Neurocognitive Changes and Their Neural Correlates in Patients with Type 2 Diabetes Mellitus

Abstract

As the prevalence and life expectancy of type 2 diabetes mellitus (T2DM) continue to increase, the importance of effective detection and intervention for the complications of T2DM, especially neurocognitive complications including cognitive dysfunction and dementia, is receiving greater attention. T2DM is thought to influence cognitive function through an as yet unclear mechanism that involves multiple factors such as hyperglycemia, hypoglycemia, and vascular disease. Recent developments in neuroimaging methods have led to the identification of potential neural correlates of T2DM-related neurocognitive changes, which extend from structural to functional and metabolite alterations in the brain. The evidence indicates various changes in the T2DM brain, including global and regional atrophy, white matter hyperintensity, altered functional connectivity, and changes in neurometabolite levels. Continued neuroimaging research is expected to further elucidate the underpinnings of cognitive decline in T2DM and allow better diagnosis and treatment of the condition.

Cerebrolysin reverses hippocampal neural atrophy in a mice model of diabetes mellitus type 1

“…Diabetes mellitus (DM) is a metabolic disorder that increases the risk of cognitive dysfunction and dementia (for reviews see Lee et al, ; Meusel et al, ). These disorders might be due in part to the occurrence of morphological changes at the cortical level (for review see Grillo and Reagan, ).…”

“…Several reports have demonstrated an association between DM, ischemic stroke, depression, and Alzheimeŕs disease (AD) (for reviews see Hasan et al, ; Siddiqui, ). Clinical observations suggest that DM might be accompanied by reduced cognitive function (for review see Lee et al, ; Lips et al, ), such as impaired performance in global memory and learning (for review see Lee et al, ).…”

Long-term Variability in Glycemic Control Is Associated With White Matter Hyperintensities in APOE4 Genotype Carriers With Type 2 Diabetes

“…Other studies did not find such associations (17). This inconsistency may be explained by the diversity of WMH quantification methodology (2) or, as implied from the current results, by interactions with disease factors such as HbA 1c variability and APOE genotype.…”

“…Neuroimaging studies have examined the neural correlates of cognitive impairment in T2D, revealing white matter hyperintensities (WMHs), which are believed to reflect ischemic injury, and cortical and subcortical atrophy, which may underlie observed cognitive changes (2). …”

Whenever You Lose Connection, Take Intranasal Insulin?

“…Diabetes mellitus-a disease affecting millions of people worldwide-is the prototype of such a multiorgan dysfunction syndrome compromising neurocognitive function via poorly understood pathways (1). Not only longterm diabetes but also short-term dysregulations of blood glucose are linked to profound permanent neurocognitive impairment (e.g., when they are experienced during critical illness) (2).…”