Kavita Venkataraman1, Vivian Pun2, Abdalla Z Mohamed3, Miyang Luo2, Caroline Wong4, Fangrong Zong3, Eric Y H Khoo5, E Shyong Tai5, Fatima Nasrallah6. 1. Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore f.nasrallah@uq.edu.au ephkv@nus.edu.sg. 2. Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore. 3. The Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia. 4. The Clinical Imaging Research Center, National University of Singapore, Singapore. 5. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore. 6. The Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia f.nasrallah@uq.edu.au ephkv@nus.edu.sg.
Abstract
OBJECTIVE: To compare central nervous system (CNS) activation in patients with and without diabetic peripheral neuropathy (DPN) during motor and motor imagery tasks and to correlate activation with functional performance. RESEARCH DESIGN AND METHODS: Twenty-six participants (13 with DPN, 13 without DPN) underwent functional MRI during three tasks: ankle dorsi plantar flexion (motor task [MT]) and motor imagery tasks of walking on a smooth surface (SMIT) and rough surface (RMIT). Functional assessment included gait analysis, ankle muscle strength, and ankle range of motion. RESULTS: The tasks activated the sensorimotor, motor preparation, visual processing, and decision-making regions. Activation was significantly lower in patients with DPN than in those without DPN during MT and SMIT but not RMIT. Poor functional performance in patients with DPN was associated with greater activation in motor preparation regions. CONCLUSIONS: In patients with DPN, CNS responses appear muted compared with patients without DPN, but they remain capable of enhancing CNS activation when tasks are more challenging or when functional deficits are substantial.
OBJECTIVE: To compare central nervous system (CNS) activation in patients with and without diabetic peripheral neuropathy (DPN) during motor and motor imagery tasks and to correlate activation with functional performance. RESEARCH DESIGN AND METHODS: Twenty-six participants (13 with DPN, 13 without DPN) underwent functional MRI during three tasks: ankle dorsi plantar flexion (motor task [MT]) and motor imagery tasks of walking on a smooth surface (SMIT) and rough surface (RMIT). Functional assessment included gait analysis, ankle muscle strength, and ankle range of motion. RESULTS: The tasks activated the sensorimotor, motor preparation, visual processing, and decision-making regions. Activation was significantly lower in patients with DPN than in those without DPN during MT and SMIT but not RMIT. Poor functional performance in patients with DPN was associated with greater activation in motor preparation regions. CONCLUSIONS: In patients with DPN, CNS responses appear muted compared with patients without DPN, but they remain capable of enhancing CNS activation when tasks are more challenging or when functional deficits are substantial.