Fiber loss is primary and multifocal in sural nerves in diabetic polyneuropathy

Peter J Dyck, A. Lais, J. L. Karnes, P. O'Brien, R. Rizza

Research output: Contribution to journalArticle

265 Citations (Scopus)

Abstract

Pathological, morphometric, and teased fiber studies of sural nerve from 36 diabetic patients with (n = 32) and without (n = 4) neuropathy and from 47 healthy subjects provide evidence that in diabetic polyneuropathy: (1) fiber loss is primary; (2) demyelination and remyelination with or without onion bulb formation are secondary; (3) remaining fibers, on average, have the same ratio of small to large fibers as in healthy individuals, but with a greatly increased variability; and (4) the spatial distribution of fiber loss is both diffuse and multifocal. Criteria developed during the study of experimental models of ischemic neuropathy were employed to assess whether ischemic nerve damage had occurred in diabetic polyneuropathy. We conclude that there is increasing evidence that microvascular pathological abnormality and ischemia may be involved in the pathogenesis of human diabetic polyneuropathy. Cases with selective loss of small or large afferent fibers are probably extremes of normal distribution and not different disorders.

Original languageEnglish (US)
Pages (from-to)425-439
Number of pages15
JournalAnnals of Neurology
Volume19
Issue number5
StatePublished - 1986

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Sural Nerve
Diabetic Neuropathies
Onions
Normal Distribution
Demyelinating Diseases
Healthy Volunteers
Theoretical Models
Ischemia

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Dyck, P. J., Lais, A., Karnes, J. L., O'Brien, P., & Rizza, R. (1986). Fiber loss is primary and multifocal in sural nerves in diabetic polyneuropathy. Annals of Neurology, 19(5), 425-439.

Fiber loss is primary and multifocal in sural nerves in diabetic polyneuropathy. / Dyck, Peter J; Lais, A.; Karnes, J. L.; O'Brien, P.; Rizza, R.

In: Annals of Neurology, Vol. 19, No. 5, 1986, p. 425-439.

Research output: Contribution to journalArticle

Dyck, PJ, Lais, A, Karnes, JL, O'Brien, P & Rizza, R 1986, 'Fiber loss is primary and multifocal in sural nerves in diabetic polyneuropathy', Annals of Neurology, vol. 19, no. 5, pp. 425-439.
Dyck, Peter J ; Lais, A. ; Karnes, J. L. ; O'Brien, P. ; Rizza, R. / Fiber loss is primary and multifocal in sural nerves in diabetic polyneuropathy. In: Annals of Neurology. 1986 ; Vol. 19, No. 5. pp. 425-439.
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