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延缓糖尿病所致脑神经病变影响的非药物干预措施综述

Review of nonpharmacological interventions for delaying the effects of cerebral neuropathy caused by diabetes.

作者信息

Lee Chi, Lai Chien-Wen, Wu Guan-Lin, Yen Shaoyu, Huang Chih-Mao, Liu Zong-Hsin, Hu Po-Chi, Liao Lun-De

机构信息

Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Miaoli,, Taiwan.

Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan.

出版信息

Front Endocrinol (Lausanne). 2025 Aug 27;16:1621448. doi: 10.3389/fendo.2025.1621448. eCollection 2025.

Abstract

Diabetic peripheral neuropathy (DPN) is a debilitating complication of diabetes that affects nearly half of diabetic patients and manifests as chronic pain, sensory loss, and motor dysfunction. The limited efficacy of traditional pharmacological treatments, coupled with their side effects, has intensified the search for alternative therapies that not only mitigate symptoms but also delay the progression of diabetes-related neural complications. In this review, the potential of transcranial magnetic stimulation (TMS) as a nonpharmacological intervention for DPN is explored, with a focus on the ability of TMS to delay neural inflammation-a key factor in the progression of DPN-rather than directly treating diabetes. TMS has shown promising results in alleviating neuropathic pain, promoting nerve regeneration, and regulating autonomic nervous function, making it a strong candidate for delaying adverse neural outcomes. Other neuromodulation techniques, such as spinal cord stimulation (SCS), decompression nerve surgery (DNS), and transcranial direct current stimulation (tDCS), have also been examined for their efficacy in treating DPN. While TMS has significant therapeutic potential for protecting neural function and delaying inflammation, further research is needed to optimize treatment protocols and understand their long-term benefits. This review emphasizes the translational potential of neuromodulation technologies in delaying the progression of diabetes-induced neural damage, underscoring the need for further studies to translate these therapies into clinical practice.

摘要

糖尿病周围神经病变(DPN)是糖尿病一种使人衰弱的并发症,影响近半数糖尿病患者,表现为慢性疼痛、感觉丧失和运动功能障碍。传统药物治疗效果有限,且伴有副作用,这促使人们加紧寻找替代疗法,这些疗法不仅能缓解症状,还能延缓糖尿病相关神经并发症的进展。在本综述中,探讨了经颅磁刺激(TMS)作为DPN非药物干预手段的潜力,重点关注TMS延缓神经炎症(DPN进展的关键因素)的能力,而非直接治疗糖尿病。TMS在缓解神经病理性疼痛、促进神经再生和调节自主神经功能方面已显示出有前景的结果,使其成为延缓不良神经结局的有力候选方法。其他神经调节技术,如脊髓刺激(SCS)、减压神经手术(DNS)和经颅直流电刺激(tDCS),也已针对其治疗DPN的疗效进行了研究。虽然TMS在保护神经功能和延缓炎症方面具有显著的治疗潜力,但仍需要进一步研究来优化治疗方案并了解其长期益处。本综述强调了神经调节技术在延缓糖尿病性神经损伤进展方面的转化潜力,突出了进一步研究以将这些疗法转化为临床实践的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e16/12420265/04f62e9e33b5/fendo-16-1621448-g001.jpg

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