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

Authors
  • Brown, Ryan1
  • Sharafi, Azadeh2
  • Slade, Jill M3
  • Convit, Antonio4, 5
  • Davis, Nathan6
  • Baete, Steven2
  • Milton, Heather7
  • Mroczek, Kenneth J8
  • Kluding, Patricia M9
  • Regatte, Ravinder R2
  • Parasoglou, Prodromos2
  • Rao, Smita10
  • 1 Department of Radiology, New York University Grossman School of Medicine, New York City, New York, USA [email protected]
  • 2 Department of Radiology, New York University Grossman School of Medicine, New York City, New York, USA.
  • 3 Department of Radiology, Michigan State University, East Lansing, Michigan, USA.
  • 4 Department of Psychiatry, New York University Grossman School of Medicine, New York City, New York, USA.
  • 5 Department of Psychiatry, Nathan S Kline Institute for Psychiatric Research, Orangeburg, New York, USA.
  • 6 Department of Osteopathic Medicine, New York Institute of Technology, Old Westbury, New York, USA.
  • 7 Sports Performance Center, New York University Langone Health, New York City, New York, USA.
  • 8 Department of Orthopedic Surgery, New York University Grossman School of Medicine, New York City, New York, USA.
  • 9 Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, Kansas, USA.
  • 10 Department of Physical Therapy, New York University, New York City, New York, USA.
Type
Published Article
Journal
BMJ Open Diabetes Research & Care
Publisher
BMJ
Publication Date
Sep 01, 2021
Volume
9
Issue
1
Identifiers
DOI: 10.1136/bmjdrc-2021-002312
PMID: 34518157
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The 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). Twenty 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. There 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). The 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. © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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