Intracranial Vascular Lesions in Patients With Diabetes Mellitus

Aronson, Stanley M

doi:10.1097/00005072-197304000-00001

Cited by 87 publications

(55 citation statements)

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“…In the present study, unlike most previous studies, we selected only subjects with no current or past medical or neurological conditions. An increased incidence of microinfarction has been linked to both chronic hypertension (Kobayashi et al, 1991) and diabetes (Aronson, 1973;Desmond et al, 1993). We excluded patients with any history of substance abuse because alcohol dependence can cause cerebral atrophy (Charness, 1993).…”

Section: Discussionmentioning

confidence: 99%

Depression Duration But Not Age Predicts Hippocampal Volume Loss in Medically Healthy Women with Recurrent Major Depression

Sanghavi²,

et al. 1999

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This study takes advantage of continuing advances in the precision of magnetic resonance imaging (MRI) to quantify hippocampal volumes in a series of human subjects with a history of depression compared with controls. We sought to test the hypothesis that both age and duration of past depression would be inversely and independently correlated with hippocampal volume. A sample of 24 women ranging in age from 23 to 86 years with a history of recurrent major depression, but no medical comorbidity, and 24 case-matched controls underwent MRI scanning. Subjects with a history of depression (post-depressed) had smaller hippocampal volumes bilaterally than controls. Post-depressives also had smaller amygdala core nuclei volumes, and these volumes correlated with hippocampal volumes. In addition, post-depressives scored lower in verbal memory, a neuropsychological measure of hippocampal function, suggesting that the volume loss was related to an aspect of cognitive functioning. In contrast, there was no difference in overall brain size or general intellectual performance. Contrary to our initial hypothesis, there was no significant correlation between hippocampal volume and age in either post-depressive or control subjects, whereas there was a significant correlation with total lifetime duration of depression. This suggests that repeated stress during recurrent depressive episodes may result in cumulative hippocampal injury as reflected in volume loss.

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Section: Discussionmentioning

confidence: 99%

Depression Duration But Not Age Predicts Hippocampal Volume Loss in Medically Healthy Women with Recurrent Major Depression

Sanghavi²,

et al. 1999

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“…In the Honolulu Heart Program, diabetes was not associated with an increased risk of hemorrhagic stroke in men, whereas in the Framingham Study, there was a 4.5-fold higher risk of hemorrhagic stroke in men with diabetes (3). For hemorrhagic stroke, a study showed that in patients with both diabetes and arterial hypertension, the severity of fibrinoid necrosis of small cerebral arteriole walls, often associated with intracerebral hemorrhage, was less pronounced than in those with hypertension alone (36).…”

Section: Discussionmentioning

confidence: 99%

Prospective Study of Type 1 and Type 2 Diabetes and Risk of Stroke Subtypes

et al. 2007

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OBJECTIVE -The aim of this study was to examine the relationship between type 1 and type 2 diabetes and risk of stroke subtypes in women.RESEARCH DESIGN AND METHODS -We followed 116,316 women aged 30 -55 years in 1976 through 2002 for incidence of stroke. At baseline and through biennial follow-up, women were asked about their history and treatment of diabetes and other potential risk factors for stroke.RESULTS -During 2.87 million person-years of follow-up, 3,463 incident strokes occurred. In multivariate analyses, the incidence of total stroke was fourfold higher in women with type 1 diabetes (relative risk [RR] I n many (1-11) but not all (12-15) epidemiological studies, type 2 diabetes has been an important risk factor for ischemic stroke; however, relative risks (RRs) have varied widely, from 1.3 to 4.9 (1-11). The disparate RRs may be explained in part by differences in populations, definitions of diabetes, types of stroke studied, and analytical methods. The increased risk of stroke has been linked to the pathophysiological changes seen in the cerebral vessels of individuals with diabetes (1). In contrast, the association with hemorrhagic stroke remains controversial; reported associations have been positive (3,5), null (16,17), or even inverse (1,18 -20). Further, only a few small studies have examined the risk of stroke in patients with type 1 diabetes (18 -21), and this relationship remains unsettled. We used the large ongoing Nurses' Health Study to examine the risk of total stroke and its subtypes in women with type 1 or type 2 diabetes. RESEARCH DESIGN AND METHODS Data collectionThe Nurses' Health Study is an ongoing cohort established in 1976 when 121,701 female registered nurses aged 30 -55 years completed a mailed questionnaire on their health status and various lifestyle and behavioral risk factors. Participants complete biennial follow-up questionnaires to update risk factors and report newly diagnosed diseases including stroke. The biennial follow-up rate exceeds 90%, and mortality follow-up is estimated as Ͼ98% complete (22). The human research committees at the Harvard School of Public Health and Brigham and Women's Hospital approved the study. Ascertainment of strokeIncident strokes were defined as the first nonfatal stroke or stroke death occurring after the baseline questionnaire in 1976 but before 1 June 2002. Women who reported a stroke were asked for permission to access their medical records, which were reviewed by a physician without knowledge of the participant's exposure status. Women for whom medical record release was refused or for whom medical records were unavailable were classified as probable if supporting information was provided. Cerebrovascular pathology due to infection, trauma, or malignancy was excluded, as were "silent" strokes discovered only by radiological imaging. Stroke was classified according to criteria established by the National Survey of Stroke (23), which required evidence of a neurological deficit with sudden or rapid onset that persisted for Ͼ24 h or u...

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“…In line with these results, the frequency of infratentorial encephalomalacia, especially in the pontine base, has been reported to be significantly elevated in patients with DM compared to non-DM patients, based on a large autopsy series examined at a facility in Iceland [20,21]. Previous neuroradiological studies have also documented that DM is closely associated with BSI and infratentorial infarctions [22,23,24,25] and some have reported that DM is especially correlated with pontine infarcts of the branch atheromatous type [23,24,25].…”

Section: Discussionmentioning

confidence: 68%

The Brainstem Is at High Risk for Recurrent Noncardioembolic Cerebral Infarction in Association with Diabetes Mellitus: A Hospital-Based Study

Ichikawa

Shimizu²,

Kuriki³

et al. 2011

Eur Neurol

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The goals of the study were to investigate the importance of brainstem infarction (BSI) in recurrent noncardioembolic ischemic stroke and to examine the relevant clinical background. Data were retrospectively reviewed for 655 consecutive patients with acute noncardioembolic infarction who were admitted to our hospital from January 2004 to August 2010. The patients were divided into first-stroke (n = 592) and recurrent-stroke (n = 63) groups. Acute infarcted lesions were explored on MRI, and clinical background factors including age, sex, smoking, atrial fibrillation, coronary heart disease, hypertension, hyperlipidemia and diabetes mellitus (DM) were assessed. The frequency of BSI in the recurrent-stroke group was significantly higher than that in first-stroke patients (30.2 vs. 14.9%, p = 0.0033). No other clinical background factors differed between the two groups. Only the frequency of DM differed significantly among four subgroups formed based on stroke recurrence and BSI (p < 0.0001): DM was present in 63.2% of recurrent-stroke patients with BSI, 54.5% of first-stroke patients with BSI, 27.4% of first-stroke patients without BSI, and 20.5% of recurrent-stroke patients without BSI. We conclude that the brainstem is at high risk for recurrent cerebral infarction in patients with DM.

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Intracranial Vascular Lesions in Patients With Diabetes Mellitus

Cited by 87 publications

References 0 publications

Depression Duration But Not Age Predicts Hippocampal Volume Loss in Medically Healthy Women with Recurrent Major Depression

Depression Duration But Not Age Predicts Hippocampal Volume Loss in Medically Healthy Women with Recurrent Major Depression

Prospective Study of Type 1 and Type 2 Diabetes and Risk of Stroke Subtypes

The Brainstem Is at High Risk for Recurrent Noncardioembolic Cerebral Infarction in Association with Diabetes Mellitus: A Hospital-Based Study

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