Skip to main content
Erschienen in: Current Diabetes Reports 4/2013

01.08.2013 | Microvascular Complications-Neuropathy (D Ziegler, Section Editor)

Magnetic Resonance Imaging of the Central Nervous System in Diabetic Neuropathy

verfasst von: Iain D. Wilkinson, Dinesh Selvarajah, Marni Greig, Pallai Shillo, Elaine Boland, Rajiv Gandhi, Solomon Tesfaye

Erschienen in: Current Diabetes Reports | Ausgabe 4/2013

Einloggen, um Zugang zu erhalten

Abstract

Diabetic ‘peripheral’ neuropathy (DPN) is one of the common sequelae to the development of both type-1 and type-2 diabetes mellitus. Neuropathy has a major negative impact on quality of life. Abnormalities in both peripheral vasculature and nerve function are well documented and, in addition, evidence is emerging regarding changes within the central nervous system (CNS) that are concomitant with the presence of DPN. The often-resistant nature of DPN to medical treatment highlights the need to understand the role of the CNS in neuropathic symptomatology and progression, as this may modulate therapeutic approaches. Advanced neuroimaging techniques, especially those that can provide quantitative measures of structure and function, can provide objective markers of CNS status. With that comes great potential for not only furthering our understanding of involvement of the CNS in neuropathic etiology but also most importantly aiding the development of new and more effective, targeted, analgesic interventions.
Literatur
1.
Zurück zum Zitat Tesfaye S. Advances in the management of painful diabetic neuropathy. Curr Opin Support Palliat Care. 2009;3:136–43.PubMedCrossRef Tesfaye S. Advances in the management of painful diabetic neuropathy. Curr Opin Support Palliat Care. 2009;3:136–43.PubMedCrossRef
2.
Zurück zum Zitat Daousi C, MacFarlane IA, Woodward A, et al. Chronic painful peripheral neuropathy in an urban community: a controlled comparison of people with and without diabetes. Diabet Med. 2004;21:976–82.PubMedCrossRef Daousi C, MacFarlane IA, Woodward A, et al. Chronic painful peripheral neuropathy in an urban community: a controlled comparison of people with and without diabetes. Diabet Med. 2004;21:976–82.PubMedCrossRef
3.
Zurück zum Zitat Davies M, Brophy S, Williams R, Taylor A. The prevalence, severity, and impact of painful diabetic peripheral neuropathy in type 2 diabetes. Diabetes Care. 2006;29:1518–22.PubMedCrossRef Davies M, Brophy S, Williams R, Taylor A. The prevalence, severity, and impact of painful diabetic peripheral neuropathy in type 2 diabetes. Diabetes Care. 2006;29:1518–22.PubMedCrossRef
4.
Zurück zum Zitat Gore M, Brandenburg N, Dukes, et al. Pain severity in diabetic peripheral neuropathy is associated with patient functioning, symptom levels of anxiety and depression, and sleep. J Pain Symptoms Manage. 2005;30:374–85.CrossRef Gore M, Brandenburg N, Dukes, et al. Pain severity in diabetic peripheral neuropathy is associated with patient functioning, symptom levels of anxiety and depression, and sleep. J Pain Symptoms Manage. 2005;30:374–85.CrossRef
5.
Zurück zum Zitat Zelman DC, Brandenburg NA, Gore M. Sleep impairment in patients with painful diabetic peripheral neuropathy. Clin J Pain. 2006;22:681–5.PubMedCrossRef Zelman DC, Brandenburg NA, Gore M. Sleep impairment in patients with painful diabetic peripheral neuropathy. Clin J Pain. 2006;22:681–5.PubMedCrossRef
6.
Zurück zum Zitat Galer BS, Gianas A, Jensen MP. Painful diabetic polyneuropathy: epidemiology, pain description, and quality of life. Diabetes Res Clin Pract. 2000;47(2):123–8.PubMedCrossRef Galer BS, Gianas A, Jensen MP. Painful diabetic polyneuropathy: epidemiology, pain description, and quality of life. Diabetes Res Clin Pract. 2000;47(2):123–8.PubMedCrossRef
7.
Zurück zum Zitat Gore M, Brandenburg N, Hoffman DL, et al. Burden of illness in painful diabetic peripheral neuropathy: the patients’ perspectives. J Pain. 2006;7(12):982–900. Gore M, Brandenburg N, Hoffman DL, et al. Burden of illness in painful diabetic peripheral neuropathy: the patients’ perspectives. J Pain. 2006;7(12):982–900.
8.
Zurück zum Zitat Quattrini C, Tesfaye S. Understanding the impact of painful diabetic neuropathy. Diabetes Metab Res Rev. 2003;19:S2–8.PubMedCrossRef Quattrini C, Tesfaye S. Understanding the impact of painful diabetic neuropathy. Diabetes Metab Res Rev. 2003;19:S2–8.PubMedCrossRef
9.
Zurück zum Zitat Jensen T, Baconja MM, Jimenez H, Tesfaye S, Valensi P, Ziegler. Management of diabetic neuropathic pain. Diab Vas Dis Res. 2006;3:108–19.CrossRef Jensen T, Baconja MM, Jimenez H, Tesfaye S, Valensi P, Ziegler. Management of diabetic neuropathic pain. Diab Vas Dis Res. 2006;3:108–19.CrossRef
10.
Zurück zum Zitat Tesfaye S, Vileikyte L, Rayman G, et al on behalf of the Toronto Expert Panel on diabetic neuropathy painful diabetic peripheral neuropathy: consensus recommendations on diagnosis, assessment and management. Diabetes Metab Res Rev. 2011. [Epub ahead of print]. Tesfaye S, Vileikyte L, Rayman G, et al on behalf of the Toronto Expert Panel on diabetic neuropathy painful diabetic peripheral neuropathy: consensus recommendations on diagnosis, assessment and management. Diabetes Metab Res Rev. 2011. [Epub ahead of print].
11.
Zurück zum Zitat Lukic IK, Humpert PM, Nawroth PP, Bierhaus A. The RAGE pathway: activation and perpetuation in the pathogenesis of diabetic neuropathy. Ann N Y Acad Sci. 2008;1126:76–80.PubMedCrossRef Lukic IK, Humpert PM, Nawroth PP, Bierhaus A. The RAGE pathway: activation and perpetuation in the pathogenesis of diabetic neuropathy. Ann N Y Acad Sci. 2008;1126:76–80.PubMedCrossRef
12.
Zurück zum Zitat Obrosova IG. Diabetic painful and insensate neuropathy: pathogenesis and potential treatments. Neurotherapeutics. 2009;6:638–47.PubMedCrossRef Obrosova IG. Diabetic painful and insensate neuropathy: pathogenesis and potential treatments. Neurotherapeutics. 2009;6:638–47.PubMedCrossRef
13.
Zurück zum Zitat Vincent AM, Callaghan BC, Smith AL, Feldman EL. Diabetic neuropathy: cellular mechanisms as therapeutic targets. Nat Rev Neurol. 2011;7:573–83.PubMedCrossRef Vincent AM, Callaghan BC, Smith AL, Feldman EL. Diabetic neuropathy: cellular mechanisms as therapeutic targets. Nat Rev Neurol. 2011;7:573–83.PubMedCrossRef
14.
Zurück zum Zitat Said G, Slama G, Selva J. Progressive centripital degeneration of axons in small-fiber type diabetic polyneuropathy. A clinical and pathological study. Brain. 1983;106:791.PubMedCrossRef Said G, Slama G, Selva J. Progressive centripital degeneration of axons in small-fiber type diabetic polyneuropathy. A clinical and pathological study. Brain. 1983;106:791.PubMedCrossRef
15.
Zurück zum Zitat Malik RA, Newrick PG, Sharma AK, et al. Microangiopathy in human diabetic neuropathy: relationship between capillary abnormalities and the severity of neuropathy. Diabetologia. 1989;32:92–102.PubMedCrossRef Malik RA, Newrick PG, Sharma AK, et al. Microangiopathy in human diabetic neuropathy: relationship between capillary abnormalities and the severity of neuropathy. Diabetologia. 1989;32:92–102.PubMedCrossRef
16.
Zurück zum Zitat Tesfaye S, Malik R, Ward JD. Vascular factors in diabetic neuropathy. Diabetologia. 1994;37:847–54.PubMedCrossRef Tesfaye S, Malik R, Ward JD. Vascular factors in diabetic neuropathy. Diabetologia. 1994;37:847–54.PubMedCrossRef
17.
Zurück zum Zitat Malik RA, Tesfaye S, Thompson SD, et al. Endoneurial localisation of microvascular damage in human diabetic neuropathy. Diabetologia. 1993;36:454–9.PubMedCrossRef Malik RA, Tesfaye S, Thompson SD, et al. Endoneurial localisation of microvascular damage in human diabetic neuropathy. Diabetologia. 1993;36:454–9.PubMedCrossRef
18.
Zurück zum Zitat Malik RA, Tesfaye S, Thompson SD, et al. Transperineurial capillary abnormalities in the sural nerve of patients with diabetic neuropathy. Microvasc Res. 1994;48:236–45.PubMedCrossRef Malik RA, Tesfaye S, Thompson SD, et al. Transperineurial capillary abnormalities in the sural nerve of patients with diabetic neuropathy. Microvasc Res. 1994;48:236–45.PubMedCrossRef
19.
Zurück zum Zitat Giannini C, Dyck PJ. Ultrastructural morphometric abnormalities of sural nerve endoneurial microvessels in diabetes mellitus. Ann Neurol. 1994;36:408–15.PubMedCrossRef Giannini C, Dyck PJ. Ultrastructural morphometric abnormalities of sural nerve endoneurial microvessels in diabetes mellitus. Ann Neurol. 1994;36:408–15.PubMedCrossRef
20.
Zurück zum Zitat Ferguson SC, Blane A, Perros P, McCrimmon RJ, Best JJ, Wardlaw J, et al. Cognitive ability and brain structure in type 1 diabetes: relation to microangiopathy and preceding severe hypoglycemia. Diabetes. 2003;52:149–56.PubMedCrossRef Ferguson SC, Blane A, Perros P, McCrimmon RJ, Best JJ, Wardlaw J, et al. Cognitive ability and brain structure in type 1 diabetes: relation to microangiopathy and preceding severe hypoglycemia. Diabetes. 2003;52:149–56.PubMedCrossRef
21.
Zurück zum Zitat Manschot SM, Brands AM, van der Grond J, et al. Utrecht Diabetic Encephalopathy Study Group. Brain magnetic resonance imaging correlates of impaired cognition in patients with type 2 diabetes. Diabetes. 2006;55:1106–13.PubMedCrossRef Manschot SM, Brands AM, van der Grond J, et al. Utrecht Diabetic Encephalopathy Study Group. Brain magnetic resonance imaging correlates of impaired cognition in patients with type 2 diabetes. Diabetes. 2006;55:1106–13.PubMedCrossRef
22.
Zurück zum Zitat Reske-Neilsen E, Lundbaek K, Rafaelsen OJ. Pathological changes in the central and peripheral nervous system of young long-term diabetics: II. Spinal cord and peripheral nerve. Diabetologia. 1968;4:34–43.CrossRef Reske-Neilsen E, Lundbaek K, Rafaelsen OJ. Pathological changes in the central and peripheral nervous system of young long-term diabetics: II. Spinal cord and peripheral nerve. Diabetologia. 1968;4:34–43.CrossRef
23.
Zurück zum Zitat Slager UT. Diabetic myelopathy. Arch Pathol Lab Med. 1978;102:467–9.PubMed Slager UT. Diabetic myelopathy. Arch Pathol Lab Med. 1978;102:467–9.PubMed
24.
Zurück zum Zitat Lauterbur PC. Image formation by induced local interactions: examples employing NMR. Nature. 1973;242:190–1.CrossRef Lauterbur PC. Image formation by induced local interactions: examples employing NMR. Nature. 1973;242:190–1.CrossRef
25.
Zurück zum Zitat Wilkinson ID, Paley MNJ. Magnetic resonance imaging: basic principles, Chapter 4. In: Grainger A, Adam D, editors. Diagnostic radiology: a textbook of medical imaging. 5th ed. Churchill Livingstone; 2007. Philadelphia, USA. Wilkinson ID, Paley MNJ. Magnetic resonance imaging: basic principles, Chapter 4. In: Grainger A, Adam D, editors. Diagnostic radiology: a textbook of medical imaging. 5th ed. Churchill Livingstone; 2007. Philadelphia, USA.
26.
Zurück zum Zitat Ogawa S, Tank DW, Menon R, et al. Intrinsic signal changes accompanying sensory stimulation: functional brain mapping with magnetic resonance imaging. Proc Natl Acad Sci U S A. 1992;89:5951–5.PubMedCrossRef Ogawa S, Tank DW, Menon R, et al. Intrinsic signal changes accompanying sensory stimulation: functional brain mapping with magnetic resonance imaging. Proc Natl Acad Sci U S A. 1992;89:5951–5.PubMedCrossRef
27.
Zurück zum Zitat Boguslawska R, Romanowski CAJ, Wilkinson ID, et al. Introduction to functional magnetic resonance imaging. Med Sci Monit. 1999;5:1179–86. Boguslawska R, Romanowski CAJ, Wilkinson ID, et al. Introduction to functional magnetic resonance imaging. Med Sci Monit. 1999;5:1179–86.
28.
Zurück zum Zitat Wilkinson ID. Perfusion and diffusion imaging in chronic carotid disease, Chapter 19. In: Gillard, Waldman, Barker, editors. Clinical MR neuroimaging: physiological and functional techniques. Cambridge University Press; Cambridge, UK, 2010. Wilkinson ID. Perfusion and diffusion imaging in chronic carotid disease, Chapter 19. In: Gillard, Waldman, Barker, editors. Clinical MR neuroimaging: physiological and functional techniques. Cambridge University Press; Cambridge, UK, 2010.
29.
Zurück zum Zitat Wilkinson ID, Paley M, Chong WK, et al. Proton spectroscopy in HIV infection: relaxation times of cerebral metabolites. Magn Reson Imaging. 1994;12:951–7.PubMedCrossRef Wilkinson ID, Paley M, Chong WK, et al. Proton spectroscopy in HIV infection: relaxation times of cerebral metabolites. Magn Reson Imaging. 1994;12:951–7.PubMedCrossRef
30.
Zurück zum Zitat Wilkinson ID, Lunn S, Miszkiel KA, et al. Proton MRS and quantitative MRI assessment of the short-term neurological response to anti-retroviral therapy in AIDS. J Neurol Neurosurg Psychiatry. 1997;63:477–82.PubMedCrossRef Wilkinson ID, Lunn S, Miszkiel KA, et al. Proton MRS and quantitative MRI assessment of the short-term neurological response to anti-retroviral therapy in AIDS. J Neurol Neurosurg Psychiatry. 1997;63:477–82.PubMedCrossRef
31.
Zurück zum Zitat Puts NA, Edden RA. In vivo magnetic resonance spectroscopy of GABA: a methodological review. Prog Nucl Magn Reson Spectrosc. 2012;60:29–41.PubMedCrossRef Puts NA, Edden RA. In vivo magnetic resonance spectroscopy of GABA: a methodological review. Prog Nucl Magn Reson Spectrosc. 2012;60:29–41.PubMedCrossRef
32.
Zurück zum Zitat Jones DK, editor. Diffusion MRI: theory, methods, and applications. Oxford University Press; Oxford, UK, 2010. Jones DK, editor. Diffusion MRI: theory, methods, and applications. Oxford University Press; Oxford, UK, 2010.
33.
Zurück zum Zitat Eaton S, Harris ND, Rajbhandari SM, et al. Spinal cord involvement in diabetic peripheral neuropathy. Lancet. 2001;358:35–6.PubMedCrossRef Eaton S, Harris ND, Rajbhandari SM, et al. Spinal cord involvement in diabetic peripheral neuropathy. Lancet. 2001;358:35–6.PubMedCrossRef
34.
Zurück zum Zitat Selvarajah D, Wilkinson ID, Emery CJ, et al. Early involvement of the spinal cord in diabetic peripheral neuropathy. Diabetes Care. 2006;29:2664–9.PubMedCrossRef Selvarajah D, Wilkinson ID, Emery CJ, et al. Early involvement of the spinal cord in diabetic peripheral neuropathy. Diabetes Care. 2006;29:2664–9.PubMedCrossRef
35.
Zurück zum Zitat Suzuki C, Ozaki I, Taosaki M, et al. Peripheral and central conduction abnormalities in diabetes mellitus. Neurology. 2000;54:1932–7.PubMedCrossRef Suzuki C, Ozaki I, Taosaki M, et al. Peripheral and central conduction abnormalities in diabetes mellitus. Neurology. 2000;54:1932–7.PubMedCrossRef
36.
Zurück zum Zitat Wilkinson ID, Selvarajah D, Hutton M, Griffiths PD, Gandhi R, Tesfaye S. Imaging of the cortico-spinal tracts in diabetic neuropathy using diffusion tensor magnetic resonance. Diabetes. 2009;58 (Supp 1): A214. Wilkinson ID, Selvarajah D, Hutton M, Griffiths PD, Gandhi R, Tesfaye S. Imaging of the cortico-spinal tracts in diabetic neuropathy using diffusion tensor magnetic resonance. Diabetes. 2009;58 (Supp 1): A214.
37.
Zurück zum Zitat McCormick DA, Bal T. Sensory gating mechanisms of the thalamus. Curr Opin Neurobiol. 1994;4:550–6.PubMedCrossRef McCormick DA, Bal T. Sensory gating mechanisms of the thalamus. Curr Opin Neurobiol. 1994;4:550–6.PubMedCrossRef
38.
Zurück zum Zitat Selvarajah D, Wilkinson ID, Emery CJ, Shaw PJ, Griffiths PD, Gandhi R, et al. Thalamic neuronal dysfunction and chronic sensorimotor distal symmetrical polyneuropathy in patients with type 1 diabetes mellitus. Diabetologia. 2008;51:2088–92.PubMedCrossRef Selvarajah D, Wilkinson ID, Emery CJ, Shaw PJ, Griffiths PD, Gandhi R, et al. Thalamic neuronal dysfunction and chronic sensorimotor distal symmetrical polyneuropathy in patients with type 1 diabetes mellitus. Diabetologia. 2008;51:2088–92.PubMedCrossRef
39.
Zurück zum Zitat Gandhi R, Selvarajah D, Emery CJ, Wilkinson ID, Tesfaye S. Neurochemical abnormalities within sensory pathways in the brain in diabetic neuropathy. Diabetologia. 2008;51(Supp 1):1–588. Gandhi R, Selvarajah D, Emery CJ, Wilkinson ID, Tesfaye S. Neurochemical abnormalities within sensory pathways in the brain in diabetic neuropathy. Diabetologia. 2008;51(Supp 1):1–588.
40.
Zurück zum Zitat Sorensen L, Siddall PJ, Trenell MI, Yue DK. Differences in metabolites in pain-processing brain regions in patients with diabetes and painful neuropathy. Diabetes Care. 2008;31:980–1.PubMedCrossRef Sorensen L, Siddall PJ, Trenell MI, Yue DK. Differences in metabolites in pain-processing brain regions in patients with diabetes and painful neuropathy. Diabetes Care. 2008;31:980–1.PubMedCrossRef
41.
Zurück zum Zitat Petrou M, Pop-Busui R, Foerster BR, Edden RA, et al. Altered excitation-inhibition balance in the brain of patients with diabetic neuropathy. Acad Radiol. 2012;19:607–12.PubMedCrossRef Petrou M, Pop-Busui R, Foerster BR, Edden RA, et al. Altered excitation-inhibition balance in the brain of patients with diabetic neuropathy. Acad Radiol. 2012;19:607–12.PubMedCrossRef
42.
Zurück zum Zitat •• Selvarajah D, Wilkinson ID, Gandhi R, Griffiths PD, Tesfaye S. Microvascular perfusion abnormalities of the thalamus in painful but not painless diabetic polyneuropathy: a clue to the pathogenesis of pain in type 1 diabetes. Diabetes Care. 2011;34:718–20. Data from this preliminary study implies increased blood supply to the thalamus in patients with painful diabetic neuropathy.PubMedCrossRef •• Selvarajah D, Wilkinson ID, Gandhi R, Griffiths PD, Tesfaye S. Microvascular perfusion abnormalities of the thalamus in painful but not painless diabetic polyneuropathy: a clue to the pathogenesis of pain in type 1 diabetes. Diabetes Care. 2011;34:718–20. Data from this preliminary study implies increased blood supply to the thalamus in patients with painful diabetic neuropathy.PubMedCrossRef
43.
Zurück zum Zitat Paulson PE, Wiley JW, Morrow TJ. Concurrent activation of the somatosensory forebrain and deactivation of periacqueductal gray associated with diabetes-induced neuropathic pain. Exp Neurol. 2007;208:305–13.PubMedCrossRef Paulson PE, Wiley JW, Morrow TJ. Concurrent activation of the somatosensory forebrain and deactivation of periacqueductal gray associated with diabetes-induced neuropathic pain. Exp Neurol. 2007;208:305–13.PubMedCrossRef
44.
Zurück zum Zitat Fischer TZ, Tan AM, Waxman SG. Thalamic neuron hyperexcitability and enlarged receptive fields in the STZ model of diabetic pain. Brain Res. 2009;1268:154–61.PubMedCrossRef Fischer TZ, Tan AM, Waxman SG. Thalamic neuron hyperexcitability and enlarged receptive fields in the STZ model of diabetic pain. Brain Res. 2009;1268:154–61.PubMedCrossRef
45.
Zurück zum Zitat Melzack R. From the gate to the neuromatrix. Pain. 1999;(Suppl 6):S121–6. Melzack R. From the gate to the neuromatrix. Pain. 1999;(Suppl 6):S121–6.
46.
Zurück zum Zitat Apkarian AV, Bushnell MC, Treede RD, Zubieta JK. Human brain mechanisms of pain perception and regulation in health and disease. Eur J Pain. 2005;9:463–8.PubMedCrossRef Apkarian AV, Bushnell MC, Treede RD, Zubieta JK. Human brain mechanisms of pain perception and regulation in health and disease. Eur J Pain. 2005;9:463–8.PubMedCrossRef
47.
Zurück zum Zitat Bushnell MC, Duncan GH, Hofbauer RK, et al. Pain perception: is there a role for primary somatosensory cortex? Proc Natl Acad Sci U S A. 1999;96:7705–9.PubMedCrossRef Bushnell MC, Duncan GH, Hofbauer RK, et al. Pain perception: is there a role for primary somatosensory cortex? Proc Natl Acad Sci U S A. 1999;96:7705–9.PubMedCrossRef
48.
Zurück zum Zitat Kanda M, Nagamine T, Ikeda A, et al. Primary somatosensory cortex is actively involved in pain processing in human. Brain Res. 2000;853:282–9.PubMedCrossRef Kanda M, Nagamine T, Ikeda A, et al. Primary somatosensory cortex is actively involved in pain processing in human. Brain Res. 2000;853:282–9.PubMedCrossRef
49.
Zurück zum Zitat Peyron R, García-Larrea L, Grégoire MC, et al. Parietal and cingulate processes in central pain. A combined positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) study of an unusual case. Pain. 2000;84:77–87.PubMedCrossRef Peyron R, García-Larrea L, Grégoire MC, et al. Parietal and cingulate processes in central pain. A combined positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) study of an unusual case. Pain. 2000;84:77–87.PubMedCrossRef
50.
Zurück zum Zitat Wilkinson ID, Gandhi RA, Hunter MD, et al. Functional MRI and response to pain in diabetic neuropathy. Diabet Med. 2007;24 Suppl 1:187. Wilkinson ID, Gandhi RA, Hunter MD, et al. Functional MRI and response to pain in diabetic neuropathy. Diabet Med. 2007;24 Suppl 1:187.
51.
Zurück zum Zitat Wilkinson ID, Gandhi R, Hunter MD, et al. A functional magnetic resonance imaging study demonstrating alterations in brain responses to acute pain stimulation in diabetic neuropathy. Diabetologia. 2007;50(Supp 1):1–538. Wilkinson ID, Gandhi R, Hunter MD, et al. A functional magnetic resonance imaging study demonstrating alterations in brain responses to acute pain stimulation in diabetic neuropathy. Diabetologia. 2007;50(Supp 1):1–538.
52.
Zurück zum Zitat Tseng MT, Chiang MC, Chao CC, Tseng WY, Hsieh, ST. fMRI evidence of degeneration-induced neuropathic pain in diabetes: enhanced limbic and striatal activations. Hum Brain Mapp. 2012. [Epub ahead of print]. Tseng MT, Chiang MC, Chao CC, Tseng WY, Hsieh, ST. fMRI evidence of degeneration-induced neuropathic pain in diabetes: enhanced limbic and striatal activations. Hum Brain Mapp. 2012. [Epub ahead of print].
53.
Zurück zum Zitat • Manor B, Newton E, Abduljalil A, Novak V. The relationship between brain volume and walking outcomes in older adults with and without diabetic peripheral neuropathy. Diabetes Care. 2012;35:1907–12. In this study, patients’ walking disability is linked with the presence of intracranial brain atrophy.PubMedCrossRef • Manor B, Newton E, Abduljalil A, Novak V. The relationship between brain volume and walking outcomes in older adults with and without diabetic peripheral neuropathy. Diabetes Care. 2012;35:1907–12. In this study, patients’ walking disability is linked with the presence of intracranial brain atrophy.PubMedCrossRef
54.
Zurück zum Zitat •• Selvarajah D, Maxwell M, Davies J, et al. Diabetic neuropathy associated with increased cortical atrophy on brain MRI in patients with Type-1 Diabetes. Diabetic Med. 2013;30 Suppl 1:14. This work identifies atrophy of the somatosensory cortex in people with diabetic neuropathy. •• Selvarajah D, Maxwell M, Davies J, et al. Diabetic neuropathy associated with increased cortical atrophy on brain MRI in patients with Type-1 Diabetes. Diabetic Med. 2013;30 Suppl 1:14. This work identifies atrophy of the somatosensory cortex in people with diabetic neuropathy.
Metadaten
Titel
Magnetic Resonance Imaging of the Central Nervous System in Diabetic Neuropathy
verfasst von
Iain D. Wilkinson
Dinesh Selvarajah
Marni Greig
Pallai Shillo
Elaine Boland
Rajiv Gandhi
Solomon Tesfaye
Publikationsdatum
01.08.2013
Verlag
Springer US
Erschienen in
Current Diabetes Reports / Ausgabe 4/2013
Print ISSN: 1534-4827
Elektronische ISSN: 1539-0829
DOI
https://doi.org/10.1007/s11892-013-0394-8

Weitere Artikel der Ausgabe 4/2013

Current Diabetes Reports 4/2013 Zur Ausgabe

Microvascular Complications-Nephropathy (B Roshan, Section Editor)

Novel Biomarkers for the Progression of Diabetic Nephropathy: Soluble TNF Receptors

Microvascular Complications-Nephropathy (B Roshan, Section Editor)

Temporal Profile of Diabetic Nephropathy Pathologic Changes

Microvascular Complications-Retinopathy (JK Sun, Section Editor)

Imaging of the Parafoveal Capillary Network in Diabetes

Microvascular Complications-Nephropathy (B Roshan, Section Editor)

Emerging Roles for miRNAs in the Development, Diagnosis, and Treatment of Diabetic Nephropathy

Microvascular Complications-Neuropathy (D Ziegler, Section Editor)

New and Developing Drugs for the Treatment of Neuropathic Pain in Diabetes

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren. 

Aquatherapie bei Fibromyalgie wirksamer als Trockenübungen

03.05.2024 Fibromyalgiesyndrom Nachrichten

Bewegungs-, Dehnungs- und Entspannungsübungen im Wasser lindern die Beschwerden von Patientinnen mit Fibromyalgie besser als das Üben auf trockenem Land. Das geht aus einer spanisch-brasilianischen Vergleichsstudie hervor.

Wo hapert es noch bei der Umsetzung der POMGAT-Leitlinie?

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

Das Risiko für Vorhofflimmern in der Bevölkerung steigt

02.05.2024 Vorhofflimmern Nachrichten

Das Risiko, im Lauf des Lebens an Vorhofflimmern zu erkranken, ist in den vergangenen 20 Jahren gestiegen: Laut dänischen Zahlen wird es drei von zehn Personen treffen. Das hat Folgen weit über die Schlaganfallgefährdung hinaus.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.