Reduced Regional Cerebral Blood Flow Relates to Poorer Cognition in Older Adults With Type 2 Diabetes.
Reduced Regional Cerebral Blood Flow Relates to Poorer Cognition in Older Adults With Type 2 Diabetes.
复制标题
DOI：
10.3389/fnagi.2018.00270
复制
发表时间：
2018
影响因子：
4.8
通讯作者：
Bondi MW
中科院分区：
文献类型：
--
作者：
Bangen KJ;Werhane ML;Weigand AJ;Edmonds EC;Delano-Wood L;Thomas KR;Nation DA;Evangelista ND;Clark AL;Liu TT;Bondi MW
2型糖尿病(T2 DM)会增加患痴呆症的风险，包括阿尔茨海默病(AD)。以往许多关于T2 DM认知损害的脑部改变的研究都应用了常规的结构磁共振成像(MRI)来检测与脑血管疾病相关的宏观结构变化，如白质高信号或脑梗塞。然而，这种病理可能反映了慢性脑血流(CBF)减少的终末期表现。测量CBF的MRI技术可以(1)阐明不可逆的实质损伤之前的机制，以及(2)作为认知功能下降的风险标记。动脉自旋标记(ASL)MRI测量的CBF可作为T2 DM及相关疾病患者脑血流灌注缺陷的有用指标。我们在49名特征良好的非痴呆症老年人样本中研究了T2 DM、CBF和认知之间的关系。除了标准的T1加权扫描，还在3T GE扫描仪上获得了针对老年人优化的伪连续ASL序列(通过增加标记后延迟，使血液有更多时间到达脑组织)，以测量自由漫游衍生的感兴趣区域的局部CBF。参与者还完成了一项神经心理学评估。结果显示，患有和不患有T2 DM的个体在皮质厚度或局部脑体积方面没有显著差异。然而，调整了年龄、性别、合并血管危险因素和参考CBF(中央后回)的老年T2 DM患者，发现海马区、颞叶下皮质、顶叶下皮质和额叶皮质的CBF减少。低CBF与较差的记忆力和执行功能/处理速度有关。在对糖尿病进行调整时，局部脑血流量降低与较差的执行功能/处理速度之间的显著关联仍然存在。结果表明，老年T2 DM患者的脑血流量降低，提示脑血流量的改变可能先于体积改变。值得注意的是，与非糖尿病对照组参与者相比，患有T2 DM的患者在AD病理的好发部位(内侧颞叶和顶下区域)的脑血流量较低。最近的研究表明，血流灌注缺陷可能是在老年T2 DM患者中经常观察到的认知衰退的原因。结果还表明，ASL MRI测量的CBF可以反映T2 DM及其相关疾病认知损害风险的早期和重要标志。
Type 2 diabetes mellitus (T2DM) increases risk for dementia, including Alzheimer’s disease (AD). Many previous studies of brain changes underlying cognitive impairment in T2DM have applied conventional structural magnetic resonance imaging (MRI) to detect macrostructural changes associated with cerebrovascular disease such as white matter hyperintensities or infarcts. However, such pathology likely reflects end-stage manifestations of chronic decrements in cerebral blood flow (CBF). MRI techniques that measure CBF may (1) elucidate mechanisms that precede irreversible parenchymal damage and (2) serve as a marker of risk for cognitive decline. CBF measured with arterial spin labeling (ASL) MRI may be a useful marker of perfusion deficits in T2DM and related conditions. We examined associations among T2DM, CBF, and cognition in a sample of 49 well-characterized nondemented older adults. Along with a standard T1-weighted scan, a pseudocontinuous ASL sequence optimized for older adults (by increasing post-labeling delays to allow more time for the blood to reach brain tissue) was obtained on a 3T GE scanner to measure regional CBF in FreeSurfer derived regions of interest. Participants also completed a neuropsychological assessment. Results showed no significant differences between individuals with and without T2DM in terms of cortical thickness or regional brain volume. However, adjusting for age, sex, comorbid vascular risk factors, and reference CBF (postcentral gyrus) older adults with T2DM demonstrated reduced CBF in the hippocampus, and inferior temporal, inferior parietal, and frontal cortices. Lower CBF was associated with poorer memory and executive function/processing speed. When adjusting for diabetes, the significant associations between lower regional CBF and poorer executive function/processing speed remained. Results demonstrate that CBF is reduced in older adults with T2DM, and suggest that CBF alterations likely precede volumetric changes. Notably, relative to nondiabetic control participants, those with T2DM showed lower CBF in predilection sites for AD pathology (medial temporal lobe and inferior parietal regions). Findings augment recent research suggesting that perfusion deficits may underlie cognitive decrements frequently observed among older adults with T2DM. Results also suggest that CBF measured with ASL MRI may reflect an early and important marker of risk of cognitive impairment in T2DM and related conditions.
登录
查看更多内容
影响因子：
4.2
作者：
Dai W;Duan W;Alfaro FJ;Gavrieli A;Kourtelidis F;Novak V
通讯作者：
Novak V
影响因子：
4.8
作者：
Bangen KJ;Clark AL;Edmonds EC;Evangelista ND;Werhane ML;Thomas KR;Locano LE;Tran M;Zlatar ZZ;Nation DA;Bondi MW;Delano-Wood L
通讯作者：
Delano-Wood L
DOI：
10.1093/gerona/60.4.471
发表时间：
2005-04-01
影响因子：
5.1
作者：
Beeri, MS;Silverman, JM;Haroutunian, V
通讯作者：
Haroutunian, V
脑自动调节，β-淀粉样蛋白和白质超强度相互关联。
影响因子：
2.5
作者：
Brickman AM;Guzman VA;Gonzalez-Castellon M;Razlighi Q;Gu Y;Narkhede A;Janicki S;Ichise M;Stern Y;Manly JJ;Schupf N;Marshall RS
通讯作者：
Marshall RS
影响因子：
4.2
作者：
Bangen, Katherine J.;Restom, Khaled;Bondi, Mark W.
通讯作者：
Bondi, Mark W.