A diminished sciatic nerve structural integrity is associated with distinct peripheral sensory phenotypes in individuals with type 2 diabetes
Authors' conclusion
The most severe sensory phenotypes of DSPN (MH and SL) showed diminishing sciatic nerve structural integrity indexed by lower FA, likely representing progressive axonal loss, as well as increasing CSA of the sciatic nerve, which cannot be detected in individuals with TH. Individuals with type 2 diabetes may experience a predefined cascade of nerve fibre damage in the course of the disease, from healthy to TH, to MH and finally SL, while structural changes in the proximal nerve seem to precede the sensory loss of peripheral nerves and indicate potential targets for the prevention of end-stage DSPN.
Study context
- Population
- Individuals with T2D; Quantitative sensory testing (QST) of right foot and high-resolution MR neurography with diffusion tensor imaging of right distal sciatic nerve
- Participants
- 76 individuals
- Exposure
- Sciatic nerve structural integrity across 4 QST sensory phenotypes
- HSPn = 16reference
- THn = 24
- MHn = 17
- SLn = 19
- Outcome
- Sciatic nerve fractional anisotropy (FA) and cross-sectional area (CSA) across sensory phenotypes
Main finding
As reported in the abstract
Unstandardised regression coefficient (B)
−0.048
95% CI −0.091 to −0.006P = 0.027
MH
Unstandardised regression coefficient (B)
−0.062
95% CI −0.103 to −0.020P = 0.004
SL
HSP
0.444
TH
0.437
MH
0.395
SL
0.382
- Gradual decrease of sciatic fractional anisotropy (FA) across the 4 phenotypes
- P = 0.005
Observational data: associations, not effects.
Further findings
Sciatic nerve CSA — MH vs HSP · multivariable regression
β 4.3 (0.5–8.0) · P = 0.028
| Outcome | Unstandardised regression coefficient (B) (95% CI) | P value |
|---|---|---|
| Sciatic nerve CSASL vs HSP · multivariable regression | 4.0 (0.4–7.7) | P = 0.032 |
- Sciatic nerve cross-sectional area (CSA) — Increase of sciatic CSA across the 4 phenotypes
- p=0.011
Correlation of sciatic FA with sciatic CSA
- R
- −0.35, p=0.002
- Sciatic FA correlated negatively with markers of microvascular damage (high-sensitivity troponin T, urine albumin/creatinine ratio)
Objective neurological deficits
- Gradual increase across HSP, TH, MH and SL; higher in MH vs HSP and in SL vs HSP and TH
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →