Decreased Microstructural Integrity of the Central Somatosensory Tracts in Diabetic Peripheral Neuropathy
Decreased Microstructural Integrity of the Central Somatosensory Tracts in Diabetic Peripheral Neuropathy
复制标题
糖尿病周围神经病变中枢体感束微观结构完整性降低
DOI：
10.1210/clinem/dgab158
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发表时间：
2021-03-12
影响因子：
5.8
通讯作者：
Peng, Yong-De
中科院分区：
文献类型：
--
作者：
Fang, Fang;Luo, Qian;Peng, Yong-De
内容：虽然糖尿病周围神经病变（DPN）主要被认为是周围神经的疾病，但最近出现了一些中枢神经系统受累的证据。目的：检测2型糖尿病患者中枢体感束的微结构，并探讨其与糖尿病周围神经病变严重程度的关系。方法：在一家三级转诊医院进行了一项病例对照研究，纳入57例2型糖尿病患者（25例DPN，32例无DPN）和33例非糖尿病对照。基于扩散张量纤维束成像评估2个主要躯体感觉束（脊髓丘脑束及其丘脑皮质[脊髓-丘脑-皮质，STC]通路，内侧丘系及其丘脑皮质[内侧丘系-丘脑-皮质，MLTC]通路）的各向异性分数（FA）值。结果：DPN患者左STC和左MLTC通路的FA值均显著低于无DPN者和对照组。此外，FA值的左STC和左MLTC途径与DPN的严重程度（表示为多伦多临床评分系统值）在调整多个confersider.Conclusion：我们的研究结果表明，轴突变性的2型糖尿病患者的DPN的中枢躯体感觉束。颅内和颅外躯体感觉系统的平行疾病进展值得进一步关注糖尿病合并DPN患者的中枢神经。
Context: Although diabetic peripheral neuropathy (DPN) is predominantly considered a disorder of the peripheral nerves, some evidence for central nervous system involvement has recently emerged. However, whether or to what extent the microstructure of central somatosensory tracts may be injured remains unknown.Objective: This work aimed to detect the microstructure of central somatosensory tracts in type 2 diabetic patients and to correlate it with the severity of DPN.Methods: A case-control study at a tertiary referral hospital took place with 57 individuals with type 2 diabetes (25 with DPN, 32 without DPN) and 33 nondiabetic controls. The fractional anisotropy (FA) values of 2 major somatosensory tracts (the spinothalamic tract and its thalamocortical [spino-thalamo-cortical, STC] pathway, the medial lemniscus and its thalamocortical [medial lemnisco-thalamo-cortical, MLTC] pathway) were assessed based on diffusion tensor tractography. Regression models were further applied to detect the association of FA values with the severity of DPN in diabetic patients.Results: The mean FA values of left STC and left MLTC pathways were significantly lower in patients with DPN than those without DPN and controls. Moreover, FA values of left STC and left MLTC pathways were significantly associated with the severity of DPN (expressed as Toronto Clinical Scoring System values) in patients after adjusting for multiple confounders.Conclusion: Our findings demonstrated the axonal degeneration of central somatosensory tracts in type 2 diabetic patients with DPN. The parallel disease progression of the intracranial and extracranial somatosensory system merits further attention to the central nerves in diabetic patients with DPN.