Venkataraman K, Pun V, Mohamed AZ, et al. - In patients with and without diabetic peripheral neuropathy (DPN) during motor and motor imagery tasks, researchers compared central nervous system (CNS) activation and correlated activation with functional performance. For this investigation, 26 candidates underwent functional MRI during three tasks: ankle dorsi plantar flexion (motor task [MT]) and motor imagery tasks of walking on a smooth surface (SMIT) and rough surface (RMIT). The functional evaluation involved gait analysis, ankle muscle strength, and ankle range of motion. Investigators found that the tasks activated the sensorimotor, motor preparation, visual processing, and decision-making regions. During MT and SMIT, but not RMIT, activation was significantly lower in DPN patients than in those without DPN. In patients with DPN, poor functional performance was linked to greater activation in motor preparation regions. CNS responses appear muted in patients with DPN compared with patients without DPN, but they remain capable of enhancing CNS activation when tasks are more challenging or when there are significant functional deficits.