Impaired blood flow and arterio-venous shunting in human diabetic neuropathy: a novel technique of nerve photography and fluorescein angiography - PubMed (original) (raw)

. 1993 Dec;36(12):1266-74.

doi: 10.1007/BF00400804.

Affiliations

• PMID: 8307254
• DOI: 10.1007/BF00400804

Impaired blood flow and arterio-venous shunting in human diabetic neuropathy: a novel technique of nerve photography and fluorescein angiography

S Tesfaye et al. Diabetologia. 1993 Dec.

Abstract

New techniques of sural nerve photography and fluorescein angiography which are able to provide an index of nerve blood flow have been developed. Under local anaesthetic, 3 cm of sural nerve was exposed at the ankle using an operating microscope. Without disturbing the epineurium, vessels were identified and photographed at a standard magnification (x 30). These were independently graded by an ophthalmologist not otherwise involved with the study. Fluorescein angiography was then carried out on the exposed nerve. The fluorescein appearance time and intensity of fluorescence were quantified, using computer analysis of digitised images. Thirteen subjects with chronic sensory motor neuropathy, five non-neuropathic diabetic and nine normal control subjects were studied. The mean epineurial vessel pathology score of the neuropathic group was significantly higher than the combined normal control and non-neuropathic diabetic groups (p < 0.01). Direct epineurial arteriovenous shunting was observed in six neuropathic and one non-neuropathic diabetic patients and not in any of the normal control subjects. The nerve fluorescein appearance time was significantly delayed in subjects with chronic sensory motor neuropathy (51.5 +/- 12 s) compared to both normal (34.7 +/- 9 s, p < 0.01) and non-neuropathic diabetic subjects (33.4 +/- 11 s, p < 0.025). The mean intensity of fluorescence at 96, 252 and 576 s, was significantly lower in subjects with chronic sensory motor neuropathy compared with both of the other groups (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PubMed Disclaimer

Comment in

• Endothelial dysfunction and diabetic angiopathy.
  Wascher TC, Toplak H. Wascher TC, et al. Diabetologia. 1994 Nov;37(11):1167-8. doi: 10.1007/BF00418383. Diabetologia. 1994. PMID: 7867890 No abstract available.

Similar articles

• Arterio-venous shunting and proliferating new vessels in acute painful neuropathy of rapid glycaemic control (insulin neuritis).
  Tesfaye S, Malik R, Harris N, Jakubowski JJ, Mody C, Rennie IG, Ward JD. Tesfaye S, et al. Diabetologia. 1996 Mar;39(3):329-35. doi: 10.1007/BF00418349. Diabetologia. 1996. PMID: 8721779
• Exercise-induced conduction velocity increment: a marker of impaired peripheral nerve blood flow in diabetic neuropathy.
  Tesfaye S, Harris ND, Wilson RM, Ward JD. Tesfaye S, et al. Diabetologia. 1992 Feb;35(2):155-9. doi: 10.1007/BF00402548. Diabetologia. 1992. PMID: 1547920
• Increased sural nerve epineurial blood flow in human subjects with painful diabetic neuropathy.
  Eaton SE, Harris ND, Ibrahim S, Patel KA, Selmi F, Radatz M, Ward JD, Tesfaye S. Eaton SE, et al. Diabetologia. 2003 Jul;46(7):934-9. doi: 10.1007/s00125-003-1127-3. Epub 2003 Jun 19. Diabetologia. 2003. PMID: 12819899
• Vascular factors in diabetic neuropathy.
  Tesfaye S, Malik R, Ward JD. Tesfaye S, et al. Diabetologia. 1994 Sep;37(9):847-54. doi: 10.1007/BF00400938. Diabetologia. 1994. PMID: 7806013 Review.
• Abnormal microvasculature in diabetic neuropathy.
  Ward JD. Ward JD. Eye (Lond). 1993;7 ( Pt 2):223-6. doi: 10.1038/eye.1993.53. Eye (Lond). 1993. PMID: 7607339 Review.

Cited by

• Reversal of experimental diabetic neuropathy by VEGF gene transfer.
  Schratzberger P, Walter DH, Rittig K, Bahlmann FH, Pola R, Curry C, Silver M, Krainin JG, Weinberg DH, Ropper AH, Isner JM. Schratzberger P, et al. J Clin Invest. 2001 May;107(9):1083-92. doi: 10.1172/JCI12188. J Clin Invest. 2001. PMID: 11342572 Free PMC article.
• Pathogenesis of Distal Symmetrical Polyneuropathy in Diabetes.
  Smith S, Normahani P, Lane T, Hohenschurz-Schmidt D, Oliver N, Davies AH. Smith S, et al. Life (Basel). 2022 Jul 19;12(7):1074. doi: 10.3390/life12071074. Life (Basel). 2022. PMID: 35888162 Free PMC article. Review.
• Neuroprotective effects of carvedilol in diabetic rats: prevention of defective peripheral nerve perfusion and conduction velocity.
  Cotter MA, Cameron NE. Cotter MA, et al. Naunyn Schmiedebergs Arch Pharmacol. 1995 Jun;351(6):630-5. doi: 10.1007/BF00170163. Naunyn Schmiedebergs Arch Pharmacol. 1995. PMID: 7675122
• Restoring lower limb blood flow improves conduction velocity in diabetic patients.
  Young MJ, Veves A, Smith JV, Walker MG, Boulton AJ. Young MJ, et al. Diabetologia. 1995 Sep;38(9):1051-4. doi: 10.1007/BF00402174. Diabetologia. 1995. PMID: 8591818
• Effects of evening primrose oil treatment on sciatic nerve blood flow and endoneurial oxygen tension in streptozotocin-diabetic rats.
  Cameron NE, Cotter MA. Cameron NE, et al. Acta Diabetol. 1994 Dec;31(4):220-5. doi: 10.1007/BF00571955. Acta Diabetol. 1994. PMID: 7888693

References

1. 1. Br Med J (Clin Res Ed). 1986 Oct 25;293(6554):1053-4 - PubMed
2. 1. Neurology. 1989 Jan;39(1):111-8 - PubMed
3. 1. Diabetologia. 1982 Jan;22(1):6-8 - PubMed
4. 1. Clin Physiol. 1985 Jun;5(3):293-9 - PubMed
5. 1. Diabetes. 1976;25(2 SUPPL):839-44 - PubMed

MeSH terms

LinkOut - more resources

• Medical

  • MedlinePlus Health Information