male patients with Type 2 diabetes and compared with six PIN biopsy specimens taken post mortem from male cadavers with no history of neuropathy or trauma. Conclusions A reduction in myelinated fibre density has previously been shown to be a clinically meaningful measure of neuropathy in diabetic patients. We demonstrate similar findings using the PIN biopsy. The PIN biopsy procedure fulfils the criteria for nerve biopsy and was well tolerated by the patients. It may be a possible alternative to sural nerve biopsy to allow for diagnosis of neuropathy.

show abstract

“…STZ-induced diabetic mice undergo significant reductions in cutaneous innervation of the hindlimb by 7 weeks after STZ injection, while similar changes in cutaneous innervation have not been observed in rats (Karanth et al, 1990;Christianson et al, 2003a). Thus, the mechanical and chemogenic hypoalgesia in mice is linked to the reduced cutaneous innervation similar to diabetic humans (Bertelsmann et al, 1986;Malik et al, 2001). It is noteworthy that the mechanical hypoalgesia in mice occurs after the appearance of ATF3-positive neurons in the lumbar DRG, suggesting that the behavioral deficits may not emerge until a sufficient number of neurons are affected by diabetes.…”

Section: Diabetes-induced Mechanical Hypoalgesiamentioning

confidence: 96%

Diabetes‐induced expression of activating transcription factor 3 in mouse primary sensory neurons

Wright¹,

Ryals²,

McCarson

et al. 2004

J Peripheral Nervous Sys

View full text Add to dashboard Cite

Diabetic neuropathy (DN) is a complication of diabetes that affects the distal terminals of lengthy-projecting sensory axons. To determine whether diabetes-induced axonal degeneration induces gene expression similar to nerve injury, the expression of activating transcription factor 3 (ATF3) by primary sensory neurons was examined in an experimental mouse model of DN. Diabetes was induced using streptozotocin in C57BL/6 mice, and ATF3 expression in lumbar dorsal root ganglia was assessed at different time points and correlated with the markers of unmyelinated and myelinated neuronal populations. ATF expression was first evident 3 weeks after diabetes induction in both small unmyelinated and large myelinated neurons, but it was more prevalent in larger neurons. At 6 weeks, ATF3 was expressed by neurons among smaller size ranges, but this shift occurred principally within myelinated populations. The retrograde labeling of neurons innervating the flank and paw skin using Fluoro-Gold labeled appropriate percentages of ATF3-positive neurons at 3 weeks, suggesting ATF3 is expressed by neurons capable of transporting substances. However, the percentage of double-labeled neurons was substantially reduced at 6 weeks, suggesting this capacity decreases during disease progression. Finally, behavioral responses to noxious cutaneous stimuli were assessed. Although no differences to radiant heat were observed, diabetic mice developed severe mechanical hypoalgesia 4-5 weeks after diabetes induction. These results demonstrate that the diabetes-induced damage of sensory axons can induce the expression of genes linked to peripheral nerve injury and may identify neurons undergoing nerve damage. Finally, the ability to detect sensory deficits in diabetic mice occurs after the expression of injury-related gene ATF3, suggesting that nerve damage may be underway prior to the appearance of behavioral deficits.

show abstract

Sural nerve fibre pathology in diabetic patients with mild neuropathy: relationship to pain, quantitative sensory testing and peripheral nerve electrophysiology

Cited by 138 publications

References 27 publications

Vibrotactile sense in patients with diabetes and carpal tunnel syndrome

Vibrotactile sense in patients with diabetes and carpal tunnel syndrome

Biopsy of the posterior interosseous nerve: a low morbidity method for assessment of peripheral nerve disorders

Diabetes‐induced expression of activating transcription factor 3 in mouse primary sensory neurons

Contact Info

Product

Resources

About