IDNC Featured Speakers

IDNC Featured Speakers
23 June, 2019

Signe Toft Andersen, MD, PhD, Aarhus University, Department of Public Health, Aarhus, Denmark
Title: Risk Factors for Presence and Progression of CAN in Type 2 Diabetes


Cardiovascular autonomic neuropathy (CAN) is a predictor of higher morbidity and mortality in type 2 diabetes. CAN and cardiometabolic risk factors were assessed in the ADDITION-Denmark study at two follow-up examinations. Cardiovascular autonomic reflex tests (CARTs), i.e. lying-to-standing, deep breathing, and the Valsalva maneuver, and 2-minute resting heart rate variability (HRV) indices were obtained as main measures of CAN. A progressive yet heterogeneous course of CAN was seen between 6- and 13-year follow-up in ADDITION-Denmark. Higher levels of HbA1c, weight, BMI, and triglycerides were associated with prevalent CAN. No significant effect of risk factors was seen on CARTs when analyzed as continuous variables. Higher levels of HbA1c and BMI were associated with lower indices of HRV, but these differences diminished over time. The observed heterogeneous course of CAN may challenge the present clinical approach of using categorical classification of CARTs for diagnosing CAN or the notion of CAN irreversibility.

Dinesh Selvarajah, MbChB, PhD, University of Sheffield, Sheffield, UK
Title: Seeing What They Are Feeling - The Central Nervous System in Diabetic Peripheral Neuropathy

Distal symmetrical peripheral neuropathy is the commonest complication of diabetes . It causes disabling neuropathic pain and remains a major treatment challenge. As a result, the socioeconomic burden of painful DPN is alarming and yet, to date, we have few effective treatments. Progress is being made, but a major unresolved question remains: ‘why do some patients on the same drugs as others report no analgesia and therefore remain in persistent pain’. This talk will focus on the the involvement of the central nervous system involvement in diabetic neuropathy and how central mechanisms could provide an to answer this question.


Andreas Themistocleous, MBBCh, PhD, FCP (SA), MRCP (UK), University of Oxford, Oxford, UK
Title: Deep Phenotyping to Explore Differences Between Painful and Painless Diabetic Neuropathy


I will discuss as series of studies in which my colloborators and I adopted a multi-disciplinary approach to explore novel clinical, molecular, and brain imaging findings that differentiate patients with painful and painless diabetic neuropathy.

Daniele Cazzato, MD, IRCCS Foundation "Carlo Besta" Neurological Institute
Title: Sodium Channel Mutations in Small Fiber Neuropathy: Implications for Diabetic Neuropathy

Neuropathic pain is a common feature of peripheral neuropathies, especially when small nerve fibers mediating physiological conduction of thermal and painful somatic sensations are involved. However, among patients with peripheral neuropathy some complain of severe pain whereas others experience only mild symptoms or have a painless form, regardless the underlying etiology. Recent studies suggested a genetic substrate for neuropathic pain focusing in particular on the role of ion channels. Gain-of-function variants in voltage-gated sodium channels α-subunits expressed in sensory neurons have been identified in about 10% of patients with idiopathic painful small fiber neuropathy. Moreover, different variants have been found to cluster in painful and painless diabetic neuropathy. These findings strengthen the hypothesis of a genetic background underlying individual pain phenotypes, which could identify protecting or predisposing pain profiles.


IDNC Featured Speakers
24 June, 2019

Stefan Meng, MD, KFJ Hospital, Vienna, Austria
Title: Ultrasound of Peripheral Nerves in Diabetes


High-resolution ultrasound provides superior resolution in the visualization of peripheral nerves. With low costs and little organizational efforts a depiction of diffuse and focal peripheral nerve alterations is possible. In contrast to other imaging modalities ultrasound examination can be performed dynamically and can be extended to other body segments.

Jennifer Kollmer, MD, Heidelberg University Hospital, Department of Neuroradiology, Heidelberg, Germany
Title: MR Neurography in Peripheral Neuropathies


MR Neurography is a relatively new diagnostic technique that enables the direct visualization of peripheral nerve tissue in vivo by providing high structural resolution and large anatomical coverage at the same time. In a variety of diffuse neuropathies, MR Neurography could detect, localize and quantify peripheral nerve lesions down to the level of single nerve fascicles with high sensitivity and validity. Therewith, it contributed already to an earlier diagnosis of diffuse neuropathies and to a better understanding of underlying pathomechanisms. This talk will focus on the application of MR Neurography in amyloid and diabetic polyneuropathy as two typical examples of axonal, distally-symmetric, sensory-motor polyneuropathies. The development of new imaging biomarkers and subsequent first results of a non-invasive monitoring of structural nerve injury in neuropathy patients with and without causative therapy will also be presented.


James Russell, MD, University of Maryland, Baltimore, MD, USA
Title: Testing Autonomic Outcomes in Diabetic Neuropathy Research: Challenges and Advantages


Dr. James Russell is Professor of Neurology, Anatomy and Neurobiology at the University of Maryland, Vice Chair for Research and Head of the Neuromuscular Division in the Department of Neurology.  He is also Director of the Peripheral Neuropathy Center and Electrophysiology Laboratories.   Dr. Russell's laboratory has as its research focus the understanding of the fundamental mechanisms leading to diabetic neuropathy and other neurological complications of diabetes. This translational research is aimed at developing improved diagnosis and treatment for peripheral neuropathies.  His clinical research group focuses on the treatment of subjects with diabetic neuropathy which is being addressed in several intervention trials.  He is funded by NIH, the Department of Veterans Affairs, and the Diabetes Action Research and Education Foundation.bbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbb


Brian Callaghan, MD, MS, University of Michigan, Ann Arbor, MI, USA
Chris Gibbons, MD, Harvard, Boston, MA, USA
TitleScientific Pitfalls in Emerging Technology for Study of Neuropathy


Drs. Gibbons and Callaghan will discuss emerging technologies for the diagnosis of neuropathy including some of the scientific limitations of current studies. Diagnostic testing requires rigorous testing prior to clinical use of these emerging technologies. However, the appropriate studies are not always performed and the limitations of these tests are not always acknowledged.