The Mechanoreceptor’s Role in Plantar Skin Changes in Individuals with Diabetes Mellitus

Zippenfennig, Claudio; Drechsel, Tina J.; Monteiro, Renan Lima; Sacco, Isabel de Camargo Neves; Milani, Thomas L.

doi:10.3390/jcm10122537

Cited by 10 publications

(8 citation statements)

References 34 publications

(86 reference statements)

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“…The clinical importance of vibration sensitivity for the development of diabetic foot ulcers has been demonstrated by research associating current or past diabetic foot ulcers with altered tuning fork vibration perception 36 . In addition, Zippenfennig et al 41 reported worse vibration perception thresholds in PWDPN compared with controls and people without DPN. In our study, after 12 weeks of foot–ankle training, the IG presented better vibration sensitivity compared with the CG (p = 0.030; interaction effect, Table 2 , and Fig.…”

Section: Resultsmentioning

confidence: 98%

Foot–ankle therapeutic exercise program can improve gait speed in people with diabetic neuropathy: a randomized controlled trial

Monteiro

Ferreira

Silva

et al. 2022

Sci Rep

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This study sought to determine whether a foot–ankle therapeutic exercise program can improve daily physical activity (i.e. number of steps) and fast and self-selected gait speed in people with diabetic peripheral neuropathy (DPN). In this single-blind randomized controlled trial and intention-to-treat analysis, 78 volunteers with DPN were allocated into a control group, which received usual care, and an intervention group (IG), which received usual care plus a 12-week foot–ankle exercise program. The adherence at 12 weeks rate in the IG was 92.3% (36 participants) and the dropout was 5.1% in the control group (2 participants). The number of steps and self-selected gait speed did not change significantly in either group (p > 0.05), although a 1,365-step difference between groups were observed at 1-year followup. The 12-week foot–ankle therapeutic exercises improved significantly fast-gait speed (primary outcome) (p = 0.020), ankle range of motion (p = 0.048), and vibration perception (secondary outcomes) (p = 0.030), compared with usual-care at 12 weeks. At 24 weeks, the IG showed better quality of life than controls (p = 0.048). At 1-year, fast-gait speed and vibration perception remained higher in the IG versus controls. Overall, the program may be a complementary treatment strategy for improving musculoskeletal and functional deficits related to DPN.Trial registration ClinicalTrials.gov NCT02790931 (06/06/2016).

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Section: Resultsmentioning

confidence: 98%

Foot–ankle therapeutic exercise program can improve gait speed in people with diabetic neuropathy: a randomized controlled trial

Monteiro

Ferreira

Silva

et al. 2022

Sci Rep

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“…In addition to pain, light touch and low-frequency vibration are also impaired in DDSP [ 13 , 14 , 15 ], suggesting involvement of Aβ fibers and sensory corpuscles (Meissner and Pacinian corpuscles, Merkel cell–neurite complexes; see [ 16 ]). Thus, the analysis of sensory corpuscles in cutaneous biopsies has been proposed as a “gold standard” method of diagnostic interest in some peripheral neuropathies and neurodegenerative diseases (see for a review [ 17 , 18 ]).…”

Section: Introductionmentioning

confidence: 99%

Involvement of Cutaneous Sensory Corpuscles in Non-Painful and Painful Diabetic Neuropathy

García‐Mesa

Feito

González-Gay

et al. 2021

JCM

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Distal diabetic sensorimotor polyneuropathy (DDSP) is the most prevalent form of diabetic neuropathy, and some of the patients develop gradual pain. Specialized sensory structures present in the skin encode different modalities of somatosensitivity such as temperature, touch, and pain. The cutaneous sensory structures responsible for the qualities of mechanosensitivity (fine touch, vibration) are collectively known as cutaneous mechanoreceptors (Meissner corpuscles, Pacinian corpuscles, and Merkel cell–axonal complexes), which results are altered during diabetes. Here, we used immunohistochemistry to analyze the density, localization within the dermis, arrangement of corpuscular components (axons and Schwann-like cells), and expression of putative mechanoproteins (PIEZO2, ASIC2, and TRPV4) in cutaneous mechanoreceptors of subjects suffering clinically diagnosed non-painful and painful distal diabetic sensorimotor polyneuropathy. The number of Meissner corpuscles, Pacinian corpuscles, and Merkel cells was found to be severely decreased in the non-painful presentation of the disease, and almost disappeared in the painful presentation. Furthermore, there was a marked reduction in the expression of axonal and Schwann-like cell markers (with are characteristics of corpuscular denervation) as well as of all investigated mechanoproteins in the non-painful distal diabetic sensorimotor polyneuropathy, and these were absent in the painful form. Taken together, these alterations might explain, at least partly, the impairment of mechanosensitivity system associated with distal diabetic sensorimotor polyneuropathy. Furthermore, our results support that an increasing severity of DDSP may increase the risk of developing painful neuropathic symptoms. However, why the absence of cutaneous mechanoreceptors is associated with pain remains to be elucidated.

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“…We considered the individual biomechanical skin characteristics of the participants as a starting point. In the course of this study, we collected skin hardness data using the Shore OO Durometer and skin thickness data using the handheld ultrasound device as described in [ 39 ]. In diabetes, increased blood glucose levels lead to thicker and harder skin [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

The Effect of Subliminal Electrical Noise Stimulation on Plantar Vibration Sensitivity in Persons with Diabetes Mellitus

et al. 2022

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Subliminal electrical noise (SEN) enhances sensitivity in healthy individuals of various ages. Diabetes and its neurodegenerative profile, such as marked decreases in foot sensitivity, highlights the potential benefits of SEN in such populations. Accordingly, this study aimed to investigate the effect of SEN on vibration sensitivity in diabetes. Vibration perception thresholds (VPT) and corresponding VPT variations (coefficient of variation, CoV) of two experimental groups with diabetes mellitus were determined using a customized vibration exciter (30 and 200 Hz). Plantar measurements were taken at the metatarsal area with and without SEN stimulation. Wilcoxon signed-rank and t tests were used to test for differences in VPT and CoV within frequencies, between the conditions with and without SEN. We found no statistically significant effects of SEN on VPT and CoV (p > 0.05). CoV showed descriptively lower mean variations of 4 and 7% for VPT in experiment 1. SEN did not demonstrate improvements in VPT in diabetic individuals. Interestingly, taking into account the most severely affected (neuropathy severity) individuals, SEN seems to positively influence vibratory perception. However, the descriptively reduced variations in experiment 1 indicate that participants felt more consistently. It is possible that the effect of SEN on thick, myelinated Aβ-fibers is only marginally present.

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The Mechanoreceptor’s Role in Plantar Skin Changes in Individuals with Diabetes Mellitus

Cited by 10 publications

References 34 publications

Foot–ankle therapeutic exercise program can improve gait speed in people with diabetic neuropathy: a randomized controlled trial

Foot–ankle therapeutic exercise program can improve gait speed in people with diabetic neuropathy: a randomized controlled trial

Involvement of Cutaneous Sensory Corpuscles in Non-Painful and Painful Diabetic Neuropathy

The Effect of Subliminal Electrical Noise Stimulation on Plantar Vibration Sensitivity in Persons with Diabetes Mellitus

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