New research suggests that counting Pacinian corpuscles in the forefoot using MRI could serve as a non-invasive biomarker for the severity of diabetic sensorimotor polyneuropathy (DSP).
DSP is a common complication of type 2 diabetes, causing progressive nerve damage and loss of sensation, especially in the lower limbs. In this study, researchers used nerve conduction studies (NCS) to quantify large-fiber sensory dysfunction.
MRI Pacinian Corpuscles Reflect Nerve Damage Severity
The study evaluated 39 patients with type 2 diabetes and confirmed DSP. Pacinian corpuscles are specialized nerve endings that detect vibration and fine textures. Patients underwent forefoot MRI and NCS. Researchers quantified corpuscles in the toes and compared counts with sural sensory nerve action potential (sNAP) amplitudes.
Clear Differences Between Mild and Severe DSP
Patients with severe DSP had significantly fewer Pacinian corpuscles than those with mild-to-moderate disease (mean 54.1 vs. 146.1). In parallel, 86.1% of severe cases had absent sural sNAP amplitudes, indicating advanced sensory impairment. Statistical analysis showed a moderate-to-strong positive correlation between corpuscle counts and sNAP amplitudes (ρ = 0.638).
Clinical Implications for Diabetic Neuropathy Care
These findings position MRI Pacinian corpuscle counts as a potential non-invasive imaging biomarker for DSP severity. This could offer clinicians an adjunctive role for imaging in characterizing neuropathy alongside electrophysiological assessment. However, due to the small sample size and cross-sectional design, results should be interpreted cautiously. Further research is needed to determine if reduced counts precede nerve dysfunction or reflect established damage.