Regeneration of Nerve Fibres



Course Instructor


Regeneration of Nerve Fibres

            This paper summarises and analyses a research article titled Topiramate improves neurovascular function, epidermal nerve fiber morphology, and metabolism in patients with type 2 diabetes mellitus, by Boyd, et al. This article was published in the Dove Press journal: Diabetes, Metabolic Syndrome, and Obesity: Targets and Therapy, in the 2010 December issue. This article is about a study, which the authors conducted in type 2 diabetes patients, to establish how Topiramate affects the function of C-fibre, the morphology of nerve fibre, as well as the metabolism. The main purpose of the researchers in conducting this study was therefore, to determine the effects of Topiramate on type 2 diabetes patients’ metabolism, nerve fibre morphology, and the role of the C-fibre (Boyd, et al. 431).

In order to find answer their study question, the researchers performed an experimentation. This took 18 weeks to complete, and was performed on twenty type 2 diabetes patients aged between 35 -75 years. Of these twenty study subjects, 15 were male, while five were female. All the subjects were confirmed to suffer from diabetic peripheral neuropathy. The study compared patients’ sensory reactions, skin biopsies, and skin blood flow before and after the Topiramate treatment. The assessments of these were conducted once, before the treatment and once when the 18 weeks period ended. The treatment was introduced after the first assessment of patients (Boyd, et al.431-2).

I will explain the skin blood flow measurement experimentation, which was performed on the study subjects. Here, the laser Doppler was employed in determining how patients reacted to various stimuli in the environment. Testing was done twice, after six weeks, and on the 18th week, at the end of the study. The parts of the body used for testing included the nondominant foot and the proximal calf. These were the same parts where the skin blood flow and temperature probes were placed, but on the specific points where skin biopsy was done. Examination of blood skin flow in patients were performed while the patients were in an inclined position, with their legs slightly raised and fully stretched. After every 10 minutes, the temperature was increased, to initially 32 degrees Celsius, then 40 degrees Celsius for ten more minutes, before being increased to 44 degrees Celsius for a final 20 minutes (Boyd, et al. 434-5).

The results of this research showed that all the study subjects, except one, were able to put up with the Topiramate medication. The one patient was discontinued on the grounds of fatigue, and other cognitive implications of the Topiramate medication. The other patients did not experience this effect in a similar magnitude. The general results of the research revealed that Topiramate increased the length of dendrites in the proximal leg and forearm. There was also an improvement in the total neuropathy scores of patients (Boyd, et al. 436).

The authors in their conclusion claim to have shown the following through their research:

  • Treatment with Topiramate for eighteen weeks results in improvement in neuropathy scores.
  • There is a relationship between the distal leg IENF, and the total period of diabetes.
  • A reduction in the mean length of dendrites in patients with metabolic syndrome but without hyperglycaemia, leads to changes in the patients.
  • After every five years, a diabetic patient experiences a decrease in IENF density.

The Topiramate treatment could be incorporated in the therapies of metabolic syndrome, neuropathy, and diabetes, as this has been confirmed by this study, to have a positive influence on the investigated conditions of diabetes. This leads to pain relief, weight loss, and metabolic changes. Although the curative function of Topiramate treatment is limited in this study, this treatment remains beneficial to type 2 diabetes patients (Boyd, et al. 437).


Works Cited

Boyd, et al. “Topiramate improves neurovascular function, epidermal nerve fiber morphology,

and metabolism in patients with type 2 diabetes mellitus.” Dovepress Journal: Diabetes,

Metabolic Syndrome and Obesity: Targets and Therapy. Vol. 3 (2010): 431–437. Web. Retrieved 20 February 2013 <>


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