American Diabetes Association
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Higher sensory cortical energy metabolism in Painful-Diabetic Neuropathy: evidence from a cerebral Magnetic Resonance Spectroscopy study

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posted on 2023-04-14, 17:25 authored by Gordon Sloan, Adriana Anton, Sharon Caunt, Iain Wilkinson, Dinesh Selvarajah, Solomon Tesfaye


Alterations in the resting state functional connectivity and hyperperfusion of pain processing areas of the brain have been demonstrated in painful-Diabetic Peripheral Neuropathy (DPN). However, the mechanisms underlying these abnormalities are poorly understood. There is thus a good rationale to explore if there is higher energy consumption in the pain processing areas of the brain.

We performed a 31Phosphorus Magnetic Resonance Spectroscopy (31P-MRS) study to explore cellular energy usage (bioenergetics) in the primary somatosensory (S1) cortex in a well-characterised cohort of participants with painful- and painless-DPN. 

S1 PCr:ATP, a measure of energy consumption, was significantly reduced in painful- compared with painless-DPN. This is indicative of greater S1 cortical energy consumption in painful-DPN. Furthermore, S1 PCr:ATP correlated with pain intensity during the MRI. S1 PCr:ATP was also significantly lower in painful-DPN individuals with moderate/severe pain compared to those with low pain.

This is the first study to demonstrate higher S1 cortical energy metabolism in painful- compared with painless-DPN. Moreover, the relationship between PCr:ATP and neuropathic pain measures shows that S1 bioenergetics is related to the severity of neuropathic pain. S1 cortical energetics may represent a biomarker of painful-DPN and could have the potential to serve as a target for therapeutic interventions.


ST thanks Sheffield Teaching Hospitals Diabetes Charitable Trust for funding the study.


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