MRI PACINIAN corpuscle counts in the forefoot may offer a non-invasive marker of diabetic sensorimotor polyneuropathy (DSP) disease severity, based on imaging findings with nerve conduction measures.1
DSP is a common complication of type 2 diabetes, involving progressive nerve damage that leads to loss of sensation, and particularly affects the lower limbs.
In this study, large-fibre sensory dysfunction was quantified using nerve conduction studies (NCS).¹
MRI Pacinian Corpuscles Reflect Nerve Damage Severity
The study evaluated 39 patients with type 2 diabetes and confirmed DSP, examining whether MRI Pacinian corpuscles counts correspond to large-fibre sensory function.1
Pacinian corpuscles are specialised nerve endings in subcutaneous tissue that detect vibration and fine textures, acting as rapidly adapting mechanoreceptors within the peripheral nervous system.2
Patients underwent forefoot MRI alongside NCS, including sensory nerve action potentials (sNAP) and conduction velocities.1 Researchers quantified Pacinian corpuscles in both superficial and deep tissue regions of the toes and compared these counts with sural sNAP amplitudes.
Clear Differences Between Mild and Severe DSP
Findings showed marked differences between disease stages. Patients classified with severe DSP had substantially lower Pacinian corpuscle counts than those with mild-to-moderate disease (mean 54.1 vs 146.1).1 In parallel, 86.1% of severe cases had absent sural sNAP amplitudes, indicating advanced large-fibre sensory impairment.
Statistical analysis demonstrated a moderate-to-strong positive correlation between Pacinian corpuscle counts and sural sNAP amplitudes (ρ = 0.638). Patients with milder DSP retained higher nerve signal amplitudes and correspondingly higher corpuscle counts, indicating an association between structural findings and functional measure.1
Clinical Implications for Diabetic Neuropathy Care
These findings highlight MRI Pacinian corpuscles as a potential non-invasiver imaging biomarker for DSP severity.¹ For clinicians, this points to a possible adjunctive role for imaging in characterising neuropathy severity alongside electrophysiological assessment. Quantifying Pacinian corpuscles on MRI could help support more detailed phenotyping of DSP, particularly in differentiating mild-to-moderate from severe disease.
However, the relatively small sample size and cross-sectional design mean the results should be interpreted cautiously. It is still unclear whether reduced Pacinian corpuscle counts precede measurable nerve dysfunction or reflect established damage.
Further investigation in larger cohorts is required to determine how MRI Pacinian corpuscles could be incorporated into clinical assessment pathways and whether they offer incremental value beyond existing nerve conduction measures.
References
- Goller SS et al. Pacinian corpuscle loss on routine forefoot MRI as an imaging biomarker for large-fiber sensory dysfunction in type 2 diabetic polyneuropathy. Eur Radiol. 2026;DOI:10.1007/s00330-026-12576-7.
- Iheanacho F, Vellipuram R. Physiology, Mechanoreceptors. [Internet] (2026) Treasure Island: StatPearls. Available at: https://www.ncbi.nlm.nih.gov/books/NBK541068/. Last Accessed: 1 May 2026.
Featured image: Graphicroyalty on Adobe stock
