Diabetes is associated with a loss of somatosensory and motor function, leading to impairments in gait, balance, and manual dexterity. Data-driven neuroimaging studies frequently report a negative impact of diabetes on sensorimotor regions in the brain; however, relationships with sensorimotor behavior are rarely considered. The goal of this review is to consider existing diabetes neuroimaging evidence through the lens of sensorimotor neuroscience. We review evidence for diabetes-related disruptions to three critical circuits for movement control: the cerebral cortex, the cerebellum, and the basal ganglia. In addition, we discuss how central nervous system (CNS) degeneration might interact with the loss of sensory feedback from the limbs due to peripheral neuropathy to result in motor impairments in individuals with diabetes. We argue that our understanding of movement impairments in individuals with diabetes is incomplete without the consideration of disease complications in both the central and peripheral nervous systems. Neuroimaging evidence for disrupted central sensorimotor circuitry suggests that there may be unrecognized behavioral impairments in individuals with diabetes. Applying knowledge from the existing literature on CNS contributions to motor control and motor learning in healthy individuals provides a framework for hypothesis generation for future research on this topic.

中文翻译：

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大脑和身体：中枢神经系统对糖尿病运动障碍的影响的综述

糖尿病与躯体感觉和运动功能的丧失有关，导致步态、平衡和手部灵活性受损。数据驱动的神经影像学研究经常报告糖尿病对大脑感觉运动区域的负面影响；然而，很少考虑与感觉运动行为的关系。本综述的目的是通过感觉运动神经科学的视角考虑现有的糖尿病神经影像学证据。我们回顾了与糖尿病相关的三个运动控制关键回路中断的证据：大脑皮层、小脑和基底神经节。此外，我们讨论了中枢神经系统 (CNS) 变性如何与周围神经病变导致的四肢感觉反馈丧失相互作用，从而导致糖尿病患者的运动障碍。我们认为，如果不考虑中枢和外周神经系统的疾病并发症，我们对糖尿病患者运动障碍的理解是不完整的。中枢感觉运动回路中断的神经影像学证据表明，糖尿病患者可能存在未被识别的行为障碍。应用现有文献中关于中枢神经系统对健康个体运动控制和运动学习的贡献的知识，为未来对该主题的研究提供了假设生成框架。中枢感觉运动回路中断的神经影像学证据表明，糖尿病患者可能存在未被识别的行为障碍。应用现有文献中关于中枢神经系统对健康个体运动控制和运动学习的贡献的知识，为未来对该主题的研究提供了假设生成框架。中枢感觉运动回路中断的神经影像学证据表明，糖尿病患者可能存在未被识别的行为障碍。应用现有文献中关于中枢神经系统对健康个体运动控制和运动学习的贡献的知识，为未来对该主题的研究提供了假设生成框架。