Studies on magnetic resonance neurography (MRN) in diabetic polyneuropathy (DPN) have found proximal sciatic nerve lesions. The aim of this study was to evaluate the functional relevance of sciatic nerve lesions in DPN, with the expectation of correlations with the impairment of large-fiber function. Sixty-one patients with type 2 diabetes (48 with and 13 without DPN) and 12 control subjects were enrolled and underwent MRN, quantitative sensory testing, and electrophysiological examinations. There were differences in mechanical detection (Aβ fibers) and mechanical pain (Aδ fibers) but not in thermal pain and thermal detection clusters (C fibers) among the groups. Lesion load correlated with lower Aα-, Aβ-, and Aδ-fiber but not with C-fiber function in all participants. Patients with lower function showed a higher load of nerve lesions than patients with elevated function or no measurable deficit despite apparent DPN. Longer diabetes duration was associated with higher lesion load in patients with DPN, suggesting that nerve lesions in DPN may accumulate over time and become clinically relevant once a critical amount of nerve fascicles is affected. Moreover, MRN is an objective method for determining lower function mainly in medium and large fibers in DPN.

中文翻译：

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了解糖尿病神经病变：从亚临床神经病变到严重的神经纤维缺陷。一项针对 2 型糖尿病患者和健康对照的横断面研究

对糖尿病性多发性神经病 (DPN) 的磁共振神经成像 (MRN) 的研究发现了近端坐骨神经病变。本研究的目的是评估 DPN 中坐骨神经病变的功能相关性，预期与大纤维功能受损的相关性。61 名 2 型糖尿病患者（48 名有 DPN 和 13 名没有 DPN）和 12 名对照受试者被纳入并接受了 MRN、定量感觉测试和电生理检查。各组间在机械检测（Aβ 纤维）和机械痛（Aδ 纤维）方面存在差异，但在热痛和热检测簇（C 纤维）方面没有差异。在所有参与者中，病变负荷与较低的 Aα-、Aβ-和 Aδ-纤维相关，但与 C-纤维功能无关。尽管有明显的 DPN，但功能较低的患者表现出的神经病变负荷高于功能升高或无可测量缺陷的患者。较长的糖尿病病程与 DPN 患者较高的病变负荷相关，这表明 DPN 中的神经病变可能会随着时间的推移而积累，一旦关键数量的神经束受到影响，就会变得具有临床意义。此外，MRN 是一种客观的确定低功能的方法，主要是在 DPN 中的中、大光纤中。