MRI of the brain in diabetes mellitus

Araki, Yutaka; Nomura, Midori; Tanaka, Hisashi; Yamamoto, H.; Yamamoto, Takahiro; Tsukaguchi, I; Nakamura, Hajime

doi:10.1007/bf00588069

Cited by 126 publications

(80 citation statements)

References 7 publications

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“…Central and peripheral atrophy in type 1 diabetes [7,8,18] and subcortical white matter lesions [4,5] have been reported in the literature. The methods used in these studies are semiquantitative.…”

Section: Discussionmentioning

confidence: 99%

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Voxel-based morphometry demonstrates reduced grey matter density on brain MRI in patients with diabetic retinopathy

et al. 2006

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Aims/hypothesis: In addition to nephropathy, retinopathy and peripheral neuropathy, a microvascular complication of type 1 diabetes that may be tentatively referred to as 'diabetic encephalopathy' has gained increasing attention. There is growing evidence that lowered cognitive performance in patients with type 1 diabetes is related to chronic hyperglycaemia rather than recurrent episodes of severe hypoglycaemia, as previously speculated. The aim of our study was to use magnetic resonance imaging (MRI) to establish whether long-term hyperglycaemia, resulting in advanced retinopathy, contributes to structural changes in the brain (reduced grey matter). Subjects, materials and methods: We applied voxel-based morphometry on magnetic resonance images to compare grey matter density (GMD) between three groups of participants. GMD is used as a marker of cortical atrophy. We compared 13 type 1 diabetic patients with a microvascular complication (i.e. proliferative retinopathy) with 18 type 1 diabetic patients who did not have retinopathy in order to assess the effects of microvascular changes on GMD. Both patient groups were compared with 21 healthy control subjects to assess the effect of diabetes in itself. Results: Patients with diabetic retinopathy showed reduced GMD in the right inferior frontal gyrus and right occipital lobe compared both with patients without retinopathy and with healthy controls (p<0.05). Conclusions/interpretation: Our data show that patients with type 1 diabetes, who, as a consequence of chronic hyperglycaemia, had developed advanced retinopathy, also showed increased focal cortical atrophy on brain MRI.

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Section: Discussionmentioning

confidence: 99%

“…To date, the few neuroradiological studies that have assessed structural brain abnormalities in patients with type 1 diabetes have demonstrated conflicting results [4][5][6][7][8]. The majority of these studies have been based on manual or semi-automated region-of-interest-guided measurements, which may be inherently biased.…”

Section: Introductionmentioning

confidence: 99%

Voxel-based morphometry demonstrates reduced grey matter density on brain MRI in patients with diabetic retinopathy

et al. 2006

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“…A few studies employing in vivo brain imaging have reported 'accelerated brain ageing' in patients with diabetes (for example [4,6]). In addition, among individuals with type 2 diabetes, reductions in cognitive functioning have been reported to be associated with white matter lesions, atrophy and the presence of infarcts [4].…”

Section: Introductionmentioning

confidence: 99%

Hippocampal damage and memory impairments as possible early brain complications of type 2 diabetes

et al. 2007

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Aims/hypothesis There is evidence that type 2 diabetes mellitus is associated with cognitive impairment. Most studies investigating this association have evaluated elderly individuals, after many years of diabetes, who generally have poor glycaemic control and significant vascular disease. The aim of the current study was to investigate the early cognitive consequences and associated brain correlates of type 2 diabetes. Materials and methods With regard to cognition and brain measures, we compared 23 age-, sex-and educationmatched control subjects with 23 mostly middle-aged individuals with relatively well-controlled diabetes of less than 10 years from the time of diagnosis. Results We found deficits in hippocampal-based memory performance and preservation of other cognitive domains. Relative to control subjects, individuals with diabetes had reductions in brain volumes that were restricted to the hippocampus. There was an inverse relationship between glycaemic control and hippocampal volume; in multivariate regression analysis, HbA 1c was the only significant predictor of hippocampal volume, accounting for 33% of the observed variance. Other variables commonly associated with type 2 diabetes, such as elevated BMI, hypertension or dyslipidaemia, did not independently contribute to the variance in hippocampal volume. Conclusions/interpretation These results suggest that the medial temporal lobe may be the first brain site affected by type 2 diabetes and that individuals in poorer metabolic control may be affected to a greater extent.

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“…Although it is known that diabetic patients are at increased risk for stroke (2), little is known about the risk for other brain pathology, such as that associated with neurodegeneration or small vessel disease. Previous radiological studies of patients with diabetes were based on highly selective groups of individuals referred to computed tomography or magnetic resonance imaging (MRI) neuroimaging (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). Only a few population-based studies assessed the association of diabetes-as one of many cardiovascular disease (CVD) risk factors-to only one specific type of brain lesion (18 -22).…”

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confidence: 99%

Magnetic Resonance Imaging of the Brain in Diabetes

et al. 2004

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Diabetic patients are at increased risk for stroke, but little is known about the presence of other brain lesions. We studied the association of magnetic resonance imaging-detected brain lesions to diabetes in 1,252 individuals aged 65-75 years who were randomly selected from eight European population registries or defined working populations. All scans were centrally read for brain abnormalities, including infarcts, white matter lesions, and atrophy. We used a three-point scale to rate periventricular white matter lesions, and the volume of subcortical lesions was calculated according to their number and size. Subjective grading of cortical atrophy by lobe and summation of the lobar grades resulted in a total cortical atrophy score. The mean of three linear measurements of the ventricular diameter relative to the intracranial cavity defined the severity of subcortical atrophy. After adjustment for possible confounders, diabetes was associated with cortical brain atrophy but not with any focal brain lesions or subcortical atrophy. There was a strong interaction of diabetes and hypertension, such that the association between diabetes and cortical atrophy existed only in hypertensive but not in normotensive participants. Cognitive and pathological data are needed to determine the clinical significance of these findings as well as to understand the mechanisms underlying these associations. Diabetes 53:687-692, 2004 D iabetes is a metabolic disorder that affects many systems in the body. Nephropathy, retinopathy, peripheral neuropathy, and cardiac disease are major complications in the advanced stage of the disorder (1). Although it is known that diabetic patients are at increased risk for stroke (2), little is known about the risk for other brain pathology, such as that associated with neurodegeneration or small vessel disease. Previous radiological studies of patients with diabetes were based on highly selective groups of individuals referred to computed tomography or magnetic resonance imaging (MRI) neuroimaging (3-17). Only a few population-based studies assessed the association of diabetes-as one of many cardiovascular disease (CVD) risk factors-to only one specific type of brain lesion (18 -22). The reported results are inconsistent. Only 6 (5,6,8,11,16, 20) of 19 investigations (3-22) found diabetes to be a risk factor for small vessel disease-related brain abnormalities, including white matter lesions or lacunes. Three studies found associations with cerebral atrophy (3,7,21). Interactive effects between diabetes and other major vascular risk factors, particularly arterial hypertension, have been implicated for the development of diabetes-related complications (23). The importance of such interactions for the development of brain abnormalities in diabetic patients is unclear. We hypothesized that diabetes is associated with a variety of focal and diffuse cerebral abnormalities and that there exist interactive effects between diabetes and other major vascular risk factors on the occurrence of brain lesions....

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MRI of the brain in diabetes mellitus

Cited by 126 publications

References 7 publications

Voxel-based morphometry demonstrates reduced grey matter density on brain MRI in patients with diabetic retinopathy

Voxel-based morphometry demonstrates reduced grey matter density on brain MRI in patients with diabetic retinopathy

Hippocampal damage and memory impairments as possible early brain complications of type 2 diabetes

Magnetic Resonance Imaging of the Brain in Diabetes

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