Chitneni Ahish, Rupp Adam, Ghorayeb Joe, Abd-Elsayed Alaa
Department of Rehabilitation and Regenerative Medicine, NewYork-Presbyterian Hospital-Columbia and Cornell, New York, NY 10065, USA.
Department of Physical Medicine and Rehabilitation, University of Kansas Health System, Kansas City, MO 66160, USA.
Brain Sci. 2022 Apr 26;12(5):557. doi: 10.3390/brainsci12050557.
With the significant rise in the prevalence of diabetes worldwide, diabetic peripheral neuropathy (DPN) remains the most common complication among type 1 and 2 diabetics. The adverse sequelae of DPN, which include neuropathic pain, diabetic foot ulcers and lower-limb amputations, significantly impact quality of life and are major contributors to the biopsychosocial and economic burden of diabetes at the individual, societal and health system levels. Because DPN is often diagnosed in the late stages of disease progression by electromyography (EMG), and neuropathic pain as a result of DPN is difficult to treat, the need for earlier detection is crucial to better ascertain and manage the condition. Among the various modalities available to aid in the early detection of DPN, functional magnetic resonance imaging (fMRI) has emerged as a practical tool in DPN imaging due to its noninvasive radiation-free nature and its ability to relate real-time functional changes reflecting the local oxygen consumption of regions of the CNS due to external stimuli. This review aims to summarize the current body of knowledge regarding the utility of fMRI in detecting DPN by observing central nervous system (CNS) activity changes among individuals with DPN when compared to controls. The evidence to date points toward a tendency for increased activity in various central neuroanatomical structures that can be detected by fMRI and positively correlates with diabetic neuropathic pain.
随着全球糖尿病患病率的显著上升，糖尿病周围神经病变（DPN）仍然是1型和2型糖尿病患者中最常见的并发症。DPN的不良后果包括神经性疼痛、糖尿病足溃疡和下肢截肢，这些后果显著影响生活质量，并且是个人、社会和卫生系统层面糖尿病生物心理社会和经济负担的主要促成因素。由于DPN通常在疾病进展的晚期通过肌电图（EMG）进行诊断，并且DPN导致的神经性疼痛难以治疗，因此早期检测对于更好地确定和管理病情至关重要。在有助于早期检测DPN的各种方法中，功能磁共振成像（fMRI）由于其无创、无辐射的特性以及能够关联反映中枢神经系统（CNS）区域因外部刺激而产生的局部氧消耗的实时功能变化，已成为DPN成像的一种实用工具。本综述旨在通过观察DPN患者与对照组相比中枢神经系统（CNS）活动的变化，总结目前关于fMRI在检测DPN中的效用的知识体系。迄今为止的证据表明，fMRI可以检测到各种中枢神经解剖结构的活动有增加的趋势，并且与糖尿病神经性疼痛呈正相关。
