He Miao, Yang Jiaying, Liu Xueqing, Zhou Jiamin, Zhang Xuewei, Li Jing, Shao Xiali, Li Wenhui, Guan Yuzhou, Zhang Weihong, Feng Feng
Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuai fu yuan, Dong Cheng district, Beijing, 100000, China.
Department of Interventional Radiology, Emergency General Hospital, Beijing, 100020, China.
Metab Brain Dis. 2025 May 31;40(5):216. doi: 10.1007/s11011-025-01643-5.
We investigates changes in brain volume and cortical thickness in patients with type 2 diabetes mellitus (T2DM) and peripheral neuropathy (DPN), particularly those with neuropathic pain. 105 participants were divided into three groups: T2DM (n = 26), T2DM with DPN (n = 42), and healthy controls (HCs, n = 37). The DPN group was further divided into painless (n = 22) and painful (n = 20) subgroups. Participants underwent clinical neuropsychological testing, electromyography, and brain MRI scans. Voxel-based morphometry was used to analyze gray matter volume (GMV) and cortical thickness. Associations between morphological changes and clinical/neuropsychological indicators were assessed. Average cortical thickness of the three patient subgroups was significantly reduced compared to the HCs. GMV loss in the DPN_ pain group was confined to the cerebellum, right putamen/pallidum, and caudate, while GMV increased in the brainstem. Multiple regression analysis showed correlations between brain regions and factors such as cholesterol levels, neuropathic pain severity, and nerve amplitudes (P < 0.001). The volume of right lateral geniculate nucleus volume was linked to the DN4 score (r = 0.593, P = 0.015) and onset age (r = -0.541, P = 0.031). Specific brain regions and the cortices are more vulnerable to the effects of neuropathic pain and peripheral nerve damage.
我们研究了2型糖尿病（T2DM）合并周围神经病变（DPN）患者，尤其是伴有神经性疼痛患者的脑容量和皮质厚度变化。105名参与者被分为三组：T2DM组（n = 26）、T2DM合并DPN组（n = 42）和健康对照组（HCs，n = 37）。DPN组进一步分为无痛亚组（n = 22）和疼痛亚组（n = 20）。参与者接受了临床神经心理学测试、肌电图检查和脑部MRI扫描。基于体素的形态学测量用于分析灰质体积（GMV）和皮质厚度。评估形态学变化与临床/神经心理学指标之间的关联。与健康对照组相比，三个患者亚组的平均皮质厚度均显著降低。DPN疼痛组的GMV损失局限于小脑、右侧壳核/苍白球和尾状核，而脑干的GMV增加。多元回归分析显示脑区与胆固醇水平、神经性疼痛严重程度和神经振幅等因素之间存在相关性（P < 0.001）。右侧外侧膝状体核体积与DN4评分（r = 0.593，P = 0.015）和发病年龄（r = -0.541，P = 0.031）相关。特定脑区和皮质更容易受到神经性疼痛和周围神经损伤的影响。
