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Altered Excitation-inhibition Balance in the Brain of Patients with Diabetic Neuropathy

  • Myria Petrou
    Correspondence
    Address correspondence to: M.P.
    Affiliations
    Department of Radiology, Division of Neuroradiology, University of Michigan, 1500 E. Medical Center Drive, SPC 5030, UH B2 A209, Ann Arbor, MI 48109-5030

    Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD
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  • Rodica Pop-Busui
    Affiliations
    Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan, 1500 E. Medical Center Drive, SPC 5030, UH B2 A209, Ann Arbor, MI 48109-5030
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  • Bradley R. Foerster
    Affiliations
    Department of Radiology, Division of Neuroradiology, University of Michigan, 1500 E. Medical Center Drive, SPC 5030, UH B2 A209, Ann Arbor, MI 48109-5030

    Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD

    Ann Arbor VA Healthcare System, Ann Arbor, MI
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  • Richard A. Edden
    Affiliations
    Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD

    F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD
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  • Brian C. Callaghan
    Affiliations
    Department of Neurology, University of Michigan, 1500 E. Medical Center Drive, SPC 5030, UH B2 A209, Ann Arbor, MI 48109-5030
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  • Steve E. Harte
    Affiliations
    Department of Anesthesiology, University of Michigan, 1500 E. Medical Center Drive, SPC 5030, UH B2 A209, Ann Arbor, MI 48109-5030
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  • Richard E. Harris
    Affiliations
    Department of Anesthesiology, University of Michigan, 1500 E. Medical Center Drive, SPC 5030, UH B2 A209, Ann Arbor, MI 48109-5030

    Department of Internal Medicine, Division of Rheumatology, University of Michigan, 1500 E. Medical Center Drive, SPC 5030, UH B2 A209, Ann Arbor, MI 48109-5030
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  • Daniel J. Clauw
    Affiliations
    Department of Anesthesiology, University of Michigan, 1500 E. Medical Center Drive, SPC 5030, UH B2 A209, Ann Arbor, MI 48109-5030

    Department of Internal Medicine, Division of Rheumatology, University of Michigan, 1500 E. Medical Center Drive, SPC 5030, UH B2 A209, Ann Arbor, MI 48109-5030

    Department of Psychiatry, University of Michigan, 1500 E. Medical Center Drive, SPC 5030, UH B2 A209, Ann Arbor, MI 48109-5030
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  • Eva L. Feldman
    Affiliations
    Department of Neurology, University of Michigan, 1500 E. Medical Center Drive, SPC 5030, UH B2 A209, Ann Arbor, MI 48109-5030
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      Rationale and Objectives

      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.

      Materials and 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.

      Key Words

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