Evidence mapPaperPMID 41665664Full record

ArticleDiabetologia2026

Association of corneal nerve parameters with nerve abnormalities and neuropathic pain in prediabetes and type 2 diabetes: the Maastricht Study.

Mette K Borbjerg, Sara Mokhtar, Nadia Sutedja, Annemarie Koster, Carsten D Mørch, Tos T J M Berendschot, Nicolaas Schaper, Niels Ejskjaer, Johan Røikjer

Abstract read
In one paragraph

Article in Diabetologia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Mette K BorbjergSteno Diabetes Center North Denmark, Aalborg University Hospital, Gistrup, Denmark. m.borbjerg@rn.dk.ORCID http://orcid.org/0000-0003-0178-3409
Sara MokhtarDepartment of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands.ORCID http://orcid.org/0000-0003-4209-0502
Nadia SutedjaDepartment of Clinical Neurophysiology, Maastricht University Medical Centre+, Maastricht, the Netherlands.ORCID http://orcid.org/0000-0003-4697-3644
Annemarie KosterDepartment of Social Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands.ORCID http://orcid.org/0000-0003-1583-7391
Carsten D MørchTranslational Pain Neuroscience and Precision Health, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.ORCID http://orcid.org/0000-0001-6693-2028
Tos T J M BerendschotUniversity Eye Clinic Maastricht, School of Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.ORCID http://orcid.org/0000-0002-8101-939X
Nicolaas SchaperDepartment of Clinical Neurophysiology, Maastricht University Medical Centre+, Maastricht, the Netherlands.ORCID http://orcid.org/0000-0002-2128-8029
Niels EjskjaerSteno Diabetes Center North Denmark, Aalborg University Hospital, Gistrup, Denmark.ORCID http://orcid.org/0000-0003-3749-3403
Johan RøikjerSteno Diabetes Center North Denmark, Aalborg University Hospital, Gistrup, Denmark.ORCID http://orcid.org/0000-0002-4578-1328

Funding

the European Regional Development Fund via OP-Zuid, the Province of Limburg, the Dutch Ministry of Economic Affairs 31O.041
6 · The paper itself

Abstract

aims/hypothesisCorneal confocal microscopy is a valuable technique for assessing neuropathy; however, whether it can distinguish painful from painless neuropathy remains uncertain and existing evidence is based on the results of smaller studies. This study assessed the association of corneal nerve parameters with abnormalities identified by electromyography (EMG) and neuropathic pain in a large population with and without (pre)diabetes.

methodsIn this study we included cross-sectional data for 3425 participants from the Maastricht Study. Wide-field corneal confocal microscopy (WF-CCM) was performed using fully automated analysis of three corneal nerve parameters: corneal nerve branch density (CNBD), corneal nerve fibre density (CNFD) and corneal nerve fibre length (CNFL). An axonal degeneration composite score comprising compound muscle action potential amplitudes (peroneal and tibial) and the sensory nerve action potential amplitude of the sural nerve was created by categorising EMG amplitudes as normal or indicating minor (≤10th percentile), moderate (≤5th percentile) or severe (≤2.5th percentile) abnormalities. Neuropathic pain was determined as a modified Douleur Neuropathique en 4 Questions (DN4) interview score ≥3.

resultsThe mean age of the participants was 59.2 years; 51.6% were female, 15% had prediabetes (defined as impaired fasting glucose, impaired glucose tolerance or both) and 19% had type 2 diabetes. The median diabetes duration was 3.0 years. Regression analyses revealed statistically significant associations between the axonal degeneration EMG score and WF-CCM parameters (CNFL: β=-0.51 [95% CI -0.78, -0.24]; CNFD: β=-1.56 [95% CI -3.04, -0.08]; CNBD: β=-3.08 [95% CI -5.51, -0.64]; all p<0.05) but no statistically significant associations between neuropathic pain and WF-CCM parameters (CNFL: β=-0.06; CNFD: β=-1.15; CNBD: β=-0.22; all p>0.1). CONCLUSIONS/

interpretationThe study found associations between the axonal degeneration EMG score and WF-CCM, but no associations were observed between neuropathic pain and WF-CCM parameters, suggesting that WF-CCM has limited value in assessing neuropathic pain.

Indexed as

CorneaDiabetes Mellitus, Type 2Diabetic NeuropathiesNeuralgiaPrediabetic StateAgedCross-Sectional StudiesElectromyographyFemaleHumansMaleMicroscopy, ConfocalMiddle AgedNerve FibersCorneaCorneal confocal microscopyDiabetic polyneuropathyNeuropathyPain

Identifiers

PMID41665664
PMCPMC13109147

What Socratic holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.