Peripheral and central neurologic complications in type 2 diabetes mellitus: No association in individual patients
Abstract Diabetes mellitus is associated with end-organ complications in the peripheral and central nervous system. It is unknown if these complications share a common aetiology, and if they co-occur in the same patient. The aim of the present study was to relate different measures of peripheral neu...
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| creator | Manschot, S.M Biessels, G.J Rutten, G.E.H.M Kessels, R.C.P Gispen, W.H Kappelle, L.J |
| description | Abstract Diabetes mellitus is associated with end-organ complications in the peripheral and central nervous system. It is unknown if these complications share a common aetiology, and if they co-occur in the same patient. The aim of the present study was to relate different measures of peripheral neuropathy in patients with type 2 diabetes mellitus (DM2) to cognition and brain MRI. A standardized neurological examination and questionnaire, neuropsychological examination and brain MRI were performed in 122 patients with DM2 and 56 matched controls. Measures of peripheral neuropathy were vibration threshold, a sensory examination sum score and the Toronto Clinical Neuropathy Scoring System. Neuropsychological test scores were expressed in standardized z -values across five predetermined cognitive domains. White matter lesions and cortical and subcortical atrophy were rated on MRI. Overall 38% of the patients with DM2 and 12% of the controls were classified as having any neuropathy ( p < 0.001). Patients with DM2 had a lower performance on the neuropsychological tests, more white matter lesions ( p < 0.01) and more atrophy ( p < 0.01) than controls. Within the DM2 group none of the measures of peripheral neuropathy was related to MRI abnormalities or cognitive dysfunction (linear regression analyses, adjusted for age, education, sex). We conclude that peripheral neuropathy in patients with DM2 is not related to cognitive dysfunction and brain abnormalities. This indicates that central and peripheral neurological complications of DM2 might have different etiologies. |
| doi_str_mv | 10.1016/j.jns.2007.08.011 |
| format | Article |
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It is unknown if these complications share a common aetiology, and if they co-occur in the same patient. The aim of the present study was to relate different measures of peripheral neuropathy in patients with type 2 diabetes mellitus (DM2) to cognition and brain MRI. A standardized neurological examination and questionnaire, neuropsychological examination and brain MRI were performed in 122 patients with DM2 and 56 matched controls. Measures of peripheral neuropathy were vibration threshold, a sensory examination sum score and the Toronto Clinical Neuropathy Scoring System. Neuropsychological test scores were expressed in standardized z -values across five predetermined cognitive domains. White matter lesions and cortical and subcortical atrophy were rated on MRI. Overall 38% of the patients with DM2 and 12% of the controls were classified as having any neuropathy ( p < 0.001). Patients with DM2 had a lower performance on the neuropsychological tests, more white matter lesions ( p < 0.01) and more atrophy ( p < 0.01) than controls. Within the DM2 group none of the measures of peripheral neuropathy was related to MRI abnormalities or cognitive dysfunction (linear regression analyses, adjusted for age, education, sex). We conclude that peripheral neuropathy in patients with DM2 is not related to cognitive dysfunction and brain abnormalities. This indicates that central and peripheral neurological complications of DM2 might have different etiologies.</description><identifier>ISSN: 0022-510X</identifier><identifier>EISSN: 1878-5883</identifier><identifier>DOI: 10.1016/j.jns.2007.08.011</identifier><identifier>PMID: 17850822</identifier><identifier>CODEN: JNSCAG</identifier><language>eng</language><publisher>Shannon: Elsevier B.V</publisher><subject>Aged ; Atrophy - epidemiology ; Atrophy - pathology ; Atrophy - physiopathology ; Biological and medical sciences ; Brain Diseases, Metabolic - epidemiology ; Brain Diseases, Metabolic - pathology ; Brain Diseases, Metabolic - physiopathology ; Cognition Disorders - epidemiology ; Cognition Disorders - pathology ; Cognition Disorders - physiopathology ; Diabetic Neuropathies - epidemiology ; Diabetic Neuropathies - pathology ; Diabetic Neuropathies - physiopathology ; Disease Progression ; Encephalopathy ; Female ; Humans ; Injuries of the nervous system and the skull. Diseases due to physical agents ; Magnetic Resonance Imaging ; Male ; Medical sciences ; Middle Aged ; MRI brain ; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis ; Nerve Fibers, Myelinated ; Neurologic Examination ; Neurology ; Neuropsychological investigation ; Neuropsychological Tests ; Peripheral neuropathy ; Predictive Value of Tests ; Prevalence ; Severity of Illness Index ; Somatosensory Disorders - epidemiology ; Somatosensory Disorders - pathology ; Somatosensory Disorders - physiopathology ; Surveys and Questionnaires ; Traumas. Diseases due to physical agents ; Type 2 diabetes mellitus</subject><ispartof>Journal of the neurological sciences, 2008-01, Vol.264 (1), p.157-162</ispartof><rights>2007</rights><rights>2008 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c479t-288df5c4488ba024ee6fcf3004a310abad2065b39e48df2bf1ad0ffc43e8e3b03</citedby><cites>FETCH-LOGICAL-c479t-288df5c4488ba024ee6fcf3004a310abad2065b39e48df2bf1ad0ffc43e8e3b03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jns.2007.08.011$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19998835$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17850822$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Manschot, S.M</creatorcontrib><creatorcontrib>Biessels, G.J</creatorcontrib><creatorcontrib>Rutten, G.E.H.M</creatorcontrib><creatorcontrib>Kessels, R.C.P</creatorcontrib><creatorcontrib>Gispen, W.H</creatorcontrib><creatorcontrib>Kappelle, L.J</creatorcontrib><creatorcontrib>On behalf of the Utrecht Diabetic Encephalopathy Study Group</creatorcontrib><creatorcontrib>Utrecht Diabetic Encephalopathy Study Group</creatorcontrib><title>Peripheral and central neurologic complications in type 2 diabetes mellitus: No association in individual patients</title><title>Journal of the neurological sciences</title><addtitle>J Neurol Sci</addtitle><description>Abstract Diabetes mellitus is associated with end-organ complications in the peripheral and central nervous system. It is unknown if these complications share a common aetiology, and if they co-occur in the same patient. The aim of the present study was to relate different measures of peripheral neuropathy in patients with type 2 diabetes mellitus (DM2) to cognition and brain MRI. A standardized neurological examination and questionnaire, neuropsychological examination and brain MRI were performed in 122 patients with DM2 and 56 matched controls. Measures of peripheral neuropathy were vibration threshold, a sensory examination sum score and the Toronto Clinical Neuropathy Scoring System. Neuropsychological test scores were expressed in standardized z -values across five predetermined cognitive domains. White matter lesions and cortical and subcortical atrophy were rated on MRI. Overall 38% of the patients with DM2 and 12% of the controls were classified as having any neuropathy ( p < 0.001). Patients with DM2 had a lower performance on the neuropsychological tests, more white matter lesions ( p < 0.01) and more atrophy ( p < 0.01) than controls. Within the DM2 group none of the measures of peripheral neuropathy was related to MRI abnormalities or cognitive dysfunction (linear regression analyses, adjusted for age, education, sex). We conclude that peripheral neuropathy in patients with DM2 is not related to cognitive dysfunction and brain abnormalities. This indicates that central and peripheral neurological complications of DM2 might have different etiologies.</description><subject>Aged</subject><subject>Atrophy - epidemiology</subject><subject>Atrophy - pathology</subject><subject>Atrophy - physiopathology</subject><subject>Biological and medical sciences</subject><subject>Brain Diseases, Metabolic - epidemiology</subject><subject>Brain Diseases, Metabolic - pathology</subject><subject>Brain Diseases, Metabolic - physiopathology</subject><subject>Cognition Disorders - epidemiology</subject><subject>Cognition Disorders - pathology</subject><subject>Cognition Disorders - physiopathology</subject><subject>Diabetic Neuropathies - epidemiology</subject><subject>Diabetic Neuropathies - pathology</subject><subject>Diabetic Neuropathies - physiopathology</subject><subject>Disease Progression</subject><subject>Encephalopathy</subject><subject>Female</subject><subject>Humans</subject><subject>Injuries of the nervous system and the skull. Diseases due to physical agents</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>MRI brain</subject><subject>Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis</subject><subject>Nerve Fibers, Myelinated</subject><subject>Neurologic Examination</subject><subject>Neurology</subject><subject>Neuropsychological investigation</subject><subject>Neuropsychological Tests</subject><subject>Peripheral neuropathy</subject><subject>Predictive Value of Tests</subject><subject>Prevalence</subject><subject>Severity of Illness Index</subject><subject>Somatosensory Disorders - epidemiology</subject><subject>Somatosensory Disorders - pathology</subject><subject>Somatosensory Disorders - physiopathology</subject><subject>Surveys and Questionnaires</subject><subject>Traumas. Diseases due to physical agents</subject><subject>Type 2 diabetes mellitus</subject><issn>0022-510X</issn><issn>1878-5883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kl2L1TAQhoMo7nH1B3gjudG71knanqYKgix-waKCCt6FNJlqak9SM-3C-femngMLXniVEJ55mTwzjD0WUAoQ--djOQYqJUBbgipBiDtsJ1Srikap6i7bAUhZNAK-X7AHRCMA7JXq7rML0aoGlJQ7lj5j8vNPTGbiJjhuMSzbPeCa4hR_eMttPMyTt2bxMRD3gS_HGbnkzpseFyR-wGnyy0ov-MfIDVG0_i-8sT44f-PdmiPn_JjT6SG7N5iJ8NH5vGTf3r75evW-uP707sPV6-vC1m23FFIpNzS2rpXqDcgacT_YoQKoTSXA9MZJ2Dd91WGdQdkPwjgYBltXqLDqobpkz065c4q_V6RFHzzZ3KsJGFfSLYDq2mYDxQm0KRIlHPSc_MGkoxagN9F61Fm03kRrUDqLzjVPzuFrf0B3W3E2m4GnZ8CQNdOQTLCebrmu6_KQmsy9PHGYVdx4TJps1mTR-YR20S76_7bx6p9qO_mQhzX9wiPSGNcUsmMtNEkN-su2EdtCQP580wqo_gCLvLLm</recordid><startdate>20080115</startdate><enddate>20080115</enddate><creator>Manschot, S.M</creator><creator>Biessels, G.J</creator><creator>Rutten, G.E.H.M</creator><creator>Kessels, R.C.P</creator><creator>Gispen, W.H</creator><creator>Kappelle, L.J</creator><general>Elsevier B.V</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20080115</creationdate><title>Peripheral and central neurologic complications in type 2 diabetes mellitus: No association in individual patients</title><author>Manschot, S.M ; Biessels, G.J ; Rutten, G.E.H.M ; Kessels, R.C.P ; Gispen, W.H ; Kappelle, L.J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c479t-288df5c4488ba024ee6fcf3004a310abad2065b39e48df2bf1ad0ffc43e8e3b03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Aged</topic><topic>Atrophy - epidemiology</topic><topic>Atrophy - pathology</topic><topic>Atrophy - physiopathology</topic><topic>Biological and medical sciences</topic><topic>Brain Diseases, Metabolic - epidemiology</topic><topic>Brain Diseases, Metabolic - pathology</topic><topic>Brain Diseases, Metabolic - physiopathology</topic><topic>Cognition Disorders - epidemiology</topic><topic>Cognition Disorders - pathology</topic><topic>Cognition Disorders - physiopathology</topic><topic>Diabetic Neuropathies - epidemiology</topic><topic>Diabetic Neuropathies - pathology</topic><topic>Diabetic Neuropathies - physiopathology</topic><topic>Disease Progression</topic><topic>Encephalopathy</topic><topic>Female</topic><topic>Humans</topic><topic>Injuries of the nervous system and the skull. Diseases due to physical agents</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>MRI brain</topic><topic>Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis</topic><topic>Nerve Fibers, Myelinated</topic><topic>Neurologic Examination</topic><topic>Neurology</topic><topic>Neuropsychological investigation</topic><topic>Neuropsychological Tests</topic><topic>Peripheral neuropathy</topic><topic>Predictive Value of Tests</topic><topic>Prevalence</topic><topic>Severity of Illness Index</topic><topic>Somatosensory Disorders - epidemiology</topic><topic>Somatosensory Disorders - pathology</topic><topic>Somatosensory Disorders - physiopathology</topic><topic>Surveys and Questionnaires</topic><topic>Traumas. Diseases due to physical agents</topic><topic>Type 2 diabetes mellitus</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Manschot, S.M</creatorcontrib><creatorcontrib>Biessels, G.J</creatorcontrib><creatorcontrib>Rutten, G.E.H.M</creatorcontrib><creatorcontrib>Kessels, R.C.P</creatorcontrib><creatorcontrib>Gispen, W.H</creatorcontrib><creatorcontrib>Kappelle, L.J</creatorcontrib><creatorcontrib>On behalf of the Utrecht Diabetic Encephalopathy Study Group</creatorcontrib><creatorcontrib>Utrecht Diabetic Encephalopathy Study Group</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the neurological sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Manschot, S.M</au><au>Biessels, G.J</au><au>Rutten, G.E.H.M</au><au>Kessels, R.C.P</au><au>Gispen, W.H</au><au>Kappelle, L.J</au><aucorp>On behalf of the Utrecht Diabetic Encephalopathy Study Group</aucorp><aucorp>Utrecht Diabetic Encephalopathy Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Peripheral and central neurologic complications in type 2 diabetes mellitus: No association in individual patients</atitle><jtitle>Journal of the neurological sciences</jtitle><addtitle>J Neurol Sci</addtitle><date>2008-01-15</date><risdate>2008</risdate><volume>264</volume><issue>1</issue><spage>157</spage><epage>162</epage><pages>157-162</pages><issn>0022-510X</issn><eissn>1878-5883</eissn><coden>JNSCAG</coden><abstract>Abstract Diabetes mellitus is associated with end-organ complications in the peripheral and central nervous system. It is unknown if these complications share a common aetiology, and if they co-occur in the same patient. The aim of the present study was to relate different measures of peripheral neuropathy in patients with type 2 diabetes mellitus (DM2) to cognition and brain MRI. A standardized neurological examination and questionnaire, neuropsychological examination and brain MRI were performed in 122 patients with DM2 and 56 matched controls. Measures of peripheral neuropathy were vibration threshold, a sensory examination sum score and the Toronto Clinical Neuropathy Scoring System. Neuropsychological test scores were expressed in standardized z -values across five predetermined cognitive domains. White matter lesions and cortical and subcortical atrophy were rated on MRI. Overall 38% of the patients with DM2 and 12% of the controls were classified as having any neuropathy ( p < 0.001). Patients with DM2 had a lower performance on the neuropsychological tests, more white matter lesions ( p < 0.01) and more atrophy ( p < 0.01) than controls. Within the DM2 group none of the measures of peripheral neuropathy was related to MRI abnormalities or cognitive dysfunction (linear regression analyses, adjusted for age, education, sex). We conclude that peripheral neuropathy in patients with DM2 is not related to cognitive dysfunction and brain abnormalities. This indicates that central and peripheral neurological complications of DM2 might have different etiologies.</abstract><cop>Shannon</cop><pub>Elsevier B.V</pub><pmid>17850822</pmid><doi>10.1016/j.jns.2007.08.011</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Atrophy - epidemiology Atrophy - pathology Atrophy - physiopathology Biological and medical sciences Brain Diseases, Metabolic - epidemiology Brain Diseases, Metabolic - pathology Brain Diseases, Metabolic - physiopathology Cognition Disorders - epidemiology Cognition Disorders - pathology Cognition Disorders - physiopathology Diabetic Neuropathies - epidemiology Diabetic Neuropathies - pathology Diabetic Neuropathies - physiopathology Disease Progression Encephalopathy Female Humans Injuries of the nervous system and the skull. Diseases due to physical agents Magnetic Resonance Imaging Male Medical sciences Middle Aged MRI brain Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis Nerve Fibers, Myelinated Neurologic Examination Neurology Neuropsychological investigation Neuropsychological Tests Peripheral neuropathy Predictive Value of Tests Prevalence Severity of Illness Index Somatosensory Disorders - epidemiology Somatosensory Disorders - pathology Somatosensory Disorders - physiopathology Surveys and Questionnaires Traumas. Diseases due to physical agents Type 2 diabetes mellitus |
| title | Peripheral and central neurologic complications in type 2 diabetes mellitus: No association in individual patients |
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