期刊
PAIN
卷 157, 期 2, 页码 S72-S80出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/j.pain.0000000000000465
关键词
Diabetic peripheral neuropathy; Neuropathic pain; Neuroimaging; Magnetic resonance imaging; Magnetic resonance spectroscopy; Central nervous system
资金
- Diabetes UK
- Juvenile Diabetes Research Foundation (JDRF)
- European Foundation for the Study of Diabetes (EFSD)
- National Institute of Health (NIH/NIDDK)
- Wellcome Trust
Diabetic peripheral neuropathy (DPN) affects up to 50% of patients with diabetes and is a major cause of morbidity and increased mortality. Its clinical manifestations include distressing painful neuropathic symptoms and insensitivity to trauma that result in foot ulcerations and amputations. Several recent studies have implicated poor glycemic control, duration of diabetes, hyperlipidemia (particularly hypertryglyceridaemia), elevated albumin excretion rates, and obesity as risk factors for the development of DPN. However, similar data are not available for painful DPN. Moreover, although there is now strong evidence for the importance of peripheral nerve microvascular disease in the pathogenesis of DPN, peripheral structural biomarkers of painful DPN are lacking. However, there is now emerging evidence for the involvement of the central nervous system in both painful and painless DPN afforded by magnetic resonance imaging. This review will focus on this emerging evidence for central changes in DPN, hitherto considered a peripheral nerve disease only.
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