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. 2022 Oct;43(10):6059-6065.
doi: 10.1007/s10072-022-06304-4. Epub 2022 Aug 4.

Prevalence of diabetic striatopathy and predictive role of glycated hemoglobin level

Silvia Ottaviani  1 , Anna Arecco  2 , Mara Boschetti  2   3 , Ennio Ottaviani  4 , Paolo Renzetti  5 , Lucio Marinelli  6   7
Affiliations

Prevalence of diabetic striatopathy and predictive role of glycated hemoglobin level

Silvia Ottaviani et al. Neurol Sci. 2022 Oct.

Abstract

Background: Diabetic striatopathy is defined as a state of hyperglycemia associated with chorea/ballism, striatal hyperdensity at CT, or hyperintensity at T1-weighted MRI. It is considered a rare complication of uncontrolled diabetes but prevalence data are scarce.

Objectives: Characterize diabetic striatopathy prevalence in the population afferent to the largest teaching hospital in Genova (Liguria, Italy) and investigate the role of glycated hemoglobin level in predicting the risk.

Methods: Data were retrospectively obtained from general population undergoing blood sampling for glycated hemoglobin and resulting with HbA1c values ≥ 8%, from January 2014 to June 2017. Brain neuroimaging of those who underwent at least a brain CT or MRI was examined in search of findings compatible with diabetic striatopathy and clinical information was collected. Logistic regression was used to predict the risk of diabetic striatopathy based on age and HbA1c values.

Results: Subjects with uncontrolled diabetes were 4603. Brain neuroimaging was available in 1806 subjects and three patients with diabetic striatopathy were identified, all of them reporting choreic movements. The prevalence of hemichorea due to diabetic striatopathy was therefore 3 cases out of 1806 (0.16%) in our population. Hepatic and hypoxic encephalopathies were the conditions most frequently mimicking diabetic striatopathy. Odds ratio of diabetic striatopathy and HbA1c level was significantly correlated (p = 0.0009).

Conclusions: To the best of our knowledge, this study is the first to evaluate the prevalence of diabetic striatopathy in Italy. High HbA1c values may have a role in predicting diabetic striatopathy.

Keywords: Diabetes; Glycated hemoglobin; HbA1c; Hemiballism; Hemichorea; Striatopathy.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the retrospective study
Fig. 2
Fig. 2
Brain CT (top row) and MRI (bottom row) images of the three patients diagnosed with diabetic striatopathy. The numbers refer to the three patients with diabetic striatopathy who emerged from our analysis
Fig. 3
Fig. 3
Scatterplot showing HbA1c and age of all analyzed subjects. The HbA1c values of the three patients affected by diabetic striatopathy (circles) lie at the extremes of the distribution
Fig. 4
Fig. 4
ROC curve (TPR vs FPR) for the binary test of suspected diabetic striatopathy performed on the sample
See this image and copyright information in PMC

References

    1. Posturna RB, Lang AE. Hemiballism: revisiting a classic disorder. Lancet Neurol. 2003;2(11):661–668. doi: 10.1016/S1474-4422(03)00554-4. - DOI - PubMed
    1. Bedwell SF (1960) Some observations on hemiballismus. Neurology 10:619–622. 10.1212 - PubMed
    1. Oh SH, Lee KY, Im JH, Lee MS. Chorea associated with non-ketotic hyperglycemia and hyperintensity basal ganglia lesion on T1-weighted brain MRI study: a meta-analysis of 53 cases including four present cases. J Neurol Sci. 2002;200(1–2):57–62. doi: 10.1016/s0022-510x(02)00133-8. - DOI - PubMed
    1. Taboada GF, Lima GAB, Castro JEC, Liberato B. Dyskinesia associated with hyperglycemia and basal ganglia hyperintensity: report of a rare diabetic complication. Metab Brain Dis. 2013;28(1):107–110. doi: 10.1007/s11011-012-9357-z. - DOI - PubMed
    1. Battisti C, Forte F, Rubenni E, et al. Two cases of hemichorea-hemiballism with nonketotic hyperglycemia: a new point of view. Neurol Sci. 2009;30(3):179–183. doi: 10.1007/s10072-009-0039-5. - DOI - PubMed

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