Why the study?
To compare sympathetic vasomotor activation of the brachial arteries between healthy subjects and patients with painful diabetic neuropathy to assess whether diabetic neuropathy causes significant vasomotor dysfunction in medium-sized arteries.
Does electrical stimulation of the median nerve reveal impaired vasomotor function in the brachial arteries of patients with painful diabetic neuropathy compared to healthy controls?
Does electrical stimulation of the median nerve reveal impaired vasomotor function in the brachial arteries of patients with painful diabetic neuropathy compared to healthy controls?
Patients with painful diabetic neuropathy exhibit significant vasomotor dysfunction in medium-sized peripheral arteries, characterized by an inability to vasoconstrict in response to sympathetic activation.
May indicate vasomotor dysfunction in painful diabetic neuropathy; leaves open clinical relevance and need for validation.
BACKGROUND The effect of the sympathetic nervous system on peripheral arteries causes vasoconstriction when smooth muscle cells in the walls of blood vessels contract, which leads to narrowing of arteries and reduction of the blood flow. AIM To compare sympathetic vasomotor activation of the brachial arteries in healthy subjects and patients with painful diabetic neuropathy; and therefore, to assess whether there is significant vasomotor dysfunction of medium sized arteries in diabetic neuropathy. METHODS The study included 41 diabetic neuropathy patients and 41 healthy controls. Baseline diameter and flow rate of the brachial arteries were measured. Then, using a bipolar stimulus electrode, a 10 mA, 1 Hz electrical stimulus was administered to the median nerve at the wrist level for 5 s. The brachial artery diameter and blood flow rate were re-measured after stimulation. RESULTS In the control group, the median flow rate was 70.0 mL/min prior to stimulation and 35.0 mL/min after stimulation, with a statistically significant decrease (P < 0.001), which is consistent with sympathetic nervous system functioning (vasoconstriction). In the diabetic neuropathy group, median flow rate before the stimulation was 35.0 mL/min. After stimulation, the median flow rate was 77.0 mL/min; thus, no significant decrease in the flow rate was detected. In the control group, the median brachial artery diameter, which was 3.6 mm prior to stimulation, decreased to 3.4 mm after stimulation, and this decrease was also statistically significant (P = 0.046). In the diabetic neuropathy group, the median brachial artery diameter increased from 3.4 mm to 3.6 mm following nerve stimulation. Once again, no narrowing was observed. CONCLUSION Our research suggests that diabetic neuropathy results in significant vasomotor dysfunction of medium sized peripheral arteries. Physiological vasoconstriction in response to sympathetic activation is impaired in diabetic neuropathy.
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Ege et al. (2023) studied this question.
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