Ultrasound of the Vagus Nerve as an indicator of autonomic nervous dysfunction in patients with diabetic neuropathy

Abstract



Objective: The goal is to compare the vagus nerve cross-sectional area (CSA) of diabetic patients with polyneuropathy to that of controls and ascertain whether there is a relationship between the two as well as with clinical and laboratory markers.

Methods: People with diabetes who had symptoms or indicators of peripheral nerve damage were identified. They were assessed through examination, lab work, and ultrasonography. Both the left and right vagus nerves were imaged at the level of the thyroid gland and at the common carotid bifurcation. Age, sex, and body mass index matched healthy controls were compared to the results.



Results: Two sites were used to examine a total of 40 nerves from 20 patients and 60 nerves from 30 controls. Compared to controls, diabetes patients had a smaller vagus nerve (p < 0.01). Regarding the sonographic right vagus nerve CSA at the common carotid bifurcation and thyroid gland, as well as the left vagus nerve at the common carotid bifurcation and thyroid gland, there was a significant difference between the two (p= 0.006, p= 0.001, p= 0.004, p= 0.002), respectively.



In conclusion, diabetic neuropathy patients showed a comparatively reduced CSA of the vagus nerve on ultrasonography compared to control subjects, suggesting autonomic affection in those patients.



Keywords; Diabetic neuropathy, ultrasonography, vagus nerve area