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Zafeiri M, Tsioutis C, Kleinaki Z, Manolopoulos P, Ioannidis I, Dimitriadis G. Clinical Characteristics of Patients with co-Existent Diabetic Peripheral Neuropathy and Depression: A Systematic Review. Exp Clin Endocrinol Diabetes 2018; 129:77-85. [DOI: 10.1055/a-0741-6937] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Abstract
Objectives Both diabetic peripheral neuropathy and depression have significant implications on patients’ quality of life, management and outcomes. We aimed to evaluate all available evidence concerning patients with co-existent diabetic peripheral neuropathy and depression, and describe their clinical characteristics, in order to promote early recognition and management.
Methods Systematic search of PubMed for studies providing data on patients with diabetic peripheral neuropathy and depression. The primary outcome was to evaluate all available evidence related to characteristics of diabetes, diabetic peripheral neuropathy and depression. Secondary study outcomes included comorbid conditions and complications in these patients.
Results Final analysis included 24 studies with data on 205 patients. Most patients were adults between 18–65 years of age. Mean HbA1c value was above 8% and most patients were treated with insulin. Neuropathy was predominantly painful and most patients with available data were considered to have major depressive disorder. In addition to diabetic peripheral neuropathy and depression, diabetes-related complications were recorded in 43 patients, the most common being autonomic neuropathy, retinopathy and nephropathy. The most frequently reported comorbidities were weight loss (72 patients), impotence (60 patients), hypertension (23 patients) and coronary artery disease (22 patients).
Conclusions The present study describes the characteristics of patients with co-existent diabetic peripheral neuropathy and depression, aiming for prompt detection, prevention of further deterioration and improvement of patient outcomes. Available evidence shows that the majority of these patients are adults, with painful peripheral neuropathy and with insulin-treated and inadequately controlled diabetes.
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Affiliation(s)
- Maria Zafeiri
- Diabetes and Obesity Center, Konstantopouleio Hospital, Nea Ionia, Athens, Greece
- Society of Junior Doctors, Athens, Greece
| | - Constantinos Tsioutis
- Society of Junior Doctors, Athens, Greece
- School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - Zoe Kleinaki
- Society of Junior Doctors, Athens, Greece
- School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - Philip Manolopoulos
- Society of Junior Doctors, Athens, Greece
- School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - Ioannis Ioannidis
- Diabetes and Obesity Center, Konstantopouleio Hospital, Nea Ionia, Athens, Greece
- 1st Department of Internal Medicine, Konstantopouleio Hospital, Nea Ionia, Athens, Greece
| | - George Dimitriadis
- 2nd Department of Internal Medicine, Research Institute and Diabetes Centre, National and Kapodistrian University of Athens, Attikon University Hospital, Haidari, Athens, Greece
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Ballmaier M, Kumar A, Elderkin-Thompson V, Narr KL, Luders E, Thompson PM, Hojatkashani C, Pham D, Heinz A, Toga AW. Mapping callosal morphology in early- and late-onset elderly depression: an index of distinct changes in cortical connectivity. Neuropsychopharmacology 2008; 33:1528-36. [PMID: 17712348 PMCID: PMC2810852 DOI: 10.1038/sj.npp.1301538] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
There is some evidence of corpus callosum abnormalities in elderly depression, but it is not known whether these deficits are region-specific or differ based on age at onset of depression. Twenty-four patients with early-onset depression (mean age = 68.00, SD+/-5.83), 22 patients with late-onset depression (mean age = 74.50, SD+/-8.09) and 34 elderly control subjects (mean age = 72.38; SD+/-6.93) were studied. Using 3D MRI data, novel mesh-based geometrical modeling methods were applied to compare the midsagittal thickness of the corpus callosum at high spatial resolution between groups. Neuropsychological correlates of midsagittal callosal area differences were additionally investigated in a subsample of subjects. Depressed patients exhibited significant callosal thinning in the genu and splenium compared to controls. Significant callosal thinning was restricted to the genu in early-onset patients, but patients with late-onset depression exhibited significant callosal thinning in both the genu and splenium relative to controls. The splenium of the corpus callosum was also significantly thinner in subjects with late- vs early-onset depression. Genu and splenium midsagittal areas significantly correlated with memory and attention functioning among late-onset depressed patients, but not early-onset depressed patients or controls. Circumscribed structural alterations in callosal morphology may distinguish late- from early-onset depression in the elderly. These findings suggest distinct abnormalities of cortical connectivity in late- and early-onset elderly depression with possible influence on the course of illness. Patients with a late onset of depression may be at higher risk of illness progression and eventually dementia conversion than early-onset depression, with potentially important implications for research and therapy.
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Affiliation(s)
- Martina Ballmaier
- Department of Psychiatry and Psychotherapy, Charité University Medicine, Campus Mitte, Berlin, Germany
- Laboratory of Neuro Imaging, Department of Neurology, University of California at Los Angeles, Los Angeles, CA, USA
- Department of Biomedical Sciences & Biotechnologies, Brescia University Medical School, Brescia, Italy
| | - Anand Kumar
- Department of Psychiatry and Biobehavior, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, CA, USA
| | - Virginia Elderkin-Thompson
- Department of Psychiatry and Biobehavior, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, CA, USA
| | - Katherine L Narr
- Laboratory of Neuro Imaging, Department of Neurology, University of California at Los Angeles, Los Angeles, CA, USA
| | - Eileen Luders
- Laboratory of Neuro Imaging, Department of Neurology, University of California at Los Angeles, Los Angeles, CA, USA
| | - Paul M Thompson
- Laboratory of Neuro Imaging, Department of Neurology, University of California at Los Angeles, Los Angeles, CA, USA
| | - Cornelius Hojatkashani
- Laboratory of Neuro Imaging, Department of Neurology, University of California at Los Angeles, Los Angeles, CA, USA
| | - Daniel Pham
- Department of Psychiatry and Biobehavior, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, CA, USA
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Charité University Medicine, Campus Mitte, Berlin, Germany
| | - Arthur W Toga
- Laboratory of Neuro Imaging, Department of Neurology, University of California at Los Angeles, Los Angeles, CA, USA
- Correspondence: Professor AW Toga, Laboratory of Neuro Imaging, Department of Neurology, University of California at Los Angeles, 635 Charles Young Drive, Suite 225, Los Angeles, CA 90095, USA, Tel: + 310 206 2101, Fax: + 310 206 5518,
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