Impaired ascendant central pathways conduction in impotent diabetic subjects

Objectives - Diabetic impotence is generally due to peripheral neuropathy, but a central pathway impairment has also been suggested. We evaluated soma tosensory transmission in a group of impotent diabetic men to assess the ro le of central nervous system (CNS) involvement. Materials and methods - Som atosensory evoked potentials (SEPs) of pudendal (pdn) and posterior tibial (ptn) nerves were recorded in 74 patients. Type and duration of diabetes, s everity of sexual dysfunction, medium term metabolic control, occurrence of microangiopathic chronic complications and autonomic neuropathy were evalu ated. Results - Our data show an impairment of central conduction times in pdn (25.7%) and ptn (39.2%) greater than peripheral nervous impairment (pdn 12.2%, ptn 8.1%), in impotent diabetic patients without any further major complication. Central nervous conduction delay resulted to be correlated wi th poor glycemic control. Significant evident autonomic dysfunction was fou nd only in a minority of cases. Conclusion - Our data might suggest that al tered conduction along CNS and somatic peripheral neuropathy might develop independently. We confirm the hypothesis of a "central diabetic neuropathy" and suggest that central sensory pathways involvement, not related to peri pheral impairment, could play a role in the pathogenesis of erectile dysfun ction in diabetic patients.