Prodromos Parasoglou1, Smita Rao2, Jill M Slade3. 1. Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York; Center for Advanced Imaging Innovation and Research (CAI(2)R), Department of Radiology, New York University School of Medicine, New York, New York. Electronic address: prodromos.parasoglou@nyumc.org. 2. Department of Physical Therapy, New York University, New York, New York. 3. Department of Radiology, Michigan State University, East Lansing, Michigan; Biomedical Imaging Research Center, Michigan State University, East Lansing, Michigan.
Abstract
PURPOSE: The present review highlights current concepts regarding the effects of diabetic peripheral neuropathy (DPN) in skeletal muscle. It discusses the lack of effective pharmacologic treatments and the role of physical exercise intervention in limb protection and symptom reversal. It also highlights the importance of magnetic resonance imaging (MRI) techniques in providing a mechanistic understanding of the disease and helping develop targeted treatments. METHODS: This review provides a comprehensive reporting on the effects of DPN in the skeletal muscle of patients with diabetes. It also provides an update on the most recent trials of exercise intervention targeting DPN pathology. Lastly, we report on emerging MRI techniques that have shown promise in providing a mechanistic understanding of DPN and can help improve the design and implementation of clinical trials in the future. FINDINGS: Impairments in lower limb muscles reduce functional capacity and contribute to altered gait, increased fall risk, and impaired balance in patients with DPN. This finding is an important concern for patients with DPN because their falls are likely to be injurious and lead to bone fractures, poorly healing wounds, and chronic infections that may require amputation. Preliminary studies have shown that moderate-intensity exercise programs are well tolerated by patients with DPN. They can improve their cardiorespiratory function and partially reverse some of the symptoms of DPN. MRI has the potential to bring new mechanistic insights into the effects of DPN as well as to objectively measure small changes in DPN pathology as a result of intervention. IMPLICATIONS: Noninvasive exercise intervention is particularly valuable in DPN because of its safety, low cost, and potential to augment pharmacologic interventions. As we gain a better mechanistic understanding of the disease, more targeted and effective interventions can be designed.
PURPOSE: The present review highlights current concepts regarding the effects of diabetic peripheral neuropathy (DPN) in skeletal muscle. It discusses the lack of effective pharmacologic treatments and the role of physical exercise intervention in limb protection and symptom reversal. It also highlights the importance of magnetic resonance imaging (MRI) techniques in providing a mechanistic understanding of the disease and helping develop targeted treatments. METHODS: This review provides a comprehensive reporting on the effects of DPN in the skeletal muscle of patients with diabetes. It also provides an update on the most recent trials of exercise intervention targeting DPN pathology. Lastly, we report on emerging MRI techniques that have shown promise in providing a mechanistic understanding of DPN and can help improve the design and implementation of clinical trials in the future. FINDINGS: Impairments in lower limb muscles reduce functional capacity and contribute to altered gait, increased fall risk, and impaired balance in patients with DPN. This finding is an important concern for patients with DPN because their falls are likely to be injurious and lead to bone fractures, poorly healing wounds, and chronic infections that may require amputation. Preliminary studies have shown that moderate-intensity exercise programs are well tolerated by patients with DPN. They can improve their cardiorespiratory function and partially reverse some of the symptoms of DPN. MRI has the potential to bring new mechanistic insights into the effects of DPN as well as to objectively measure small changes in DPN pathology as a result of intervention. IMPLICATIONS: Noninvasive exercise intervention is particularly valuable in DPN because of its safety, low cost, and potential to augment pharmacologic interventions. As we gain a better mechanistic understanding of the disease, more targeted and effective interventions can be designed.
Authors: Dympna Gallagher; Patrick Kuznia; Stanley Heshka; Jeanine Albu; Steven B Heymsfield; Bret Goodpaster; Marjolein Visser; Tamara B Harris Journal: Am J Clin Nutr Date: 2005-04 Impact factor: 7.045
Authors: Ann V Schwartz; Eric Vittinghoff; Deborah E Sellmeyer; Kenneth R Feingold; Nathalie de Rekeneire; Elsa S Strotmeyer; Ronald I Shorr; Aaron I Vinik; Michelle C Odden; Seok Won Park; Kimberly A Faulkner; Tamara B Harris Journal: Diabetes Care Date: 2007-12-04 Impact factor: 19.112
Authors: Stephan Morbach; Heike Furchert; Ute Gröblinghoff; Heribert Hoffmeier; Kerstin Kersten; Gerd-Thomas Klauke; Ulrike Klemp; Thomas Roden; Andrea Icks; Burkhard Haastert; Gerhard Rümenapf; Zulfiqarali G Abbas; Manish Bharara; David G Armstrong Journal: Diabetes Care Date: 2012-07-18 Impact factor: 19.112
Authors: Azadeh Sharafi; Katherine Medina; Marcelo W V Zibetti; Smita Rao; Martijn A Cloos; Ryan Brown; Ravinder R Regatte Journal: Magn Reson Med Date: 2021-02-08 Impact factor: 3.737
Authors: Hélio José Coelho Junior; Iris Callado Sanches; Marcio Doro; Ricardo Yukio Asano; Daniele Jardim Feriani; Cayque Brietzke; Ivan de Oliveira Gonçalves; Marco Carlos Uchida; Erico Chagas Capeturo; Bruno Rodrigues Journal: Biomed Res Int Date: 2018-02-14 Impact factor: 3.411
Authors: Jane S S P Ferreira; João P Panighel; Érica Q Silva; Renan L Monteiro; Ronaldo H Cruvinel Júnior; Isabel C N Sacco Journal: Diabetol Metab Syndr Date: 2019-10-30 Impact factor: 3.320
Authors: Matthew T Lewis; Jonathan D Kasper; Jason N Bazil; Jefferson C Frisbee; Robert W Wiseman Journal: Int J Mol Sci Date: 2019-10-24 Impact factor: 5.923