Cognitive dysfunction associates with white matter hyperintensities and subcortical atrophy on magnetic resonance imaging of the elderly diabetes mellitus Japanese elderly diabetes intervention trial (J-EDIT)
Cognitive dysfunction associates with white matter hyperintensities and subcortical atrophy on magnetic resonance imaging of the elderly diabetes mellitus Japanese elderly diabetes intervention trial (J-EDIT)
复制标题
DOI：
10.1002/dmrr.632
复制
发表时间：
2006-09-01
影响因子：
8
通讯作者：
Ito, Hideki
中科院分区：
文献类型：
--
作者：
Akisaki, Taichi;Sakurai, Takashi;Ito, Hideki
背景2型糖尿病与认知功能障碍有关，并增加老年痴呆症的风险。本研究的目的是探讨，通过磁共振（MR）成像，糖尿病，认知功能，白色高信号（WMH）和皮质下brain atrophy.Methods数据之间的可能关系的临床资料从95非痴呆2型糖尿病患者年龄在65岁或以上，参加了干预试验，为日本老年糖尿病患者。认知功能采用简易精神状态检查（MMSE）、文字记忆、数字符号替代和Stroop测验进行测定。高信号分为脑室周围、深部白色物质、丘脑和基底节。四个脑室-脑比率用于测量皮质下萎缩。为明确糖尿病的临床特征，检测血糖控制、脂代谢、血压和并发症等指标。结果数字符号替代和MMSE评分分别与顶叶WMH和丘脑高信号呈负相关。记忆力和数字符号替代得分较低与侧脑室内邻近的皮质下萎缩扩大呈正相关。糖尿病患者认知功能障碍的临床图片和那些与脑形态学变化之间没有关联。结论受损的认知领域的速度的心理过程和记忆与WMH和皮质下萎缩。脑小血管的退行性改变可能是老年糖尿病患者认知功能障碍发生率的预测因素。(c)版权所有2006年约翰威利父子有限公司。
Background Type 2 diabetes is associated with cognitive dysfunction and increases the risk of dementia in the elderly. The aim of this study was to explore, by means of magnetic resonance (MR) imaging, possible relationships among clinical profiles of diabetes, cognitive function, white matter hyperintensities (WMHs) and subcortical brain atrophy.Methods Data were obtained from 95 nondemented type 2 diabetic participants aged 65 years or over, enrolled in an intervention trial for Japanese elderly diabetic patients. Cognitive function was measured with neuropsychiatric tests, including mini-mental state examination (MMSE), verbal memory, digit symbol substitution and Stroop tests. Hyperintensity was classified into periventricular, deep white matter, thalamic and basal ganglia. Four ventricle-to-brain ratios were used to measure subcortical atrophy. To identify clinical features of diabetes, indices of glycemic control, lipid metabolism, blood pressure and complications were examined. Canonical correlation analysis and regression analysis were used to assess correlation.Results Scores for digit symbol substitution and MMSE negatively correlated with WMHs in the parietal lobe and hyperintensities in the thalamus, respectively. Lower scores for memory and digit symbol substitution showed positive association with enlarged subcortical atrophy adjacent to lateral ventricles. There was no association between clinical pictures of diabetic patients with cognitive dysfunction and of those with morphological changes in the brain.Conclusions Impaired cognitive domains of the speed of mental processes and memory were associated with WMHs and subcortical atrophy. Degenerative changes in the cerebral small vessels may constitute predictive factors for the rate of cognitive dysfunction in elderly diabetic patients. (c) Copyright 2006 John Wiley & Sons, Ltd.