Differences in metabolites in pain-processing brain regions in patients with diabetes and painful neuropathy.
OBJECTIVE
Magnetic resonance spectroscopy (MRS) (specifically, (1)H-MRS) has been used to show changes in the brain following peripheral nerve injury in subjects without diabetes. This study used (1)H-MRS to examine the brain in subjects with or without painful diabetic neuropathy.


METHODS
Twenty-six diabetic subjects (12 with and 14 without chronic neuropathic pain) were compared, with 18 subjects without diabetes and pain. The left thalamus, anterior cingulate cortex (ACC), and dorsolateral prefrontal cortex (DLPFC) were assessed using (1)H-MRS.


RESULTS
In the DLPFC, diabetic subjects had a decrease in N-acetyl aspartate (NAA) and creatine relative to the control group. In the thalamus, there was a reduction of NAA in the diabetic group with pain compared with that in patients with diabetes and no pain.


CONCLUSIONS
Subjects with diabetes have metabolite differences in the brain compared with control subjects. Subjects with painful neuropathy showed reduced NAA in the thalamus, which may explain the genesis of pain in some cases.
Sorensen
Lea
L
Diabetes Centre, Royal Prince Alfred Hospital, Camperdown, Australia. lea@email.cs.nsw.gov.au
Siddall
Philip J
PJ
Trenell
Michael I
MI
Yue
Dennis K
DK
D000328:Adult; D000368:Aged; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001921:Brain / Q000473:pathology*; D001931:Brain Mapping; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D003929:Diabetic Neuropathies / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D005625:Frontal Lobe / Q000473:pathology; D006179:Gyrus Cinguli / Q000473:pathology; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000473:pathology / Q000503:physiopathology*; D012016:Reference Values; D012684:Sensory Thresholds; D013788:Thalamus / Q000473:pathology
D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline