Vamadevan Sruthi, Saxena Sudhir, Kumar Mritunjay, Nandolia Khanak
Department of General Medicine, AIIMS Rishikesh, Uttarakhand, India.
Neurol India. 2025 Jul 1;73(4):746-751. doi: 10.4103/neurol-india.Neurol-India-D-24-00258. Epub 2025 Jul 24.
Diabetic myelopathy is the pathological changes in the spinal cord due to diabetes. Despite extensive histopathological evidence supporting spinal cord atrophy, only two in vivo studies have reported radiological spinal cord atrophy, without any electrophysiological correlation, in diabetic patients.
Our study aims to determine the radiological and electrophysiological patterns of spinal cord involvement in patients with and without nerve conduction study-proven neuropathy.
A cross-sectional analytical study was conducted on all consenting type 2 diabetic patients, 18-65 years old, admitted to our diabetic ward after executing stringent inclusion and exclusion criteria. After screening and categorizing the patients for neuropathy via clinical and electrophysiological methods, the patients were subjected to magnetic resonance imaging of the cervical spine and somatosensory evoked potential to trace radiological and electrophysiological evidence of spinal cord involvement and also to make a comparison between neuropathy and non-neuropathy subjects.
We demonstrated significant radiological spinal cord atrophy (P value 0.006) and electrophysiological slowing of conduction velocities within the spinal cord (P value <0.001) in patients with diabetic neuropathy as compared to diabetic patients without neuropathy. Furthermore, the post hoc analysis suggested a significant association of the severity of neuropathy with the severity of myelopathy (χ2 11.927, P value 0.003) and glycemic status (χ2 7.564, P value 0.023).
The study demonstrates significant radiological and electrophysiological spinal cord involvement in diabetic neuropathy patients than in non-neuropathy patients. The severity of spinal cord involvement is associated with the severity of neuropathy.
糖尿病性脊髓病是糖尿病导致的脊髓病理改变。尽管有大量组织病理学证据支持脊髓萎缩，但仅有两项体内研究报道了糖尿病患者的脊髓萎缩影像学表现，且未进行任何电生理相关性分析。
我们的研究旨在确定有和没有经神经传导研究证实的神经病变的糖尿病患者脊髓受累的影像学和电生理模式。
对所有符合条件的2型糖尿病患者进行横断面分析研究，这些患者年龄在18至65岁之间，在执行严格的纳入和排除标准后入住我们的糖尿病病房。通过临床和电生理方法对患者进行神经病变筛查和分类后，对患者进行颈椎磁共振成像和体感诱发电位检查，以追踪脊髓受累的影像学和电生理证据，并比较神经病变患者和非神经病变患者。
与无神经病变的糖尿病患者相比，我们发现糖尿病神经病变患者存在显著的脊髓萎缩影像学表现（P值为0.006）和脊髓内传导速度的电生理减慢（P值<0.001）。此外，事后分析表明神经病变的严重程度与脊髓病的严重程度（χ2为•11.927，P值为0.003）和血糖状态（χ2为7.564，P值为0.023）之间存在显著关联。
该研究表明糖尿病神经病变患者的脊髓受累在影像学和电生理方面比非神经病变患者更显著。脊髓受累的严重程度与神经病变的严重程度相关。
