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Diabetes Care Publish Ahead of Print published online ahead of print February 25, 2008
DOI: 10.2337/dc07-2088
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Original Research

DIFFERENCES IN METABOLITES IN PAIN PROCESSING BRAIN REGIONS IN PATIENTS WITH DIABETES AND PAINFUL NEUROPATHY

Lea Sorensen, PhD1, Phillip J Siddall, MBBS, PhD2, Michael I Trenell, PhD3 and Dennis K Yue, MD, PhD1,,4

1Diabetes Centre, Royal Prince Alfred Hospital, Camperdown, Australia
2Pain Management and Research Institute, University of Sydney, Sydney, Australia
3Diabetes Research Group & Newcastle Magnetic Resonance Centre, School of Clinical Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
5Discipline of Medicine, University of Sydney, Sydney, Australia

lea{at}email.cs.nsw.gov.au

ABSTRACT

Aim: Magnetic Resonance Spectroscopy (1H-MRS) has been used to show changes in the brain following peripheral nerve injury in subjects without diabetes. This study uses 1H-MRS to examine the brain in subjects with or without painful diabetic neuropathy.

Methods: Twenty six diabetic subjects (12 with and 14 without chronic neuropathic pain) were compared with 18 subjects without diabetes and pain. The left thalamus, anterior cingulate cortex (ACC) and dorsolateral prefrontal cortex (DLPFC) were assessed using 1H-MRS.

Results: In the DLPFC, diabetic subjects had a decrease in NAA and creatine relative to the control group. In the thalamus, there was a reduction of NAA in the diabetic group with pain compared to those with diabetes and no pain.

Conclusion: Subjects with diabetes have metabolite differences in the brain compared to controls. Subjects with painful neuropathy showed reduced NAA in the thalamus which may explain the genesis of pain in some cases.


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