Lower extremity MRI following 10-week supervised exercise intervention in patients with diabetic peripheral neuropathy

Abstract

IntroductionThe purpose of this study was to characterize using MRI the effects of a 10-week supervised exercise program on lower extremity skeletal muscle composition, nerve microarchitecture, and metabolic function in individuals with diabetic peripheral neuropathy (DPN).Research design and methodsTwenty participants with DPN completed a longitudinal trial consisting of a 30-day control period, during which subjects made no change to their lifestyle, followed by a 10-week intervention program that included three supervised aerobic and resistance exercise sessions per week targeting the upper and lower extremities. The participants’ midcalves were scanned with multinuclear MRI two times prior to intervention (baseline1 and baseline2) and once following intervention to measure relaxation times (T1, T1ρ, and T2), phosphocreatine recovery, fat fraction, and diffusion parameters.ResultsThere were no changes between baseline1 and baseline2 MRI metrics (p>0.2). Significant changes (p<0.05) between baseline2 and postintervention MRI metrics were: gastrocnemius medialis (GM) T1 –2.3%±3.0% and soleus T2 –3.2%±3.1%. Trends toward significant changes (0.05<p<0.1) between baseline2 and postintervention MRI metrics were: calf adipose infiltration –2.6%±6.4%, GM T1ρ –4.1%±7.7%, GM T2 –3.5%±6.4%, and gastrocnemius lateral T2 −4.6±7.4%. Insignificant changes were observed in gastrocnemius phosphocreatine recovery rate constant (p>0.3) and tibial nerve fractional anisotropy (p>0.6) and apparent diffusion coefficient (p>0.4).ConclusionsThe 10-week supervised exercise intervention program successfully reduced adiposity and altered resting tissue properties in the lower leg in DPN. Gastrocnemius mitochondrial oxidative capacity and tibial nerve microarchitecture changes were not observed, either due to lack of response to therapy or to lack of measurement sensitivity.

Alteration of skeletal muscle energy metabolism assessed by phosphorus‐31 magnetic resonance spectroscopy in clinical routine, part 1: Advanced quality control pipeline

“…The latter deserves special attention because the monoexponential adjustment, used to extract the time constants of PCr and Pi during the exercise and recovery phase, strongly depends on the last point of the exercise, that is, the first point for the recovery period to be considered. Therefore, based on the literature 4 and our own experience (processing hundreds of datasets across various populations [20][21][22][23][24][25] ), we proposed a quality control score (QCS), intended to reflect the quality of the data acquisition and of the estimated parameters, as described in Figure 1.…”

The Relationship between Muscle Ultrasound Parameters and Diabetic Peripheral Neuropathy among Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study

“…As a pair of antagonistic muscles, the tibialis anterior (TA) and medial head of the gastrocnemius (MG) work together to keep the ankle balanced. One study observed that patients with DPN reduced adiposity and modified tissue properties of MG based on MRI measurements after a 10-week supervised training [ 14 ]. While no difference was found in MT and shear wave velocity (SWV) of TA between patients with or without DPN [ 15 ], additional studies are needed due to its essential motor function and anatomical characteristics.…”

Intraocular Pressure Fluctuation during Aerobic Exercise at Different Exercise Intensities

“…This study also reported that continuous exercise therapy improved muscle quality in patients with diabetic neuropathy [ 8 ]. Furthermore, after 16 weeks of aerobic exercise, perceived pain interference was reduced among patients with painful diabetic polyneuropathy [ 9 ]. On the contrary, exercise has been reported to improve the severity of symptoms in patients with diabetic nephropathy and neuropathy, but there have been no studies on its effect in patients with retinopathy [ 10 , 11 ].…”