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 wellcharacterised cohort of participants with painful- and painless-DPN. S1 PCr:ATP, a measure of energy consumption, was significantly reduced in painfulcompared 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 painfulcompared 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.

中文翻译：

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疼痛性糖尿病神经病变中更高的感觉皮层能量代谢：来自脑磁共振波谱研究的证据

疼痛性糖尿病周围神经病变 (DPN) 中已经证明了大脑疼痛处理区域的静息状态功能连接和过度灌注的改变。然而，人们对这些异常的潜在机制知之甚少。因此，有一个很好的理由来探索大脑的疼痛处理区域是否存在更高的能量消耗。我们进行了一项 31 磷磁共振波谱 (31P-MRS) 研究，以探索具有良好特征的疼痛和无痛 DPN 参与者队列中初级体感 (S1) 皮层的细胞能量使用（生物能量学）。与无痛 DPN 相比，S1 PCr:ATP 是一种能量消耗量度，在疼痛中显着降低。这表明疼痛性 DPN 中 S1 皮质能量消耗更大。此外，S1 PCr：ATP 与 MRI 期间的疼痛强度相关。与轻度疼痛的患者相比，具有中度/重度疼痛的疼痛性 DPN 个体的 S1 PCr:ATP 也显着降低。这是第一项证明疼痛性 DPN 与无痛性 DPN 相比 S1 皮质能量代谢更高的研究。此外，PCr:ATP 与神经性疼痛测量值之间的关系表明，S1 生物能量学与神经性疼痛的严重程度有关。S1 皮质能量学可能代表疼痛 DPN 的生物标志物，并有可能作为治疗干预的目标。此外，PCr:ATP 与神经性疼痛测量值之间的关系表明，S1 生物能量学与神经性疼痛的严重程度有关。S1 皮质能量学可能代表疼痛 DPN 的生物标志物，并有可能作为治疗干预的目标。此外，PCr:ATP 与神经性疼痛测量值之间的关系表明，S1 生物能量学与神经性疼痛的严重程度有关。S1 皮质能量学可能代表疼痛 DPN 的生物标志物，并有可能作为治疗干预的目标。