Published online Aug 6, 2023. doi: 10.12998/wjcc.v11.i22.5244
Peer-review started: March 29, 2023
First decision: June 1, 2023
Revised: June 6, 2023
Accepted: July 3, 2023
Article in press: July 3, 2023
Published online: August 6, 2023
Processing time: 126 Days and 15.5 Hours
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.
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.
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 admini
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.
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.
Core Tip: Our research is consistent with the observations that diabetic neuropathy results in sympathetic vasomotor dysfunction. Furthermore, the new non-invasive, inexpensive, and user-friendly technique that we offer is sensitive to this phenomenon in medium sized arteries. It also has the potential to be used as a tool for early detection of sympathetic dysfunction due to other causes. Our research suggests that diabetic neuropathy results in significant vasomotor dysfunction of medium sized peripheral arteries. Moreover, this is the first study to investigate diabetic autonomic neuropathy in medium sized arteries. Physiological vasoconstriction in response to sympathetic activation is impaired in painful diabetic neuropathy.