Preservation of thalamic neuronal function may be a prerequisite for pain perception in diabetic neuropathy: A magnetic resonance spectroscopy study
IntroductionIn this study, we used proton Magnetic Resonance Spectroscopy (1H-MRS) to determine the neuronal function in the thalamus and primary somatosensory (S1) cortex in different subgroups of DPN, including subclinical- and painful-DPN.MethodOne-hundred and ten people with type 1 diabetes [20...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Pain Research |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpain.2022.1086887/full |
| _version_ | 1797959930656849920 |
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| author | Rajiv Gandhi Dinesh Selvarajah Gordon Sloan Gordon Sloan Marni Greig Iain D. Wilkinson Pamela J. Shaw Paul Griffiths Solomon Tesfaye |
| author_facet | Rajiv Gandhi Dinesh Selvarajah Gordon Sloan Gordon Sloan Marni Greig Iain D. Wilkinson Pamela J. Shaw Paul Griffiths Solomon Tesfaye |
| author_sort | Rajiv Gandhi |
| collection | DOAJ |
| description | IntroductionIn this study, we used proton Magnetic Resonance Spectroscopy (1H-MRS) to determine the neuronal function in the thalamus and primary somatosensory (S1) cortex in different subgroups of DPN, including subclinical- and painful-DPN.MethodOne-hundred and ten people with type 1 diabetes [20 without DPN (no-DPN); 30 with subclinical-DPN; 30 with painful-DPN; and 30 with painless-DPN] and 20 healthy volunteers, all of whom were right-handed men, were recruited and underwent detailed clinical and neurophysiological assessments. Participants underwent Magnetic Resonance Imaging at 1.5 Tesla with two 1H-MRS spectra obtained from 8 ml cubic volume voxels: one placed within left thalamus to encompass the ventro-posterior lateral sub-nucleus and another within the S1 cortex.ResultsIn the thalamus, participants with painless-DPN had a significantly lower NAA:Cr ratio [1.55 + 0.22 (mean ± SD)] compared to all other groups [HV (1.80 ± 0.23), no-DPN (1.85 ± 0.20), sub-clinical DPN (1.79 ± 0.23), painful-DPN (1.75 ± 0.19), ANOVA p < 0.001]. There were no significant group differences in S1 cortical neurometabolites.ConclusionIn this largest cerebral MRS study in DPN, thalamic neuronal dysfunction was found in advanced painless-DPN with preservation of function in subclinical- and painful-DPN. Furthermore, there was a preservation of neuronal function within the S1 cortex in all subgroups of DPN. Therefore, there may be a proximo-distal gradient to central nervous system alterations in painless-DPN, with thalamic neuronal dysfunction occurring only in established DPN. Moreover, these results further highlight the manifestation of cerebral alterations between painful- and painless-DPN whereby preservation of thalamic function may be a prerequisite for neuropathic pain in DPN. |
| first_indexed | 2024-04-11T00:38:28Z |
| format | Article |
| id | doaj.art-be8593af53b24277bbcc84efde16390c |
| institution | Directory Open Access Journal |
| issn | 2673-561X |
| language | English |
| last_indexed | 2024-04-11T00:38:28Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pain Research |
| spelling | doaj.art-be8593af53b24277bbcc84efde16390c2023-01-06T13:42:53ZengFrontiers Media S.A.Frontiers in Pain Research2673-561X2023-01-01310.3389/fpain.2022.10868871086887Preservation of thalamic neuronal function may be a prerequisite for pain perception in diabetic neuropathy: A magnetic resonance spectroscopy studyRajiv Gandhi0Dinesh Selvarajah1Gordon Sloan2Gordon Sloan3Marni Greig4Iain D. Wilkinson5Pamela J. Shaw6Paul Griffiths7Solomon Tesfaye8Diabetes Research Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United KingdomDepartment of Oncology and Human Metabolism, University of Sheffield, Sheffield, United KingdomDiabetes Research Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United KingdomDepartment of Oncology and Human Metabolism, University of Sheffield, Sheffield, United KingdomDiabetes Research Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United KingdomAcademic Unit of Radiology, University of Sheffield, Sheffield, United KingdomSheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, United KingdomAcademic Unit of Radiology, University of Sheffield, Sheffield, United KingdomDiabetes Research Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United KingdomIntroductionIn this study, we used proton Magnetic Resonance Spectroscopy (1H-MRS) to determine the neuronal function in the thalamus and primary somatosensory (S1) cortex in different subgroups of DPN, including subclinical- and painful-DPN.MethodOne-hundred and ten people with type 1 diabetes [20 without DPN (no-DPN); 30 with subclinical-DPN; 30 with painful-DPN; and 30 with painless-DPN] and 20 healthy volunteers, all of whom were right-handed men, were recruited and underwent detailed clinical and neurophysiological assessments. Participants underwent Magnetic Resonance Imaging at 1.5 Tesla with two 1H-MRS spectra obtained from 8 ml cubic volume voxels: one placed within left thalamus to encompass the ventro-posterior lateral sub-nucleus and another within the S1 cortex.ResultsIn the thalamus, participants with painless-DPN had a significantly lower NAA:Cr ratio [1.55 + 0.22 (mean ± SD)] compared to all other groups [HV (1.80 ± 0.23), no-DPN (1.85 ± 0.20), sub-clinical DPN (1.79 ± 0.23), painful-DPN (1.75 ± 0.19), ANOVA p < 0.001]. There were no significant group differences in S1 cortical neurometabolites.ConclusionIn this largest cerebral MRS study in DPN, thalamic neuronal dysfunction was found in advanced painless-DPN with preservation of function in subclinical- and painful-DPN. Furthermore, there was a preservation of neuronal function within the S1 cortex in all subgroups of DPN. Therefore, there may be a proximo-distal gradient to central nervous system alterations in painless-DPN, with thalamic neuronal dysfunction occurring only in established DPN. Moreover, these results further highlight the manifestation of cerebral alterations between painful- and painless-DPN whereby preservation of thalamic function may be a prerequisite for neuropathic pain in DPN.https://www.frontiersin.org/articles/10.3389/fpain.2022.1086887/fulldiabetic neuropathypainful diabetic neuropathyneuropathic painmagnetic resonace spectroscopythalamusperipheral neuropathy |
| spellingShingle | Rajiv Gandhi Dinesh Selvarajah Gordon Sloan Gordon Sloan Marni Greig Iain D. Wilkinson Pamela J. Shaw Paul Griffiths Solomon Tesfaye Preservation of thalamic neuronal function may be a prerequisite for pain perception in diabetic neuropathy: A magnetic resonance spectroscopy study Frontiers in Pain Research diabetic neuropathy painful diabetic neuropathy neuropathic pain magnetic resonace spectroscopy thalamus peripheral neuropathy |
| title | Preservation of thalamic neuronal function may be a prerequisite for pain perception in diabetic neuropathy: A magnetic resonance spectroscopy study |
| title_full | Preservation of thalamic neuronal function may be a prerequisite for pain perception in diabetic neuropathy: A magnetic resonance spectroscopy study |
| title_fullStr | Preservation of thalamic neuronal function may be a prerequisite for pain perception in diabetic neuropathy: A magnetic resonance spectroscopy study |
| title_full_unstemmed | Preservation of thalamic neuronal function may be a prerequisite for pain perception in diabetic neuropathy: A magnetic resonance spectroscopy study |
| title_short | Preservation of thalamic neuronal function may be a prerequisite for pain perception in diabetic neuropathy: A magnetic resonance spectroscopy study |
| title_sort | preservation of thalamic neuronal function may be a prerequisite for pain perception in diabetic neuropathy a magnetic resonance spectroscopy study |
| topic | diabetic neuropathy painful diabetic neuropathy neuropathic pain magnetic resonace spectroscopy thalamus peripheral neuropathy |
| url | https://www.frontiersin.org/articles/10.3389/fpain.2022.1086887/full |
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