The Rate of Decrease in Brain Perfusion in Progressive Supranuclear Palsy and Corticobasal Syndrome May Be Impacted by Glycemic Variability—A Pilot Study

Abstract

Progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS) are tauopathic parkinsonian syndromes, presently lacking disease-modifying treatments. Patients affected by these diseases suffer due to multidimensional deteriorations resulting in motor and cognitive impairment. Previously published research has confirmed risk factors that may impact the course of PSP and CBS, among them hypertension and diabetes. Less data is available regarding prediabetes and glycemic variability. In this study, 26 patients with clinical diagnoses of PSP and CBS were examined using glycated hemoglobin and perfusion single-photon emission tomography (SPECT). Patients were divided into two groups—PSP/CBS patients with glycated hemoglobin (HbA1c) below and above 5.7%. The results of the perfusion evaluation were compared with the values from healthy volunteers from the software's database. A decrease in perfusion in certain regions of interest was observed among patients affected by increased glycemic variability. A more pronounced decrement in perfusion was observed only in some regions of interest—the hippocampus, pons, left thalamus, right insula. The results indicated that, among PSP/CBS patients, individuals with more pronounced glycemic variability had more severe hypoperfusion in certain brain regions in comparison with PSP/CBS patients without carbohydrate metabolism disorders. Due to the fact that PSP and CBS are associated with cognitive impairment, an additional decrease in perfusion in the hippocampal area may impact the rate of cognitive deterioration.

Annual Incidence of Dementia from 2003 to 2018 in Metropolitan Seoul, Korea: A Population-Based Study

“…This decrement might be another reason for the gradual reduction of dementia incidence from 2011 in Seoul, although dementia patients with depression increased beginning in 2014. In addition, as educating the importance of managing vascular risk factors to patients with mild cognitive impairment plays another role of DSCs, regulation of blood pressure, blood pressure variability, diabetes, glycemic variability, and dyslipidemia might have contributed to the incidence of dementia [30][31][32]. We additionally compared the characteristic of incident dementia patients before and after 2008, the year most DSCs were introduced and performed dementia screening programs (Table S3, Supplementary Material).…”

Cognitive Stimulation as Alternative Treatment to Improve Psychological Disorders in Patients with Mild Cognitive Impairment

“…This aging, together with possible common comorbidities such as poor glycemic control, episodes of hypoglycemia and hyperglycemia or vascular complications can cause a progression of mild cognitive impairment and its possible conversion to dementia [ 3 ]. In addition, it has been shown that the glycemic variable and hypertension are associated with dementia-like diseases such as progressive supranuclear palsy, Alzheimer’s disease, and corticobasal syndrome [ 4 , 5 ]. MCI is known as a neurological disorder that is somewhere between normal functioning and dementia [ 6 ] and is defined by the WHO as a disorder characterized by memory impairment, learning difficulties, and reduced ability to concentrate on a task for more than brief periods [ 7 ].…”

Neuroinflammation in Vascular Cognitive Impairment and Dementia: Current Evidence, Advances, and Prospects

“…On the other hand, vascular risk factors can lead to cognitive dysfunction by inducing neurological damage. For example, diabetes has become the main risk factor for PSP, and the decrease in cerebral perfusion in PSP may be regulated by blood glucose variability, thereby inducing the occurrence and development of cognitive dysfunction [ 147 , 148 ]. In addition, diabetes can also be an important risk factor that participates in the cognitive decline process of other neurodegenerative diseases via mechanisms that involve cerebrovascular pathologies, such as AD [ 149 , 150 , 151 ].…”