Role of platelet rich plasma in management of diabetic peripheral neuropathy: a case-control study

Asmaa Ali Elsayed; Eman Saif Eldeen; Marwa Abdellah Osman; Seham Abdallah Elazab

doi:10.1007/s40477-025-01042-7

Role of platelet rich plasma in management of diabetic peripheral neuropathy: a case-control study

J Ultrasound. 2025 Jul 7. doi: 10.1007/s40477-025-01042-7. Online ahead of print.

Authors

Asmaa Ali Elsayed¹, Eman Saif Eldeen², Marwa Abdellah Osman², Seham Abdallah Elazab³

Affiliations

¹ Faculty of Medicine, Al-Azhar University, Cairo, Egypt. Samsomaa68@gmail.com.
² Neurology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
³ Rheumatology and Rehabilitation, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

PMID: 40624430
DOI: 10.1007/s40477-025-01042-7

Abstract

Background: Diabetic Peripheral Neuropathy (DPN) is a prevalent complication of diabetes mellitus, resulting in substantial morbidity. This study assesses the effectiveness of platelet-rich plasma (PRP) in managing DPN symptoms and enhancing nerve function.

Objective: To assess the therapeutic effects of ultrasound-guided perineural injection of PRP on neuropathic pain and nerve conduction parameters in patients with type 2DPN.

Methods: This is a prospective, case-control trial that included 80 participants with type 2 DPN, divided into two groups: Group A (intervention) (n = 40) received ultrasound-guided perineural injections of PRP in conjunction with medical treatment. In contrast, Group B (control) (n = 40) received medical treatment alone. Participants underwent detailed medical history, general and neurological examinations, and laboratory tests. Assessments included nerve conduction studies (NCS), which were conducted at baseline and reassessed after 3 months. The modified Toronto Clinical Neuropathy Score (mTCNS) and Visual Analog Scale (VAS) for pain were measured at baseline and 1- and 3-months post-treatment.

Results: Demographic and baseline clinical characteristics were analogous across groups (p > 0.05). At three months, the intervention group showed a substantial elevation in mNCV for the tibial nerves, from 38.5 ± 5.2 m/s to 45.3 ± 4.8 m/s (p < 0.001), and for the peroneal motor nerves, from 36.2 ± 4.9 m/s to 42.7 ± 5.1 m/s (p < 0.001). The mTCNS scores improved significantly from 12.4 ± 2.1 to 6.3 ± 1.8 (p < 0.001), and VAS scores decreased from 8.2 ± 1.0 to 3.5 ± 1.2 (p < 0.001). Conversely, the control group experienced a deterioration in mTCNS scores, from 12.5 ± 2.0 to 14.1 ± 2.3 (p < 0.01), and an elevation in VAS scores, from 8.1 ± 1.1 to 9.0 ± 0.9 (p < 0.05).

Conclusion: PRP therapy significantly alleviates symptoms of DPN and enhances nerve function, suggesting its potential as an effective treatment option for diabetic neuropathies.

Keywords: Diabetic Peripheral Neuropathy; Nerve conduction studies; Neuropathic pain; Platelet Rich Plasma; Randomized case-control study.