Diabetic Neuropathic Pain Linked to Brain Bioenergic Anomali
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Abnormal mitochondrial activity in pain-processing areas of the brain may explain why some persons with type 2 diabetes experience painful peripheral neuropathy while others do not, new U.K. study findings have suggested.

Painful diabetic peripheral neuropathy (pDPN) is common and often causes unremitting, distressing painful neuropathic symptoms. Unfortunately, current management of the disorder is inadequate because the disease mechanisms are not fully understood. Researchers assessed cerebral cellular bioenergetics using phosphorus magnetic resonance spectroscopy (31P-MRS) to determine whether high energy phosphate metabolite levels are altered in the pain processing regions of the brain in pDPN.

A total of 56 subjects, 44 with type 2 diabetes (12 no-DPN, 13 painless-DPN and 19 pDPN) and 12 healthy volunteers, underwent detailed clinical and neurophysiological assessments, and 31P-MRS brain imaging at 3-Tesla with voxels placed over the right somatosensory cortex and the thalamus.

Results:
-- There was a significant group effect in the ATP:PCr ratio at the thalamus and somatosensory cortex.

-- The ATP:PCr at the thalamus was significantly higher in the pDPN group compared to HV and no-DPN.

-- Moreover, the ATP:PCr ratio at the somatosensory cortex was significantly higher in pDPN compared to HV.

-- In addition, the ratio correlated with the Neuropathic Pain Symptom Inventory score at both brain regions.

Conclusively, despite considerable research into the mechanisms of pDPN, our understanding remains limited. This study is the first to use 31P-MRS to analyse cerebral energetics in human-DPN and peripheral painful neuropathies. We demonstrated significantly higher ATP:PCr ratios in patients with pDPN in the somatosensory cortex and thalamus, which correlated with neuropathic pain symptom intensity.

This could be indicative of increased cellular energy usage in pain processing regions of the brain as a result of continuous nociceptive inputs. Altered cerebral phosphorus metabolite ratios may serve as a biomarker of neuropathic pain in diabetes.

Source: https://www.abstractsonline.com/pp8/#!/9143/presentation/725
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