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Differences in Metabolites in Pain-Processing Brain Regions in Patients With Diabetes and Painful Neuropathy

  1. Lea Sorensen, PHD1,
  2. Philip J. Siddall, MBBS, PHD2,
  3. Michael I. Trenell, PHD3 and
  4. Dennis K. Yue, MD, PHD14
  1. 1Diabetes Centre, Royal Prince Alfred Hospital, Camperdown, Australia
  2. 2Pain Management and Research Institute, University of Sydney, Sydney, Australia
  3. 3Diabetes Research Group & Newcastle Magnetic Resonance Centre, School of Clinical Medical Sciences, Newcastle University, Newcastle upon Tyne, U.K.
  4. 4Discipline of Medicine, University of Sydney, Sydney, Australia
  1. Corresponding author: Dr. Lea Sorensen, Diabetes Centre Royal Prince Alfred Hospital, Camperdown, Sydney, NSW 2050, Australia. E-mail: lea{at}email.cs.nsw.gov.au

Abstract

OBJECTIVE—Magnetic resonance spectroscopy (MRS) (specifically, 1H-MRS) has been used to show changes in the brain following peripheral nerve injury in subjects without diabetes. This study used 1H-MRS to examine the brain in subjects with or without painful diabetic neuropathy.

RESEARCH DESIGN AND 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 N-acetyl aspartate (NAA) and creatine relative to the control group. In the thalamus, there was a reduction of NAA in the diabetic group with pain compared with that in patients with diabetes and no pain.

CONCLUSION—Subjects with diabetes have metabolite differences in the brain compared with control subjects. Subjects with painful neuropathy showed reduced NAA in the thalamus, which may explain the genesis of pain in some cases.

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 25 February 2008. DOI: 10.2337/dc07-2088.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Accepted February 15, 2008.
    • Received November 6, 2007.
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This Article

  1. Published online before print February 25, 2008, doi: 10.2337/dc07-2088 Diabetes Care May 2008 vol. 31 no. 5 980-981
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