A new study of patients with Type 1 and Type 2 diabetes reveals diabetic nerve damage causes more harm in the brain than previously thought. Researchers from the University of Sheffield used recent advances in magnetic resonance imaging (MRI) brain imaging and analyses techniques to make detailed nerve assessments of the brain.
The study showed that the volume of some brain regions in people with diabetic neuropathy was considerably lower compared to those without the disease. Previous studies indicated the impact of the disease on the brain is limited and isolated to outer areas of the brain thought to be secondary to core functions in the body.
Improved Diagnosis and Treatment
The breakthrough may lead to improved assessment and monitoring of the disease, which affects around a third of people with diabetes. This could also open the door to better future treatments for sufferers.
“Diabetic nerve damage has a massive impact on the quality of people’s lives, physically, mentally and socially” said Dr Dinesh Selvarajah, of the Royal Hallamshire Hospital.
“With the number of people suffering from diabetes around the world soaring, these are significant findings. Our study reveals for the first time how extensively involved diabetic neuropathy is in the brain, causing shrinking and a reduction in the main part of the brain associated with sensation. This is a new insight which will go a long way towards helping us better understand, treat and prevent a disease which we thought to be fairly innocuous in terms of effects on the brain.”
“The next steps will be for us to investigate at what stage this occurs, what the consequences of this are and whether it can be prevented as it could be impacting on patient’s behaviour and psychology.”
Volumetry MRI Scanning
The grey matter region the study identified is a major component of the central nervous system. It consists of brain cells, known as neurons, which process information from sensory organs in order to decide and execute functions.
Loss of nerve cells in the grey matter, more properly known as cerebral atrophy, is greatly detrimental as the functions of that area of the brain can become impaired.
“MRI is such a useful neuroimaging tool in both medicine and patient-based medical research,” said Iain Wilkinson, an MR Physics Professor within Academic Radiology at the University of Sheffield. “The technique that we have been using is often termed ‘volumetry’ – recent scanner improvements enable the collection of high quality, high resolution, 3D datasets of the brain in an acceptable time, which, when coupled with the latest image processing systems, enable us to look at, or ‘segment’, different parts of the brain in patients who do or do not have diabetic neuropathy. The overall technique indicates where the differences that we are observing are occurring.”
Dinesh Selvarajah, Iain D. Wilkinson, Michael Maxwell, Jennifer Davies, Adhithya Sankar, Elaine Boland, Rajiv Gandhi, Irene Tracey,and Solomon Tesfaye Magnetic Resonance Neuroimaging Study of Brain Structural Differences in Diabetic Peripheral Neuropathy Diabetes Care 2014,doi:10.2337/dc13-2610 1935-5548