Vol. 7, Issue 1 Neurographics logo Uysal N. et al
 

Demonstration of the Cerebral Reorganization in Diabetic Patients after Lower Limb Amputation by Using Functional Magnetic Resonance Imaging

Uysal N1; Ada E2; Bora A1; Ucar A2; Gezer NS2
1Izmir Ataturk Research and Training Hospital, Orthopedic and Traumatology Department, Izmir, TURKEY
2Dokuz Eylul University Hospital, Radiology Department, Izmir, TURKEY

Approach/Methods

Eleven diabetic subjects who had lower limb amputation due to peripheral neuropathy (Group I; Subject number 1 to11), four diabetic subjects who did not have limb amputation, diabetic wound or ulcer (Group II; Subject Number 12 to 15) and one healthy subject (Subject Number 16) were evaluated radiological and clinically. All the subjects were right handed. The subjects’ other demographics are given in Table 1.

Table 1. Subjects' Characteristics
Subject Number Gender Years of Diabetes Type of Diabetes Amputation Side Amputation Level Months Since Amputation
1 K 18 DM Type I Left Below the knee 18
2 E 10 DM Type II Left Below the knee 13
3 E 13 DM Type II Left Below the knee 9
4 E 15 DM Type II Left Above the knee 9
5 E 22 DM Type II Left Below the knee 1
6 K 15 DM Type II Right Below the knee 4
7 K 12 DM Type II Left Below the knee 27
8 K 14 DM Type II Left Above the knee 36
9 E 16 DM Type II Left Above the knee 7
10 E 13 DM Type II Right Below the knee 30
Left Below the knee 3
11 E 10 DM Type II Right Below the knee 7
Left Below the knee 30
12 E 6 DM Type II — — —
13 E 10 DM Type II — — —
14 K 10 DM Type II — — —
15 K 2 DM Type II — — —
16 K — — — — —

Data were acquired with a 1.5 Tesla MR scanner (Philips, Achieva). Single-shot fast field echo imaging sequences [echo time 50 ms, repetition time 3000 ms, scan time 4 min, slice number 16, slice thickness 4 mm, interslice gap 0 mm, matrix 64x64, field of view 230 mm] and T1-weighted anatomical data sets [echo time 15 ms, repetition time 2678 ms, slice number 16, slice thickness 3.3 mm, interslice gap 0.7 mm, matrix 285x512, field of view 230 mm] were used. Dynamic fMRI examinations were performed in 8 sections as 4 intervals. Each interval consisted of 30 seconds of activity and 30 seconds of resting periods. For the best functional MRI results, subjects were thought standard movements.

Functional MRI results of amputated lower limb stumps of diabetic patients were compared with fMRI results of nonamputated lower limbs of diabetic patients. Also, fMRI results of all subjects were compared with the fMRI results of healthy subject. Functional MRI results of amputated lower limb subjects were compared with fMRI results of the subjects' opposite limb.

  1. Purpose
  2. Approach/Methods
  3. Findings/Discussion
  4. Summary/Conclusion
  5. References

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