Nerve damage in distal polyneuropathy first becomes clinically apparent in in the legs and later in hands and arms. Previous studies could show, however, that peripheral nerve lesions in the leg predominate in the thigh and that upper limb nerve function can be impaired in early stages of the disease. We show that a decrease in sciatic nerve fractional anisotropy is associated with impaired nerve function in both upper and lower limbs for patients with diabetes and patients with prediabetes. Our findings therefore suggest that structural nerve damage in diabetic polyneuropathy already occurs at early, subclinical stages of the disease.
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