Department of Radiology, Aalborg University Hospital, Hobrovej Aalborg, Denmark.
Steno Diabetes Center North Denmark, Aalborg University Hospital, Mølleparkvej Aalborg, Denmark.
Exp Clin Endocrinol Diabetes. 2022 Nov;130(11):730-739. doi: 10.1055/a-1835-1877. Epub 2022 Jun 3.
This study investigated brain structure in patients of type 1 diabetes with diabetic peripheral neuropathy (DPN) and type 1 diabetes with neuropathic pain and the associations to clinical, peripheral, and cognitive measurements.
Sixty individuals with type 1 diabetes and 20 healthy controls were included in the study. Nineteen individuals with type 1 diabetes and neuropathic pain, 19 with type 1 diabetes and DPN, 18 with type 1 diabetes without DPN, and 20 healthy controls were included in the brain analyses. We utilized structural brain magnetic resonance imaging to investigate total and regional gray matter volume.
Significant lower gray matter volume was found in type 1 diabetes with neuropathic pain and in type 1 diabetes without DPN compared to healthy controls (=0.024 and =0.019, respectively). Lower insula volume was observed in all three diabetes groups (all ≤0.050). Thalamus and hippocampus volume was lower in type 1 diabetes with neuropathic pain, cerebellum volume was lower in type 1 diabetes with DPN, and somatosensory cortex volume was lower in type 1 diabetes without DPN (all ≤0.018). Attenuated memory was associated with lower gray matter volume in type 1 diabetes with DPN. No associations were found between gray matter volume and clinical/peripheral measurements.
We demonstrated lower gray matter volume in individuals with type 1 diabetes regardless of the presence of DPN and neuropathic pain. Hence, central gray matter alteration was not associated with peripheral alterations.
本研究旨在探讨伴有糖尿病周围神经病变（DPN）和伴有神经痛的 1 型糖尿病患者的脑结构，并分析其与临床、周围和认知测量的关系。
本研究纳入了 60 名 1 型糖尿病患者和 20 名健康对照者。19 名伴有神经痛的 1 型糖尿病患者、19 名伴有 DPN 的 1 型糖尿病患者、18 名无 DPN 的 1 型糖尿病患者和 20 名健康对照者纳入了脑分析。我们利用结构脑磁共振成像来研究全脑和各脑区的灰质体积。
与健康对照组相比，伴有神经痛的 1 型糖尿病患者和无 DPN 的 1 型糖尿病患者的灰质体积显著降低（=0.024 和=0.019）。所有三组糖尿病患者的脑岛体积均较低（均≤0.050）。伴有神经痛的 1 型糖尿病患者的丘脑和海马体积较低，伴有 DPN 的 1 型糖尿病患者的小脑体积较低，无 DPN 的 1 型糖尿病患者的躯体感觉皮层体积较低（均≤0.018）。记忆减退与伴有 DPN 的 1 型糖尿病患者的灰质体积降低有关。灰质体积与临床/周围测量值之间无相关性。
无论是否存在 DPN 和神经痛，我们都发现 1 型糖尿病患者的灰质体积降低。因此，中枢灰质改变与周围改变无关。
