title: Altered excitation-inhibition balance in the brain of patients with diabetic neuropathy.
abstract: OBJECTIVE
  To assess differences in excitatory (glutamate/glutamine or Glx) and inhibitory (γ-Aminobutyric acid or GABA) neurotransmitter levels using MR spectroscopy in pain processing regions of the brain in patients diabetic neuropathy (DN) and positive sensory symptoms and age-matched healthy control (HC) subjects.
  
  
  METHODS
  Seven diabetic patients (5 males, 2 females, mean age = 57.0 ± 8.5 years) with confirmed DN and positive sensory symptoms and 7 age and sex matched HC subjects (mean age = 57.7 ± 3.2 years) underwent 3 Tesla MR spectroscopy. Glx and GABA levels were quantified in the right anterior and posterior insula, anterior cingulate cortex and right thalamus.
  
  
  RESULTS
  Mean Glx levels were significantly higher and mean GABA levels were significantly lower within the posterior insula in the DN patients compared to HC (P = 0.005 and 0.012 respectively).
  
  
  CONCLUSIONS
  This pilot data demonstrates an excitatory/inhibitory neurotransmitter imbalance in the brain of in patients with DN and positive sensory symptoms compared to pain free HC subjects.
authors.affiliation: Department of Radiology, Division of Neuroradiology, University of Michigan, 1500 E. Medical Center Drive, SPC 5030, UH B2 A209, Ann Arbor, MI 48109-5030, USA. mpetrou@umich.edu
authors.forename: Myria
authors.initials: M
authors.lastname: Petrou
authors.forename: Rodica
authors.initials: R
authors.lastname: Pop-Busui
authors.forename: Bradley R
authors.initials: BR
authors.lastname: Foerster
authors.forename: Richard A
authors.initials: RA
authors.lastname: Edden
authors.forename: Brian C
authors.initials: BC
authors.lastname: Callaghan
authors.forename: Steve E
authors.initials: SE
authors.lastname: Harte
authors.forename: Richard E
authors.initials: RE
authors.lastname: Harris
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Clauw
authors.forename: Eva L
authors.initials: EL
authors.lastname: Feldman
mesh_terms: D001921:Brain / Q000378:metabolism*; D003929:Diabetic Neuropathies / Q000150:complications* / Q000378:metabolism*; D005260:Female; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D018377:Neurotransmitter Agents / Q000378:metabolism*; D010146:Pain / Q000150:complications* / Q000378:metabolism*
chemical_list: D018377:Neurotransmitter Agents