RT Journal Article SR Electronic T1 Lower extremity MRI following 10-week supervised exercise intervention in patients with diabetic peripheral neuropathy JF BMJ Open Diabetes Research & Care JO BMJ Open Diab Res Care FD American Diabetes Association SP e002312 DO 10.1136/bmjdrc-2021-002312 VO 9 IS 1 A1 Ryan Brown A1 Azadeh Sharafi A1 Jill M Slade A1 Antonio Convit A1 Nathan Davis A1 Steven Baete A1 Heather Milton A1 Kenneth J Mroczek A1 Patricia M Kluding A1 Ravinder R Regatte A1 Prodromos Parasoglou A1 Smita Rao YR 2021 UL http://drc.bmj.com/content/9/1/e002312.abstract AB Introduction The purpose of this study was to characterize using MRI the effects of a 10-week supervised exercise program on lower extremity skeletal muscle composition, nerve microarchitecture, and metabolic function in individuals with diabetic peripheral neuropathy (DPN).Research design and methods Twenty participants with DPN completed a longitudinal trial consisting of a 30-day control period, during which subjects made no change to their lifestyle, followed by a 10-week intervention program that included three supervised aerobic and resistance exercise sessions per week targeting the upper and lower extremities. The participants’ midcalves were scanned with multinuclear MRI two times prior to intervention (baseline1 and baseline2) and once following intervention to measure relaxation times (T1, T1ρ, and T2), phosphocreatine recovery, fat fraction, and diffusion parameters.Results There were no changes between baseline1 and baseline2 MRI metrics (p>0.2). Significant changes (p<0.05) between baseline2 and postintervention MRI metrics were: gastrocnemius medialis (GM) T1 –2.3%±3.0% and soleus T2 –3.2%±3.1%. Trends toward significant changes (0.05<p<0.1) between baseline2 and postintervention MRI metrics were: calf adipose infiltration –2.6%±6.4%, GM T1ρ –4.1%±7.7%, GM T2 –3.5%±6.4%, and gastrocnemius lateral T2 −4.6±7.4%. Insignificant changes were observed in gastrocnemius phosphocreatine recovery rate constant (p>0.3) and tibial nerve fractional anisotropy (p>0.6) and apparent diffusion coefficient (p>0.4).Conclusions The 10-week supervised exercise intervention program successfully reduced adiposity and altered resting tissue properties in the lower leg in DPN. Gastrocnemius mitochondrial oxidative capacity and tibial nerve microarchitecture changes were not observed, either due to lack of response to therapy or to lack of measurement sensitivity.Data are available upon reasonable request. The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. No applicable resources were generated or analyzed during the current study. The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.