Cerebral haemodynamics, cognition and brain volumes in patients with type 2 diabetes
Cerebral haemodynamics, cognition and brain volumes in patients with type 2 diabetes
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DOI：
10.1016/j.jdiacomp.2012.03.021
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发表时间：
2012-05-01
影响因子：
3
通讯作者：
Biessels, Geert Jan
中科院分区：
文献类型：
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作者：
Brundel, Manon;van den Berg, Esther;Biessels, Geert Jan
背景：2型糖尿病(T2 DM)与认知功能障碍和MRI脑部异常有关。其潜在机制尚不清楚。方法：对114例年龄在56~80岁的T2 DM患者进行详细的认知功能评估和MRI扫描。在68名患者中，四年后再次进行评估。基线测量CBF(二维血流编码相位对比MRI)和CVR(Carbogen呼吸反应大脑中动脉；经颅多普勒)。认知表现用综合z得分和基于回归的指数得分表示。在MRI上通过自动分割测量脑体积。结果：平均CVR为51.8%+/-18.0%，平均rCBF为53.3+/-11.3ml/min/100ml脑组织。CBF与基线认知功能(标准化回归系数β(95%CI)：0.17(0.00；0.32)和总脑体积(0.23(0.05；0.41))相关。未发现CVR与基线认知成绩之间的相关性。CBF和CVR均不能预测认知功能的变化(CBF0.11(-0.21：0.44)；CVR0.07(-0.21：0.36))或总脑容量(CBF0.09(-0.22：0.39)；CVR0.13(-0.13；0.40))。结论：在横断面分析中，CBF与认知损害和总脑容量有关，但不能预测认知或脑容量随时间的变化。显然，在非痴呆性T2 DM患者中，脑血流动力学的改变并不是认知能力下降或脑体积改变的主要原因。(C)2012 Elsevier Inc.保留所有权利。
Background: Type 2 diabetes mellitus (T2DM) is associated with cognitive impairment and brain abnormalities on MRI. The underlying mechanisms are unclear. We examined the relationship between cerebral haemodynamics (cerebral blood flow (CBF) and cerebrovascular reactivity (CVR)) and cognitive performance and brain volumes in patients with T2DM, at baseline and after four years.Methods: 114 patients with T2DM, aged 56-80 years, underwent a detailed cognitive assessment and MRI scan. In 68 patients the evaluation was repeated after four years. CBF (two-dimensional flow-encoded phase-contrast MRI) and CVR (carbogen breathing response middle cerebral artery; transcranial Doppler) were measured at baseline. Cognitive performance was expressed as composite z-score and regression based index score. Brain volumes were measured on MRI by automated segmentation. The relationship of haemodynamics with cognition and brain volumes was examined with linear regression analyses adjusted for age, sex and IQ.Results: Mean CVR was 51.8% +/- 18.0% and mean rCBF 53.3 +/- 11.3 ml/min/100 ml brain tissue. CBF was associated with baseline cognitive performance (standardized regression coefficient beta (95% CI): 0.17 (0.00; 0.32) and total brain volume (0.23 (0.05; 0.41)). No correlation was found between CVR and baseline cognitive performance. Neither CBF nor CVR predicted change in cognition (CBF 0.11 (-0.21: 0.44); CVR 0.07 (-0.21: 0.36)) or total brain volume (CBF 0.09 (-0.22: 0.39); CVR 0.13 (-0.13; 0.40)) over four years.Conclusions: CBF was associated with impaired cognition and total brain volume in cross-sectional analyses, but did not predict changes in cognition or brain volumes over time. Apparently, alterations in cerebral haemodynamics play no major etiological role in cognitive decline or change in brain volumes in non-demented individuals with T2DM. (c) 2012 Elsevier Inc. All rights reserved.