Evidence map›Paper›PMID 40808862›Full record

ArticleDiabetes, metabolic syndrome and obesity : targets and therapy2025

Causal Central Network Remodeling in Diabetic Neuropathy: An Integrated MR-fMRI Study.

Xiya Li, Ling Gao

Abstract read
In one paragraph

Article in Diabetes, metabolic syndrome and obesity : targets and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Xiya LiDepartment of Endocrinology and Metabolism, Renmin Hospital, Wuhan University, Wuhan, People's Republic of China.ORCID 0009-0008-3233-3674
Ling GaoDepartment of Endocrinology and Metabolism, Renmin Hospital, Wuhan University, Wuhan, People's Republic of China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: Diabetic peripheral neuropathy (DPN) is traditionally viewed as a peripheral disorder, yet emerging evidence implicates central nervous system (CNS) network dysfunction in its pathogenesis, though causal mechanisms remain incompletely understood. Methods: Bidirectional two-sample Mendelian randomization (MR) analysis examined causal relationships between Resting-State Functional Magnetic Resonance Imaging (rs-fMRI) phenotypes (n=34,691) and DPN (n=96,474). For validation, amplitude of low-frequency fluctuation (ALFF) and functional connectivity (FC) analyses were conducted using rs-fMRI scans from DPN patients (n=16), diabetic controls without DPN (NDPN, n=24), and healthy controls (HC, n=20). Results: Bidirectional MR demonstrated that: (a) reduced default mode-visual network connectivity causally elevates DPN risk (OR=0.61, P=0.04); (b) DPN promotes subcortical-cerebellar hyperconnectivity (OR=1.04, P=0.01). DPN patients exhibited significantly higher age, triglyceride levels, pain scores, and cognitive impairment relative to comparison groups (all P<0.001). Neuroimaging identified increased ALFF in the left superior frontal gyrus (LSFG) (AUC=0.79, P<0.05), which correlated positively with disease duration, accompanied by decoupled FC with the lingual gyrus but enhanced FC with the precuneus. Conclusion: This study establishes DPN as a CNS-periphery integrated network disorder: genetic drivers disrupt default mode-visual integration, while compensatory subcortical-cerebellar hyperconnectivity stabilizes motor function via adaptive mechanisms. The LSFG emerges as a neuroadaptive hub, where elevated ALFF and connectivity reorganization (↓lingual gyrus/↑precuneus) reflect dynamic rebalancing between impaired basic vision and enhanced visuospatial processing. These findings redefine DPN pathogenesis beyond pure peripheral neurodegeneration, providing a theoretical foundation for early detection and circuit-targeted neuromodulation therapies.

Indexed as

diabetic peripheral neuropathyfMRIlow-frequency fluctuationsMendelian random analysistype 2 diabetes mellitus

Identifiers

PMID40808862
PMCPMC12345936

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.