Christoph M Mooshage, Lukas Schimpfle, Zoltan Kender, Dimitrios Tsilingiris, Taraneh Aziz-Safaie, Anja Hohmann, Julia Szendroedi, Peter Nawroth, Volker Sturm, Sabine Heiland, Martin Bendszus, Stefan Kopf, Felix T Kurz, Johann M E Jende
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This study aimed to assess associations between quantitative sensory testing (QST) and parameters of peripheral nerve perfusion obtained from dynamic contrast enhanced (DCE) magnetic resonance neurography (MRN) in type 2 diabetes patients with and without SFN.</p><p><strong>Methods: </strong>A total of 18 patients with type 2 diabetes (T2D, 8 with SFN, 10 without SFN) and 10 healthy controls (HC) took part in this cross-sectional single-center study and underwent QST of the right leg and DCE-MRN of the right thigh with subsequent calculation of the sciatic nerve constant of capillary permeability (K<sup>trans</sup>), extravascular extracellular volume fraction (V<sub>e</sub>), and plasma volume fraction (V<sub>p</sub>).</p><p><strong>Results: </strong>The K<sup>trans</sup> (HC 0.031 min<sup>-1</sup> ± 0.009, T2D 0.043 min<sup>-1</sup> ± 0.015; p = 0.033) and V<sub>e</sub> (HC 1.2% ± 1.5, T2D: 4.1% ± 5.1; p = 0.027) were lower in T2D patients compared to controls. In T2D patients, compound z‑scores of thermal and mechanical detection correlated with K<sup>trans</sup> (r = 0.73; p = 0.001, and r = 0.57; p = 0.018, respectively) and V<sub>e</sub> (r = 0.67; p = 0.002, and r = 0.69; p = 0.003, respectively). Compound z‑scores of thermal pain and V<sub>p</sub> (r = -0.57; p = 0.015) correlated negatively.</p><p><strong>Discussion: </strong>The findings suggest that parameters of peripheral nerve microcirculation are related to different symptoms in SFN: A reduced capillary permeability may result in a loss of function related to insufficient nutritional supply, whereas increased capillary permeability may be accompanied by painful symptoms related to a gain of function.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":null,"pages":null},"PeriodicalIF":2.8000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10881621/pdf/","citationCount":"0","resultStr":"{\"title\":\"Association of Small Fiber Function with Microvascular Perfusion of Peripheral Nerves in Patients with Type 2 Diabetes : Study using Quantitative Sensory Testing and Magnetic Resonance Neurography.\",\"authors\":\"Christoph M Mooshage, Lukas Schimpfle, Zoltan Kender, Dimitrios Tsilingiris, Taraneh Aziz-Safaie, Anja Hohmann, Julia Szendroedi, Peter Nawroth, Volker Sturm, Sabine Heiland, Martin Bendszus, Stefan Kopf, Felix T Kurz, Johann M E Jende\",\"doi\":\"10.1007/s00062-023-01328-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction/aims: </strong>Diabetic small fiber neuropathy (SFN) is caused by damage to thinly myelinated A‑fibers (δ) and unmyelinated C‑fibers. 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引用次数: 0
摘要
导言/目的：糖尿病小纤维神经病（SFN）是由薄髓鞘A纤维（δ）和无髓鞘C纤维损伤引起的。本研究旨在评估患有和未患有 SFN 的 2 型糖尿病患者的定量感觉测试（QST）与动态对比增强（DCE）磁共振神经成像（MRN）获得的周围神经灌注参数之间的关联：共有 18 名 2 型糖尿病患者（T2D，8 人有 SFN，10 人无 SFN）和 10 名健康对照组（HC）参加了这项横断面单中心研究，他们接受了右腿 QST 和右大腿 DCE-MRN，随后计算了坐骨神经毛细血管通透性常数（Ktrans）、血管外细胞外体积分数（Ve）和血浆体积分数（Vp）：结果：与对照组相比，T2D 患者的 Ktrans（HC 0.031 min-1 ± 0.009，T2D 0.043 min-1 ± 0.015; p = 0.033）和 Ve（HC 1.2% ± 1.5，T2D：4.1% ± 5.1; p = 0.027）较低。在 T2D 患者中，热检测和机械检测的复合 z 值与 Ktrans（分别为 r = 0.73；p = 0.001 和 r = 0.57；p = 0.018）和 Ve（分别为 r = 0.67；p = 0.002 和 r = 0.69；p = 0.003）相关。热痛和 Vp 的复合 z 值（r = -0.57；p = 0.015）呈负相关：讨论：研究结果表明，外周神经微循环参数与 SFN 的不同症状有关：毛细血管通透性降低可能导致营养供应不足引起的功能丧失，而毛细血管通透性增加可能伴随着功能增强引起的疼痛症状。
Association of Small Fiber Function with Microvascular Perfusion of Peripheral Nerves in Patients with Type 2 Diabetes : Study using Quantitative Sensory Testing and Magnetic Resonance Neurography.
Introduction/aims: Diabetic small fiber neuropathy (SFN) is caused by damage to thinly myelinated A‑fibers (δ) and unmyelinated C‑fibers. This study aimed to assess associations between quantitative sensory testing (QST) and parameters of peripheral nerve perfusion obtained from dynamic contrast enhanced (DCE) magnetic resonance neurography (MRN) in type 2 diabetes patients with and without SFN.
Methods: A total of 18 patients with type 2 diabetes (T2D, 8 with SFN, 10 without SFN) and 10 healthy controls (HC) took part in this cross-sectional single-center study and underwent QST of the right leg and DCE-MRN of the right thigh with subsequent calculation of the sciatic nerve constant of capillary permeability (Ktrans), extravascular extracellular volume fraction (Ve), and plasma volume fraction (Vp).
Results: The Ktrans (HC 0.031 min-1 ± 0.009, T2D 0.043 min-1 ± 0.015; p = 0.033) and Ve (HC 1.2% ± 1.5, T2D: 4.1% ± 5.1; p = 0.027) were lower in T2D patients compared to controls. In T2D patients, compound z‑scores of thermal and mechanical detection correlated with Ktrans (r = 0.73; p = 0.001, and r = 0.57; p = 0.018, respectively) and Ve (r = 0.67; p = 0.002, and r = 0.69; p = 0.003, respectively). Compound z‑scores of thermal pain and Vp (r = -0.57; p = 0.015) correlated negatively.
Discussion: The findings suggest that parameters of peripheral nerve microcirculation are related to different symptoms in SFN: A reduced capillary permeability may result in a loss of function related to insufficient nutritional supply, whereas increased capillary permeability may be accompanied by painful symptoms related to a gain of function.
期刊介绍：
Clinical Neuroradiology provides current information, original contributions, and reviews in the field of neuroradiology. An interdisciplinary approach is accomplished by diagnostic and therapeutic contributions related to associated subjects.
The international coverage and relevance of the journal is underlined by its being the official journal of the German, Swiss, and Austrian Societies of Neuroradiology.
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