Hansen Tine Maria, Muthulingam Janusiya Anajan, Brock Birgitte, Drewes Asbjørn Mohr, Juhl Anne, Vorum Henrik, Jakobsen Poul Erik, Karmisholt Jesper, Brock Christina, Frøkjær Jens Brøndum
Mech-Sense, Department of Radiology, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Søndre Skovvej 15, 9000, Aalborg, Denmark.
Steno Diabetes Center Copenhagen, Niels Steensens Vej 6, 2820, Gentofte, Denmark.
Neurosci Res. 2022 Mar;176:66-72. doi: 10.1016/j.neures.2021.10.002. Epub 2021 Oct 14.
In this study we investigated brain morphology in adults with diabetic neuropathy. We aimed to characterize gray matter volume (GMV) and cortical thickness, and to explore associations between whole brain morphology and clinical characteristics. 46 adults with type 1 diabetes and distal symmetric peripheral neuropathy (DSPN) and 28 healthy controls underwent magnetic resonance imaging scans. GMV and cortical thickness were estimated using voxel-/surface-based morphometry. Associations between total GMV and clinical characteristics were explored. Adults with DSPN had reduced total GMV compared with controls (627.4 ± 4.1 mL vs. 642.5 ± 5.2 mL, P = 0.026). GMV loss was more pronounced for participants with painful neuropathy compared with controls (619.1±8.9 mL vs. 642.4±5.2 mL, P = 0.026) and for those with proliferative vs. non-proliferative retinopathy (609.9 ± 6.8 mL vs. 636.0 ± 4.7 mL, P = 0.003). Characteristics such as severity of neuropathy and decreased parietal N-acetylaspartate/creatine metabolite concentration seem to be related to GMV loss in this cohort. Regional GMV loss was confined to bilateral thalamus/putamen/caudate, occipital and precentral regions, and decreased cortical thickness was identified in frontal areas. Since the observed total GMV loss influenced with clinical characteristics, brain imaging could be useful for supplementary characterization of diabetic neuropathy. The regional brain changes could suggest that some areas are more vulnerable in this cohort.
在本研究中，我们调查了患有糖尿病性神经病变的成年人的脑形态。我们旨在描述灰质体积（GMV）和皮质厚度的特征，并探讨全脑形态与临床特征之间的关联。46名患有1型糖尿病和远端对称性周围神经病变（DSPN）的成年人以及28名健康对照者接受了磁共振成像扫描。使用基于体素/表面的形态测量法估计GMV和皮质厚度。探讨了总GMV与临床特征之间的关联。与对照组相比，患有DSPN的成年人总GMV减少（627.4±4.1 mL对642.5±5.2 mL，P = 0.026）。与对照组相比，患有疼痛性神经病变的参与者（619.1±8.9 mL对642.4±5.2 mL，P = 0.026）以及患有增殖性与非增殖性视网膜病变的参与者（609.9±6.8 mL对636.0±4.7 mL，P = 0.003）的GMV损失更为明显。在该队列中，神经病变的严重程度以及顶叶N-乙酰天门冬氨酸/肌酸代谢物浓度降低等特征似乎与GMV损失有关。局部GMV损失局限于双侧丘脑/壳核/尾状核、枕叶和中央前回区域，并且在额叶区域发现皮质厚度降低。由于观察到的总GMV损失受临床特征影响，脑成像可能有助于对糖尿病性神经病变进行补充特征描述。局部脑变化可能表明在该队列中某些区域更易受损。
