Type-2 diabetes mellitus reduces cortical thickness and decreases oxidative metabolism in sensorimotor regions after stroke
Type-2 diabetes mellitus reduces cortical thickness and decreases oxidative metabolism in sensorimotor regions after stroke
复制标题
2型糖尿病可减少脑卒中后感觉运动区皮质厚度和氧化代谢
DOI：
10.1177/0271678x17703887
复制
发表时间：
2018-05-01
影响因子：
6.3
通讯作者：
Boyd, Lara A.
中科院分区：
文献类型：
--
作者：
Ferris, Jennifer K.;Peters, Sue;Boyd, Lara A.
2 型糖尿病患者在缺血性中风后运动效果较差。最近的研究表明，2 型糖尿病会对神经元完整性和功能产生不利影响，但很少有研究考虑这些神经元变化如何影响中风后的感觉运动结果。在这里，我们使用体积磁共振成像 (MRI) 和磁共振波谱 (MRS) 来考虑 2 型糖尿病如何影响中风后感觉运动皮层的结构和代谢功能。我们假设，与单独患有慢性中风的个体相比，慢性中风和 2 型糖尿病的结合会对感觉运动皮层的完整性产生负面影响。与单纯中风相比，中风合并糖尿病的个体的初级体感皮层、初级和次级运动皮层的双侧皮质厚度较低。中风和糖尿病患者的感觉运动皮层双侧肌酸水平也降低。在中风和糖尿病组中，对侧初级和次级运动皮层厚度与中风和糖尿病组的麻痹上肢的感觉运动结果呈负相关，因此那些初级和次级运动皮层较薄的人具有更好的运动功能。这些数据表明，2 型糖尿病会改变大脑能量代谢，并与中风后感觉运动皮层变薄有关。这些因素可能会影响中风后的运动结果。
Individuals with type-2 diabetes mellitus experience poor motor outcomes after ischemic stroke. Recent research suggests that type-2 diabetes adversely impacts neuronal integrity and function, yet little work has considered how these neuronal changes affect sensorimotor outcomes after stroke. Here, we considered how type-2 diabetes impacted the structural and metabolic function of the sensorimotor cortex after stroke using volumetric magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS). We hypothesized that the combination of chronic stroke and type-2 diabetes would negatively impact the integrity of sensorimotor cortex as compared to individuals with chronic stroke alone. Compared to stroke alone, individuals with stroke and diabetes had lower cortical thickness bilaterally in the primary somatosensory cortex, and primary and secondary motor cortices. Individuals with stroke and diabetes also showed reduced creatine levels bilaterally in the sensorimotor cortex. Contralesional primary and secondary motor cortex thicknesses were negatively related to sensorimotor outcomes in the paretic upper-limb in the stroke and diabetes group such that those with thinner primary and secondary motor cortices had better motor function. These data suggest that type-2 diabetes alters cerebral energy metabolism, and is associated with thinning of sensorimotor cortex after stroke. These factors may influence motor outcomes after stroke.