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Nerve Blood Flow in Diabetic Peripheral Neuropathy: Revisiting the ‘Vasa nervorum’ Hypothesis

Kumar Senthil P. , Kumar Senthil P. , Adhikari Prabha , Jeganathan P.S.

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Indian Journal of Anatomy 3(2):p 137-138, April - June 2014. | DOI:

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Abstract

The aim of this short communication article was to highlight the role of altered nerve blood flow as a patho-anatomical manifestation in diabetic peripheral neuropathy (DPN), a common microvascular complication of globally prevalent metabolic disorder, diabetes mellitus. Limited evidence suggested that higher epineurial blood flow was present in DPN, which indirectly influenced impairments in exercise-induced nerve conduction increments. Newer methods like Nerve photography and fluorescein angiography provide useful objective information on nerve blood flow in terms of epineurial vessel pathology score, epineurialarteriovenous shunting, nerve fluorescein appearance time and intensity of fluorescence. Treatments using Adenosine and adenosine A2A receptor agonist, and alpha-lipoic acid administration were shown o be beneficial, with dose-dependent effects on nerve blood flow.

Keywords: Neuroanatomy; Vascular neurology; Epineurial circulation; Neural hemodynamics.

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