Evaluation of interoceptive accuracy in diabetic individuals with or without polyneuropathy

Year 2024, Volume: 29 Issue: 1, 62 - 68, 27.01.2024

Serkan Aksu , Melik Gürsoy , Esra Daloğlu , Yadigar Bacakoğlu , Gülnihal Kutlu

https://doi.org/10.21673/anadoluklin.1336415

Abstract

Aim: Diabetic peripheral neuropathy (DPN) is a heterogeneous disease with a complex pathophysiology that can affect both autonomic and somatic components of the nervous system. Interoception is a perceptual and cognitive concept expressing the internal sensory perception that evaluates signals from the body and internal organs. Interoceptive abilities have been indicated to be reduced in various chronic pain syndromes and chronic neuropathies. That said, interoceptive skills in individuals with Type 2 Diabetes Mellitus with and without a previous DPN comorbidity have not been comparatively examined. We aimed to examine whether there is a difference in terms of interoceptive accuracy in individuals diagnosed with Type 2 Diabetes Mellitus with and without DPN for the first time.

Methods: 20 individuals with a diagnosis of Type 2 Diabetes Mellitus with a co-diagnosis of DPN and 20 individuals with a diagnosis of Type 2 Diabetes Mellitus without a co-diagnosis of DPN were recruited in the Electroneurophysiology Laboratory of Muğla Sıtkı Koçman University. The presence of DPN was evaluated with both Toronto Clinical Scoring System and electromyographic examination. General cognitive status was evaluated with the Mini-Mental State Examination, general psychiatric status with the Patient Health Questionnaire-9, and cardiac interoceptive accuracy with the Heartbeat Counting Test.

Results: No difference was found in terms of cardiac interoceptive accuracy in individuals with Type 2 Diabetes Mellitus with and without DPN.

Conclusions: The potential decrease in cardiac interoception might be related to chronic pain or autonomic neuropathy rather than the presence of DPN. Studies examining interoception in these subgroups are required.

Keywords

Cognition, diabetic polyneuropathy, neurophysiology, Type 2 Diabetes Mellitus

Polinöropatisi olan ve olmayan diyabetik bireylerde interoseptif keskinliğin değerlendirilmesi

Abstract

Amaç: Diyabetik periferik nöropati (DPN), kompleks bir patofizyolojisi olan ve sinir sisteminin otonom ve somatik olmak üzere her iki komponentini de etkileyebilen heterojen bir hastalıktır. Interosepsiyon ise bedenden ve iç organlardan gelen sinyallerin değerlendirildiği iç duyu algısını ifade eden algısal ve bilişsel bir kavramdır. Interoseptif becerilerin çeşitli kronik ağrı sendromlarında ve kronik nöropatilerde azalmış olabileceği gösterilmiştir. Bu bilgiyle beraber daha önce DPN eştanısı olan ve olmayan Tip 2 Diyabetes Mellitus tanılı bireylerde interoseptif beceriler karşılaştırmalı olarak incelenmemiştir. Bu çalışmada ilk kez DPN olan ve olmayan Tip 2 Diyabetes Mellitus tanılı bireylerde interoseptif keskinlik açısından fark olup olmadığının incelenmesi amaçlanmıştır.

Yöntemler: Muğla Sıtkı Koçman Üniversitesi Elektronörofizyoloji Laboratuvarında DPN eştanısı olan 20 Tip 2 Diyabetes Mellitus tanılı birey ile DPN eştanısı olmayan 20 Tip 2 Diyabetes Mellitus tanılı birey çalışmaya dahil edildi. DPN varlığı Toronto Klinik Skorlama Sistemi ve elektromyografik inceleme ile değerlendirildi. Standardize Mini Mental Test ile genel bilişsel durum, Hasta Sağlık Anketi-9 ile genel psikiyatrik durum, Kalp Hızı Sayma Testi ile kardiyak interoseptif keskinlik incelendi.

Bulgular: Bu çalışmada DPN tanısı olan ve olmayan Tip 2 Diyabetes Mellitus tanılı bireylerde kardiyak interoseptif keskinlik açısından fark saptanmamıştır.

Sonuçlar: Kardiyak interoseptif becerilerdeki potansiyel azalmanın DPN varlığından ziyade kronik ağrı ya da otonom nöropati ile ilişkili olabileceği düşünülmüştür. Bu alt gruplarda interosepsiyonu inceleyen çalışmalara gereksinim duyulmaktadır.

Keywords

Biliş, diyabetik polinöropati, nörofizyoloji, Tip 2 Diyabetes Mellitus

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