Ultrasound assessment of the brachial plexus nerve root cross-sectional areas in asymptomatic patients with type 2 diabetes

Abstract

Type 2 diabetes mellitus (T2D) is one of the most common metabolic diseases and is often associated with cervical radiculoplexus neuropathies. Magnetic resonance imaging is the modality of choice for evaluating the brachial plexus, however, the use of ultrasound for its evaluation has increased and has been shown to be an additional reliable method. We aimed to compare the cross-sectional areas of the C5, C6, and C7 nerve roots of the brachial plexus, at the interscalene groove, in asymptomatic patients with T2D to that of an asymptomatic control cohort without T2D. A total of 25 asymptomatic patients with T2D were recruited from outpatient clinics. A total of 18 asymptomatic subjects without T2D were also recruited from hospital staff volunteers to form the control cohort. High-resolution ultrasound imaging of the bilateral C5, C6, and C7 nerve roots of the brachial plexus was performed in the short axis, at the level of the interscalene grooves. The nerve root cross-sectional areas were recorded and compared. In the patients with T2D, HbA1c and fasting blood glucose (FBG) levels were obtained as well as the duration of T2D in years and correlated with cross-sectional areas. The cross-sectional areas of C6 and C7 were significantly smaller in the T2D cohort. Additionally, HbA1c, and FBG levels as well as the duration of T2D were negatively correlated with the C5, C6, and C7 cross-sectional areas. Our study demonstrated smaller brachial plexus nerve root cross-sectional areas in asymptomatic patients with T2D which negatively correlated with HbA1c, and FBG levels as well as the duration of T2D.