Cerebral Perfusion in Insulin Resistance and Type 2 Diabetes

Rusinek, Henry; Ha, Jenny; Yau, Po Lai; Storey, Pippa; Tirsi, Aziz; Tsui, Wai; Frosch, Olivia; Azova, Svetlana; Convit, Antonio

doi:10.1038/jcbfm.2014.173

Cited by 64 publications

(58 citation statements)

References 37 publications

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“…The results did not reach an agreement yet. Some studies have reported decreased CBF in T2DM (Xia et al 2015; Novak et al 2006; Last et al 2007; Nagamachi et al 1994), while others did not observe CBF alteration in T2DM (Tiehuis et al 2008; Rusinek et al 2015; Novak et al 2011). Most of the studies reporting no CBF alteration in T2DM typically used large regions of interest (ROI) and/or did not adequately account for the potential risk factors.…”

Section: Discussionmentioning

confidence: 98%

“…ASL has been recently used to evaluate CBF in T2DM patients, however the reports are contradictory. Some studies found that resting CBF is similar between T2DM patients and controls (Tiehuis et al 2008; Rusinek et al 2015; Novak et al 2011), while others reported reduced CBF in patients with T2DM (Xia et al 2015; Novak et al 2006; Last et al 2007; Nagamachi et al 1994). The cross-sectional design of these studies however, did not allow to investigate the association between T2DM and changes in brain perfusion or structure and cognitive or mobility functions over time.…”

Section: Introductionmentioning

confidence: 99%

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The resting perfusion pattern associates with functional decline in type 2 diabetes

Dai

Duan

Alfaro

et al. 2017

Neurobiology of Aging

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We investigated the relationships between cerebral blood flow (CBF), cognitive and mobility decline in type 2 diabetes mellitus (T2DM) over a two-year period. Seventy-three participants (41 T2DM and 32 controls) were evaluated using volumetric CBF with arterial spin labeling (ASL) perfusion magnetic resonance imaging (pMRI) at baseline and at the two-year follow-up. Regions with significant CBF differences between T2DM participants and controls at baseline were detected using voxel-wise analysis. Correlation analysis was performed to investigate the association between regional CBF and cognitive or mobility performance over the two-year span. Compared to controls, participants with T2DM had decreased CBF in the resting state default mode, visual, and cerebellum networks. Greater decrease in longitudinal CBF values at these regions over a two-year span was associated with worse gait, memory and executive functions, and higher baseline insulin resistance and worse baseline cognitive performance. In T2DM, impairment of resting regional perfusion is closely related to worse cognitive and mobility performance. Insulin resistance may further contribute to regional perfusion deficit in T2DM.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

The resting perfusion pattern associates with functional decline in type 2 diabetes

Dai

Duan

Alfaro

et al. 2017

Neurobiology of Aging

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“…Although neuropsychological tests such as Mini-Mental State Examination and Montreal Cognitive Assessment remain to be the prevailing methods for evaluating T2DM patients with and without cognitive decline, a number of neuroimaging studies have emerged to investigate the compromised brain functions of T2DM patients by measuring changes in perfusion, 4 metabolism, 5 spontaneous brain activity at resting-state, 6 and functional connectivity. 7 The observed functional changes have been associated with sustained hyperglycemia and the resulting alterations in cerebral vasculature, neurotrophic factors, and neurotransmitters.…”

Section: Introductionmentioning

confidence: 99%

A Diffusion Tensor Imaging Study on White Matter Abnormalities in Patients with Type 2 Diabetes Using Tract-Based Spatial Statistics

Xiong

Sui

et al. 2016

American Journal of Neuroradiology

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Background and Purpose To demonstrate that gradual and continuous WM change and the associated cognitive decline in type 2 diabetes mellitus (T2DM) patients can be captured by DTI parameters and the DTI parameters can be used to complement neuropsychological test scores in identifying T2DM patients with and without mild cognitive impairment (MCI). Materials and Methods Forty-two T2DM patients, divided into a group with MCI (DM-MCI; n = 20) and a group with normal cognition (DM-NC; n = 22) based on cognitive assessments, were enrolled together with age-, gender-, and education-matched healthy controls (HC; n = 26). DTI was performed at 3 Tesla, followed by an analysis using tract-based spatial statistics (TBSS) to investigate the differences in fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (λ1), and radial diffusivity (λ23) among the groups. A receiver operating characteristic (ROC) analysis was used to assess the performance of using DTI parameters for separating the two T2DM groups. Results The whole-brain TBSS analysis revealed that 7.3% and 24.9% of the WM exhibited decreased FA and increased MD (p < 0.05), respectively, between the DM-MCI and the DM-NC groups, while considerably larger WM regions showed FA (36.6%) and MD (58.8%) changes between the DM-MCI and the HC groups. These changes were caused primarily by an elevated radial diffusivity observed in the DM-MCI patients. Radial diffusivity also exhibited subtle but statistically significant changes between the DM-NC and the HC group. Analyses on individual fiber tracts showed pronounced FA reduction and MD elevation in regions related to cognitive functions. The ROC analysis on the right cingulum (hippocampus) showed that FA produced a larger area under the curve (AUC = 0.832) than MD (0.753) for separating MCI from normal cognition among T2DM patients. When FA was combined with MD, the AUC was further improved to 0.857. Conclusion This study demonstrates that the DTI parameters can show a significant difference between the T2DM patients with and without MCI, suggesting their potential use as an imaging marker for detecting cognitive decline in T2DM patients. More importantly, this study also suggests that the DTI parameters may capture gradual and continuous WM changes that can be associated with early stages of cognitive decline in T2DM patients before they can be diagnosed clinically using the conventional neuropsychological tests.

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“…Dado que los mayores ancianos institucionalizados y con diabetes, son más proclives al deterioro cognitivo en general (Awad, et al 2004;Arvanitakis et al, 2004;y Salinas-Contreras et al, 2013), y de la memoria en particular (Donohoe et al, 2000;Redondo et al, 2010;y Rusinek et al, 2015), podemos concluir que los ancianos con enfermedades metabólicas como la DM2 podrían beneficiarse de la participación en programas de estimulación de la memoria como proponen Best et al (1992) y Kliegl et al (1989), profundizando a la vez en la línea de la promoción del envejecimiento saludable en mayores institucionalizados (Cabaco y Crespo, 2015;Wobbeking, Cabaco, Urchaga, Sánchez, García, 2015).…”

Section: Discusión Y Conclusionesunclassified

“…Por otra parte, encontramos que la memoria episódica explícita se altera más que la memoria implícita en mayores diabéticos, en comparación con mayores no diabéticos (Redondo et al, 2010). Más recientemente, Rusinek et al (2015) obtienen rendimientos inferiores en tareas de memoria verbal y de memoria espacial, así como déficits en la velocidad del procesamiento verbal, en participantes con DM2 en comparación con sujetos sin DM2.…”

Section: Introductionunclassified

Entrenamiento de la memoria en personas mayores con diabetes mellitus tipo 2. / Memory training in older people with type 2 diabetes mellitus.

Lancho¹,

Esteban²,

Mateos³

et al. 2017

PSYE

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RESUMENLas enfermedades metabólicas en los ancianos están asociadas con un mayor riesgo de desarrollar alguna disfunción cognitiva. Este estudio investigó el efecto del entrenamiento en estrategias de memoria en adultos mayores con diabetes mellitus tipo 2, siguiendo un diseño semiexperimental. Participaron en el estudio 11 personas que padecían diabetes mellitus tipo 2, sin deterioro cognitivo, ansiedad ni depresión. Su función mnésica fue medida antes y después de la implementación del programa. Los resultados mostraron diferencias significativas en la tarea de Memoria de Textos Inmediata, Evocada por Preguntas. Al analizar el tamaño del efecto se observó un aumento del rendimiento en tareas de Memoria de Textos Inmediata y Memoria de Textos Diferida. En un análisis ideográfico se observó que los pacientes con puntuaciones más altas en ansiedad y depresión y con puntuaciones más bajas en las pruebas de memoria pretest mostraron una mejoría clínica en memoria. Se puede concluir que los adultos mayores diabéticos, propensos a desarrollar déficits mnésicos, pueden beneficiarse de un programa de estimulación de la memoria. Destacamos que el 89,1% de los sujetos diabéticos seleccionados inicialmente para el estudio cumplían alguno de los criterios de exclusión y no pudieron participar en el programa. Por ello se plantea la posibilidad de replicar el estudio con muestras más amplias. ABSTRACTMetabolic diseases in older people are associated with an increased risk of developing some cognitive dysfunction. This study investigated the effect of training on memory strategies in older people with type 2 diabetes mellitus following a semiexperimental design. Eleven patients with diabetes mellitus type 2, without cognitive impairment, anxiety nor depression, participated in the study. Measurements of their mnesic function were taken before and after implementation of the program. The results showed significant differences in Immediate Text Memory Task, Evoked by Clues. By analyzing the effect size, an increased performance in Immediate and Delayed Text Memory Tasks is observed. In an idiographic analysis, it was observed that patients with higher scores in anxiety and depression and with low scores in the pretest memory tasks showed a greater clinical improvement in memory. It can be concluded that older diabetics, prone to developing mnesic deficits, may benefit from a program of memory stimulation. We emphasize that 89.1% of the diabetic subjects initially selected for the study met some of the exclusion criteria and were not able to participate in the program. Therefore, the possibility to extend the study with larger samples is raised.

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Cerebral Perfusion in Insulin Resistance and Type 2 Diabetes

Cited by 64 publications

References 37 publications

The resting perfusion pattern associates with functional decline in type 2 diabetes

The resting perfusion pattern associates with functional decline in type 2 diabetes

A Diffusion Tensor Imaging Study on White Matter Abnormalities in Patients with Type 2 Diabetes Using Tract-Based Spatial Statistics

Entrenamiento de la memoria en personas mayores con diabetes mellitus tipo 2. / Memory training in older people with type 2 diabetes mellitus.

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