Croosu Suganthiya S, Røikjer Johan, Mørch Carsten D, Ejskjaer Niels, Frøkjær Jens B, Hansen Tine M
Department of Radiology, Aalborg University Hospital, Aalborg, Denmark.
Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark.
Diabetes Care. 2023 Jan 1;46(1):173-182. doi: 10.2337/dc22-0587.
In this study we aimed to investigate the functional connectivity of brain regions involved in sensory processing in diabetes with and without painful and painless diabetic peripheral neuropathy (DPN) and the association with peripheral nerve function and pain intensity.
In this cross-sectional study we used resting-state functional MRI (fMRI) to investigate functional brain connectivity of 19 individuals with type 1 diabetes and painful DPN, 19 with type 1 diabetes and painless DPN, 18 with type 1 diabetes without DPN, and 20 healthy control subjects. Seed-based connectivity analyses were performed for thalamus, postcentral gyrus, and insula, and the connectivity z scores were correlated with peripheral nerve function measurements and pain scores.
Overall, compared with those with painful DPN and healthy control subjects, subjects with type 1 diabetes without DPN showed hyperconnectivity between thalamus and motor areas and between postcentral gyrus and motor areas (all P ≤ 0.029). Poorer peripheral nerve functions and higher pain scores were associated with lower connectivity of the thalamus and postcentral gyrus (all P ≤ 0.043). No connectivity differences were found in insula (all P ≥ 0.071).
Higher functional connectivity of thalamus and postcentral gyrus appeared only in diabetes without neuropathic complications. Thalamic/postcentral gyral connectivity measures demonstrated an association with peripheral nerve functions. Based on thalamic connectivity, it was possible to group the phenotypes of type 1 diabetes with painful/painless DPN and type 1 diabetes without DPN. The results of the current study support that fMRI can be used for phenotyping, and with validation, it may contribute to early detection and prevention of neuropathic complications.
在本研究中，我们旨在调查患有和未患有疼痛性及无痛性糖尿病周围神经病变（DPN）的糖尿病患者中参与感觉处理的脑区的功能连接性，以及其与周围神经功能和疼痛强度的关联。
在这项横断面研究中，我们使用静息态功能磁共振成像（fMRI）来研究19例1型糖尿病伴疼痛性DPN患者、19例1型糖尿病伴无痛性DPN患者、18例1型糖尿病无DPN患者以及20名健康对照者的脑功能连接性。对丘脑、中央后回和脑岛进行基于种子点的连接性分析，并将连接性z分数与周围神经功能测量值和疼痛评分进行相关性分析。
总体而言，与疼痛性DPN患者和健康对照者相比，1型糖尿病无DPN患者在丘脑与运动区之间以及中央后回与运动区之间表现出高连接性（所有P≤0.029）。较差的周围神经功能和较高的疼痛评分与丘脑和中央后回较低的连接性相关（所有P≤0.043）。在脑岛未发现连接性差异（所有P≥0.071）。
丘脑和中央后回较高的功能连接性仅出现在无神经病变并发症的糖尿病患者中。丘脑/中央后回连接性测量结果显示与周围神经功能有关联。基于丘脑连接性，可以将1型糖尿病伴疼痛性/无痛性DPN和1型糖尿病无DPN的表型进行分组。本研究结果支持fMRI可用于表型分析，经验证后，它可能有助于早期发现和预防神经病变并发症。
