Impaired ascendant central pathways conduction in impotent diabetic subjects.
OBJECTIVE
Diabetic impotence is generally due to peripheral neuropathy, but a central pathway impairment has also been suggested. We evaluated somatosensory transmission in a group of impotent diabetic men to assess the role of central nervous system (CNS) involvement.


METHODS
Somatosensory evoked potentials (SEPs) of pudendal (pdn) and posterior tibial (ptn) nerves were recorded in 74 patients. Type and duration of diabetes, severity of sexual dysfunction, medium term metabolic control, occurrence of microangiopathic chronic complications and autonomic neuropathy were evaluated.


RESULTS
Our data show an impairment of central conduction times in pdn (25.7%) and ptn (39.2%) greater than peripheral nervous impairment (pdn 12.2%, ptn 8.1%), in impotent diabetic patients without any further major complication. Central nervous conduction delay resulted to be correlated with poor glycemic control. Significant evident autonomic dysfunction was found only in a minority of cases.


CONCLUSIONS
Our data might suggest that altered conduction along CNS and somatic peripheral neuropathy might develop independently. We confirm the hypothesis of a "central diabetic neuropathy" and suggest that central sensory pathways involvement, not related to peripheral impairment, could play a role in the pathogenesis of erectile dysfunction in diabetic patients.
Sartucci
F
F
Department of Neurosciences, Institute of Neurology, University of Pisa, Italy.
Piaggesi
A
A
Logi
F
F
Bonfiglio
L
L
Bongioanni
P
P
Pellegrinetti
A
A
Baccetti
F
F
Navalesi
R
R
Murri
L
L
D000328:Adult; D000344:Afferent Pathways / Q000503:physiopathology; D000368:Aged; D016009:Chi-Square Distribution; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D007172:Erectile Dysfunction / Q000503:physiopathology*; D005073:Evoked Potentials, Somatosensory / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology; D010413:Penis / Q000294:innervation*; D011930:Reaction Time / Q000502:physiology; D012720:Severity of Illness Index; D013003:Somatosensory Cortex / Q000503:physiopathology*; D013979:Tibial Nerve / Q000502:physiology