Disrupted Regional Cerebral Blood Flow in Children With Newly-Diagnosed Type 1 Diabetes Mellitus: An Arterial Spin Labeling Perfusion Magnetic Resonance Imaging Study

Abstract

Object: Diabetes is associated with cerebral vascular dysfunction and increased vascular cognitive impairment. The objective of this study was to use arterial spin labeling (ASL) perfusion-weighted magnetic resonance imaging to investigate whether cerebral perfusion was changed in newly-diagnosed children with type 1 diabetes mellitus (T1DM) and the possible relationship between aberrant cerebral blood flow (CBF) with cognitive as well as clinical variables. Methods: Between January 2017 and February 2018, 34 children with newly-diagnosed T1DM and 34 age, gender, and education-matched healthy controls were included. Three dimensional pseudo-continuous ASL perfusion MRI was used to evaluate CBF. A conventional T2WI sequence was added to exclude intracranial disease. Regions with CBF differences between T1DM children and the controls were detected via voxel-wise comparisons in REST software. Associations among the result of neuropsychological test, clinical variables, and CBF values of different brains were investigated by using partial correlation analysis. Results: Compared with the controls, T1DM children show decreased CBF in the left calcarine and postcentral gyrus, and right precentral gyrus. The perfusion in the postcentral gyrus was positively correlated with IQ performance. No significant correlations were found between CBF and HbA1c, blood glucose level before imaging and IQ in other brain regions in T1DM children. Conclusion: There is an abnormal cerebral perfusion in children with newly diagnosed T1DM. The visual and sensorimotor areas are brain areas where perfusion is prone to change at the beginning of T1DM. Our study provided clues for cerebral pathophysiological changes in the initial stage of T1DM.

Cerebral Blood Flow and its Connectivity Deficits in Patients With Lung Cancer After Chemotherapy

“…Precentral gyrus is a part of the premotor area and the supplementary motor area, which integrate the incoming sensory information from the outside world and the current state of bod ( Hooks, 2017 ). Existing studies have suggested that changes in the neurovascular coupling and cerebral perfusion patterns in the motor region are related to motor development ( Song et al, 2020 ). We also observed decreased negative CBF connectivity between the right caudate and the right lingual gyrus as well as the right preceneus.…”

Brain perfusion in type 1 diabetes and cognitive dysfunction

“…Патофизиологические механизмы, лежащие в основе когнитивных нарушений, связанных c СД 1 типа, сложны и многофакторны: как гипогликемия, так и гипергликемия могут способствовать когнитивным нарушениям при данной патологии [6]. Многие исследования брали за основу роль гипогликемии в данном процессе, однако крупное продольное эпидемиологическое исследование не выявило такой связи [7].…”

“…В данном иссле довании наибольшее значение, кроме гипергликемии, имели анамнестические данные, длительность заболевания, уровень холестерина и степень АГ, которые являются общими для развития нейродегенеративного процесса [17]. Дисгликемия была подтверждена не во всех работах, так, при манифестации уровень HbA 1c не показал ассоциацию с гипоперфузией головного мозга, тогда как хроническая гипергликемии при СД 2 типа была связана с более низким общим церебральным кровотоком в височной области [6,18].…”

Corresponding risk factors between cognitive impairment and type 1 diabetes mellitus: A narrative review

“…A study examining children aged 6-11 with T1DM found that structural changes in the brains of children with T1DM were associated with CI and that they tend to have poor glycemic control compared with controls [10]. In newly diagnosed children with T1DM, the researchers found reduced cerebral blood perfusion in the visual and sensorimotor areas of the cerebral cortex [15]. Moreover, compared with non-diabetic children, T1DM children exhibited significantly lower performance on the full IQ and motor speed tests.…”