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探索糖尿病性神经病变的认知影响:一项综述

Exploring the cognitive impacts of diabetic neuropathy: a comprehensive review.

作者信息

Mian Maamoon, Salehi Farhood, Patel Rishi, Tahiri Jihane, Bel-Hadj-Kacem Adam, Alhaque Ali, Eldin Ryan, Reddy P Hemachandra

机构信息

Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock 79430, TX, USA.

School of Biology, Texas Tech University, Lubbock 79430, TX, USA.

出版信息

Biochim Biophys Acta Mol Basis Dis. 2025 Aug;1871(6):167892. doi: 10.1016/j.bbadis.2025.167892. Epub 2025 May 3.

Abstract

Diabetic neuropathy (DPN) is known to affect various aspects of health, including cognitive function. This study explores how DPN influences cognitive performance and examines the interplay between DPN, gender differences, Alzheimer's Disease (AD), and the socioeconomic burden of neuropathic pain. The research involved a comprehensive review and analysis of 55 studies focusing on cognitive function in diabetic patients with and without DPN. Various cognitive assessments, including memory, processing speed, and olfactory function, were used to evaluate cognitive performance. Gender differences were analyzed in the context of cognitive impairment and neuropathic pain. Additionally, the relationship between peripheral neuropathy and AD was investigated through measures of nerve conduction velocities and amyloid protein deposits. The impact of physical and psychological factors on neuropathic pain and cognitive function was also examined. The findings indicate that diabetic patients with DPN exhibit more severe cognitive impairments compared to those without DPN and healthy controls. Cognitive deficits were particularly notable in memory and processing speed. Gender differences revealed that women with DPN experience more pronounced cognitive dysfunction and a higher incidence of painful neuropathy compared to men. Analysis of peripheral nerve conduction velocities and amyloid deposits suggested a link between neuropathy and AD. Furthermore, poor glycemic control emerged as a critical factor affecting both neuropathy and cognitive function. Psychological distress and socioeconomic factors were found to significantly influence the management and outcomes of neuropathic pain. The study underscores the complex interaction between DPN and cognitive impairment, highlighting the importance of integrated diagnostic and therapeutic approaches. The pronounced cognitive deficits in women and the link between DPN and AD emphasize the need for gender-specific and multifaceted treatment strategies. The socioeconomic impact of neuropathic pain and the role of psychological factors in exacerbating pain and cognitive decline suggest that comprehensive management plans should address both physical and mental health aspects to improve overall patient outcomes.

摘要

糖尿病性神经病变(DPN)已知会影响健康的各个方面,包括认知功能。本研究探讨DPN如何影响认知表现,并研究DPN、性别差异、阿尔茨海默病(AD)以及神经性疼痛的社会经济负担之间的相互作用。该研究对55项聚焦于有和没有DPN的糖尿病患者认知功能的研究进行了全面综述和分析。使用了包括记忆、处理速度和嗅觉功能在内的各种认知评估来评价认知表现。在认知障碍和神经性疼痛的背景下分析了性别差异。此外,通过神经传导速度测量和淀粉样蛋白沉积来研究周围神经病变与AD之间的关系。还考察了身体和心理因素对神经性疼痛和认知功能的影响。研究结果表明,与没有DPN的糖尿病患者及健康对照相比,患有DPN的糖尿病患者表现出更严重的认知障碍。记忆和处理速度方面的认知缺陷尤为明显。性别差异显示,与男性相比,患有DPN的女性经历更明显的认知功能障碍且神经性疼痛的发生率更高。对周围神经传导速度和淀粉样蛋白沉积的分析表明神经病变与AD之间存在联系。此外,血糖控制不佳成为影响神经病变和认知功能的关键因素。发现心理困扰和社会经济因素会显著影响神经性疼痛的管理和结果。该研究强调了DPN与认知障碍之间的复杂相互作用,突出了综合诊断和治疗方法的重要性。女性明显的认知缺陷以及DPN与AD之间的联系强调了针对性别和多方面治疗策略的必要性。神经性疼痛的社会经济影响以及心理因素在加剧疼痛和认知衰退中的作用表明,综合管理计划应兼顾身心健康方面以改善患者的整体预后。

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