ArticleDiabetologia2026
Thalamic neuronal and bioenergetic function in painful diabetic peripheral neuropathy: a dual magnetic resonance spectroscopy study.
Article in Diabetologia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aims/hypothesisThe aim of this cross-sectional study was to investigate three imaging parameters in people with type 2 diabetes to examine the volume, neuronal function and bioenergetic status of the thalamus in painful diabetic peripheral neuropathy (DPN) compared with painless DPN.
methodsForty-nine participants were recruited: 38 with type 2 diabetes (of whom 11 had painless DPN, nine had diabetes without DPN and 18 had painful DPN) and 11 healthy volunteers. All underwent detailed neurological phenotyping, structural brain MRI, and dual
resultsThalamic volume did not differ between groups. However, significant group differences were observed in neuronal function, as assessed by the N-acetylaspartate:choline (NAA:Cho) ratio, and in bioenergetics, as assessed by the inorganic phosphate:ATP (Pi:ATP) ratio. NAA:Cho was significantly higher in individuals with painful DPN than in those with painless DPN. The Pi:ATP ratio was significantly lower in individuals with painful DPN than in those with painless DPN. Moreover, within the painful DPN group, pain intensity correlated with thalamic Pi:ATP, and NAA:Cho significantly correlated with Pi:ATP across the whole cohort. CONCLUSIONS/
interpretationThese findings suggest that an impaired thalamic neuronal and altered bioenergetic state, potentially consistent with impaired oxidative phosphorylation, exists in painless DPN, and that preservation of thalamic bioenergetic and neuronal profiles could be an important central mechanism of painful DPN. These findings may have clinical relevance as metabolites measured by
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