What question did this study set out to answer?

This study aims to explore the relationship between corneal nerve parameters and neuropathic pain in individuals with prediabetes and type 2 diabetes.

February 12, 2026Diabetologia2 citationsOpen Access

Association of corneal nerve parameters with nerve abnormalities and neuropathic pain in prediabetes and type 2 diabetes: the Maastricht Study

MBMette K. BorbjergSteno Diabetes Centers SMSara MokhtarMaastricht University NSNadia A. SutedjaMaastricht University Medical Centre

Puntos clave

This study aims to explore the relationship between corneal nerve parameters and neuropathic pain in individuals with prediabetes and type 2 diabetes.
Analyzed cross-sectional data from 3425 participants in the Maastricht Study
Utilized wide-field corneal confocal microscopy to measure corneal nerve parameters
Created an axonal degeneration score using compound muscle action potentials and sensory nerve action potentials
Significant associations were found between axonal degeneration EMG scores and corneal nerve parameters
No significant associations were observed between neuropathic pain and corneal nerve parameters
Mean age of participants was 59.2 years, with noted prediabetes and diabetes rates among the population

Resumen

Abstract Aims/hypothesis Corneal confocal microscopy is a valuable technique for assessing neuropathy; however, whether it can distinguish painful from painless neuropathy remains uncertain and existing evidence is based on the results of smaller studies. This study assessed the association of corneal nerve parameters with abnormalities identified by electromyography (EMG) and neuropathic pain in a large population with and without (pre)diabetes. Methods In this study we included cross-sectional data for 3425 participants from the Maastricht Study. Wide-field corneal confocal microscopy (WF-CCM) was performed using fully automated analysis of three corneal nerve parameters: corneal nerve branch density (CNBD), corneal nerve fibre density (CNFD) and corneal nerve fibre length (CNFL). An axonal degeneration composite score comprising compound muscle action potential amplitudes (peroneal and tibial) and the sensory nerve action potential amplitude of the sural nerve was created by categorising EMG amplitudes as normal or indicating minor (≤10th percentile), moderate (≤5th percentile) or severe (≤2.5th percentile) abnormalities. Neuropathic pain was determined as a modified Douleur Neuropathique en 4 Questions (DN4) interview score ≥3. Results The mean age of the participants was 59.2 years; 51.6% were female, 15% had prediabetes (defined as impaired fasting glucose, impaired glucose tolerance or both) and 19% had type 2 diabetes. The median diabetes duration was 3.0 years. Regression analyses revealed statistically significant associations between the axonal degeneration EMG score and WF-CCM parameters (CNFL: β=−0.51 95% CI −0.78, −0.24; CNFD: β=−1.56 95% CI −3.04, −0.08; CNBD: β=−3.08 95% CI −5.51, −0.64; all p 0.1). Conclusions/interpretation The study found associations between the axonal degeneration EMG score and WF-CCM, but no associations were observed between neuropathic pain and WF-CCM parameters, suggesting that WF-CCM has limited value in assessing neuropathic pain. Graphical Abstract

Preguntar a la IA

Me gusta

Guardar

Ver artículo completo