Decreased microstructural integrity of the central somatosensory tracts in diabetic peripheral neuropathy.

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.To detect the microstructure of central somatosensory tracts in type 2 diabetic patients and to correlate it with the severity of DPN.Case-control study.Tertiary referral hospital.Fifty-seven subjects with type 2 diabetes (25 with DPN, 32 without DPN) and thirty-three nondiabetic controls.None.The fractional anisotropy (FA) values of two 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.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.Our findings demonstrated the axonal degeneration of central somatosensory tracts in type 2 diabetic patients with DPN. The parallel disease progression of the intra- and extracranial somatosensory system merits further attention to the central nerves in diabetic patients with DPN.



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Authors: Fang Fang, Qian Luo, Ren-Bin Ge, Meng-Yu Lai, Yu-Jia Gong, Mei Kang, Ming-Ming Ma, Lei Zhang, Yao Li, Yu-Fan Wang, Yong-De Peng