Abstract

Aims: Emerging evidence shows, that distal symmetric peripheral neuropathy (DSPN) also involves alterations in the central nervous system. Hence, the aims were to investigate brain metabolites in white matter of adults with diabetes and DSPN, and to compare any cerebral disparities with peripheral nerve characteristics. Methods: In type 1 diabetes, brain metabolites of 47 adults with confirmed DSPN were compared with 28 matched healthy controls using proton magnetic resonance spectroscopy (H-MRS) in the parietal region including the sensorimotor fiber tracts. Results: Adults with diabetes had 9.3% lower ratio of N-acetylaspartate/creatine (NAA/cre) in comparison to healthy (p < 0.001). Lower NAA/cre was associated with lower sural (p = 0.01) and tibial (p = 0.04) nerve amplitudes, longer diabetes duration (p = 0.03) and higher age (p = 0.03). In addition, NAA/cre was significantly lower in the subgroup with proliferative retinopathy as compared to the subgroup with non-proliferative retinopathy (p = 0.02). Conclusions: The association to peripheral nerve dysfunction, indicates concomitant presence of DSPN and central neuropathies, supporting the increasing recognition of diabetic neuropathy being, at least partly, a disease leading to polyneuropathy. Decreased NAA, is a potential promising biomarker of central neuronal dysfunction or loss, and thus may be useful to measure progression of neuropathy in diabetes or other neurodegenerative diseases.

Original languageEnglish
JournalJournal of Diabetes and its Complications
Volume33
Issue number4
Pages (from-to)323-328
Number of pages6
ISSN1056-8727
DOIs
Publication statusPublished - Apr 2019

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Peripheral Nervous System Diseases
Type 1 Diabetes Mellitus
Creatine
Spectrum Analysis
Brain
Peripheral Nerves
Parietal Lobe
Polyneuropathies
Diabetic Neuropathies
Neurodegenerative Diseases
Central Nervous System
Biomarkers
N-acetylaspartate

Keywords

  • Central nervous system
  • Diabetes neuropathy
  • Magnetic resonance spectroscopy
  • Metabolites
  • N-acetylaspartate
  • Peripheral neuropathy

Cite this

@article{10d29fde92df41b1bcc2d38bb8aa7443,
title = "Brain spectroscopy reveals that N-acetylaspartate is associated to peripheral sensorimotor neuropathy in type 1 diabetes",
abstract = "Aims: Emerging evidence shows, that distal symmetric peripheral neuropathy (DSPN) also involves alterations in the central nervous system. Hence, the aims were to investigate brain metabolites in white matter of adults with diabetes and DSPN, and to compare any cerebral disparities with peripheral nerve characteristics. Methods: In type 1 diabetes, brain metabolites of 47 adults with confirmed DSPN were compared with 28 matched healthy controls using proton magnetic resonance spectroscopy (H-MRS) in the parietal region including the sensorimotor fiber tracts. Results: Adults with diabetes had 9.3{\%} lower ratio of N-acetylaspartate/creatine (NAA/cre) in comparison to healthy (p < 0.001). Lower NAA/cre was associated with lower sural (p = 0.01) and tibial (p = 0.04) nerve amplitudes, longer diabetes duration (p = 0.03) and higher age (p = 0.03). In addition, NAA/cre was significantly lower in the subgroup with proliferative retinopathy as compared to the subgroup with non-proliferative retinopathy (p = 0.02). Conclusions: The association to peripheral nerve dysfunction, indicates concomitant presence of DSPN and central neuropathies, supporting the increasing recognition of diabetic neuropathy being, at least partly, a disease leading to polyneuropathy. Decreased NAA, is a potential promising biomarker of central neuronal dysfunction or loss, and thus may be useful to measure progression of neuropathy in diabetes or other neurodegenerative diseases.",
keywords = "Central nervous system, Diabetes neuropathy, Magnetic resonance spectroscopy, Metabolites, N-acetylaspartate, Peripheral neuropathy",
author = "Hansen, {Tine Maria} and Birgitte Brock and Anne Juhl and Drewes, {Asbj{\o}rn Mohr} and Henrik Vorum and Andersen, {Carl Uggerh{\o}j} and Jakobsen, {Poul Erik} and Jesper Karmisholt and Fr{\o}kj{\ae}r, {Jens Br{\o}ndum} and Christina Brock",
year = "2019",
month = "4",
doi = "10.1016/j.jdiacomp.2018.12.016",
language = "English",
volume = "33",
pages = "323--328",
journal = "Journal of Diabetes and its Complications",
issn = "1056-8727",
publisher = "Elsevier",
number = "4",

}

TY - JOUR

T1 - Brain spectroscopy reveals that N-acetylaspartate is associated to peripheral sensorimotor neuropathy in type 1 diabetes

AU - Hansen, Tine Maria

AU - Brock, Birgitte

AU - Juhl, Anne

AU - Drewes, Asbjørn Mohr

AU - Vorum, Henrik

AU - Andersen, Carl Uggerhøj

AU - Jakobsen, Poul Erik

AU - Karmisholt, Jesper

AU - Frøkjær, Jens Brøndum

AU - Brock, Christina

PY - 2019/4

Y1 - 2019/4

N2 - Aims: Emerging evidence shows, that distal symmetric peripheral neuropathy (DSPN) also involves alterations in the central nervous system. Hence, the aims were to investigate brain metabolites in white matter of adults with diabetes and DSPN, and to compare any cerebral disparities with peripheral nerve characteristics. Methods: In type 1 diabetes, brain metabolites of 47 adults with confirmed DSPN were compared with 28 matched healthy controls using proton magnetic resonance spectroscopy (H-MRS) in the parietal region including the sensorimotor fiber tracts. Results: Adults with diabetes had 9.3% lower ratio of N-acetylaspartate/creatine (NAA/cre) in comparison to healthy (p < 0.001). Lower NAA/cre was associated with lower sural (p = 0.01) and tibial (p = 0.04) nerve amplitudes, longer diabetes duration (p = 0.03) and higher age (p = 0.03). In addition, NAA/cre was significantly lower in the subgroup with proliferative retinopathy as compared to the subgroup with non-proliferative retinopathy (p = 0.02). Conclusions: The association to peripheral nerve dysfunction, indicates concomitant presence of DSPN and central neuropathies, supporting the increasing recognition of diabetic neuropathy being, at least partly, a disease leading to polyneuropathy. Decreased NAA, is a potential promising biomarker of central neuronal dysfunction or loss, and thus may be useful to measure progression of neuropathy in diabetes or other neurodegenerative diseases.

AB - Aims: Emerging evidence shows, that distal symmetric peripheral neuropathy (DSPN) also involves alterations in the central nervous system. Hence, the aims were to investigate brain metabolites in white matter of adults with diabetes and DSPN, and to compare any cerebral disparities with peripheral nerve characteristics. Methods: In type 1 diabetes, brain metabolites of 47 adults with confirmed DSPN were compared with 28 matched healthy controls using proton magnetic resonance spectroscopy (H-MRS) in the parietal region including the sensorimotor fiber tracts. Results: Adults with diabetes had 9.3% lower ratio of N-acetylaspartate/creatine (NAA/cre) in comparison to healthy (p < 0.001). Lower NAA/cre was associated with lower sural (p = 0.01) and tibial (p = 0.04) nerve amplitudes, longer diabetes duration (p = 0.03) and higher age (p = 0.03). In addition, NAA/cre was significantly lower in the subgroup with proliferative retinopathy as compared to the subgroup with non-proliferative retinopathy (p = 0.02). Conclusions: The association to peripheral nerve dysfunction, indicates concomitant presence of DSPN and central neuropathies, supporting the increasing recognition of diabetic neuropathy being, at least partly, a disease leading to polyneuropathy. Decreased NAA, is a potential promising biomarker of central neuronal dysfunction or loss, and thus may be useful to measure progression of neuropathy in diabetes or other neurodegenerative diseases.

KW - Central nervous system

KW - Diabetes neuropathy

KW - Magnetic resonance spectroscopy

KW - Metabolites

KW - N-acetylaspartate

KW - Peripheral neuropathy

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U2 - 10.1016/j.jdiacomp.2018.12.016

DO - 10.1016/j.jdiacomp.2018.12.016

M3 - Journal article

VL - 33

SP - 323

EP - 328

JO - Journal of Diabetes and its Complications

JF - Journal of Diabetes and its Complications

SN - 1056-8727

IS - 4

ER -