Cognitive Dysfunctions in Middle-Aged Type 2 Diabetic Patients and Neuroimaging Correlations: A Cross-Sectional Study
Cognitive Dysfunctions in Middle-Aged Type 2 Diabetic Patients and Neuroimaging Correlations: A Cross-Sectional Study
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DOI：
10.3233/jad-140702
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发表时间：
2014-01-01
影响因子：
4
通讯作者：
Gonzalez-Santos, Pedro
中科院分区：
文献类型：
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作者：
Garcia-Casares, Natalia;Jorge, Ricardo E.;Gonzalez-Santos, Pedro
背景/目的：本研究的目的是评估一组控制良好的中年2型糖尿病(T2 DM)患者的神经心理表现，并检查神经心理缺陷是否与脑结构和功能改变有关。方法：我们对25例45-65岁的T2 DM患者和25名年龄、性别和教育水平匹配的对照组进行了比较。神经心理学组件的设计是为了检查执行功能、注意力、信息处理速度和语言记忆。使用汉密尔顿抑郁评定量表评估抑郁的严重程度，并使用Framingham心血管风险概况评分评估心血管风险因素。确定至少存在一个apoE epsilon 4等位基因。结果：T2 DM患者在连线测验B(p<；0.004)、颜色词Stroop测验(p<；0.005)、语义流畅性(p<；0.006)、数字符号形式测验(p<；0.02)、韦氏记忆量表的文本回忆(p<；0.0001)、雷伊-奥斯特里思复杂图形抄写(p<；0.005)上的得分显著低于非T2 DM组。0.004)和延迟繁殖(p<；0.03)。执行功能和记忆功能的下降主要与眼眶和前额叶皮质、颞叶(中回、副海马区和钩区)和小脑区的灰质密度降低和糖代谢降低有关(p<；0.001)。结论：T2 DM患者存在认知功能障碍。临床神经影像与大脑变化(灰质密度降低和葡萄糖代谢减少)相对应，主要发生在额颞区。
Background/Objective: The aim was to assess the neuropsychological performance of a group of middle-aged patients with well-controlled type 2 diabetes mellitus (T2DM) and to examine whether the neuropsychological deficits correlate with structural and functional brain alterations.Methods: We compared 25 subjects with T2DM aged 45-65 years with 25 control participants matched for age, gender, and educational level. The neuropsychological battery was designed to examine executive functions, attention, information processing speed, and verbal memory. Severity of depression was assessed using the Hamilton Depression Rating Scale and cardiovascular risk factors were assessed using the Framingham Cardiovascular Risk Profile Score. The presence of at least one APOE epsilon 4 allele was determined. Reduced gray matter density was analyzed using voxel-based morphometry and brain glucose metabolic changes were assessed by (18)FDG-PET.Results: T2DM subjects had significantly lower scores than subjects without T2DM in the Trail-making Test B (p < 0.004), Color-Word Stroop test (p < 0.005), Semantic Fluency (p < 0.006), Digit-Symbol modalities test (p < 0.02), Text Recall from the Wechsler Memory Scale (p < 0.0001), Rey-Osterrieth Complex Figure-copy (p < 0.004), and delayed reproduction (p < 0.03). Worse executive functions and memory functioning correlated predominantly with less gray matter density and reduced glucose metabolism in the orbital and prefrontal cortex, temporal (middle gyrus, parahippocampus and uncus), and cerebellum regions (p < 0.001).Conclusions: T2DM subjects presented cognitive dysfunctions compared with controls. Clinical-neuroimaging correlations corresponded to brain changes (reduced gray matter density and glucose metabolism) mainly in fronto-temporal areas.