Asbjørn Mohr Drewes

Brain changes in diabetes mellitus patients with gastrointestinal symptoms

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

  • Anne Mohr Drewes, Anne M Drewes, Eirik Søfteland, Georg Dimcevski, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway.
  • ,
  • Eirik Søfteland, Anne M Drewes, Eirik Søfteland, Georg Dimcevski, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway.
  • ,
  • Georg Dimcevski, Anne M Drewes, Eirik Søfteland, Georg Dimcevski, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway.
  • ,
  • Adam D Farmer, Department of Gastroenterology, University Hospitals of North Midlands
  • ,
  • Christina Brock
  • Jens B Frøkjær, Department of Radiology, Aalborg University Hospital, Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital
  • ,
  • Klaus Krogh
  • Asbjørn M Drewes

Diabetes mellitus is a common disease and its prevalence is increasing worldwide. In various studies up to 30%-70% of patients present dysfunction and complications related to the gut. To date several clinical studies have demonstrated that autonomic nervous system neuropathy and generalized neuropathy of the central nervous system (CNS) may play a major role. This systematic review provides an overview of the neurodegenerative changes that occur as a consequence of diabetes with a focus on the CNS changes and gastrointestinal (GI) dysfunction. Animal models where diabetes was induced experimentally support that the disease induces changes in CNS. Recent investigations with electroencephalography and functional brain imaging in patients with diabetes confirm these structural and functional brain changes. Encephalographic studies demonstrated that altered insular processing of sensory stimuli seems to be a key player in symptom generation. In fact one study indicated that the more GI symptoms the patients experienced, the deeper the insular electrical source was located. The electroencephalography was often used in combination with quantitative sensory testing mainly showing hyposensitivity to stimulation of GI organs. Imaging studies on patients with diabetes and GI symptoms mainly showed microstructural changes, especially in brain areas involved in visceral sensory processing. As the electrophysiological and imaging changes were associated with GI and autonomic symptoms they may represent a future therapeutic target for treating diabetics either pharmacologically or with neuromodulation.

OriginalsprogEngelsk
TidsskriftWorld Journal of Diabetes
Vol/bind7
Nummer2
Sider (fra-til)14-26
Antal sider13
ISSN1948-9358
DOI
StatusUdgivet - 25 jan. 2016

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