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Zhao Q, Du X, Liu F, Zhang Y, Qin W, Zhang Q. ECHDC3 Variant Regulates the Right Hippocampal Microstructural Integrity and Verbal Memory in Type 2 Diabetes Mellitus. Neuroscience 2024; 538:30-39. [PMID: 38070593 DOI: 10.1016/j.neuroscience.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 11/29/2023] [Accepted: 12/02/2023] [Indexed: 12/25/2023]
Abstract
ECHDC3 is a risk gene for white matter (WM) hyperintensity and is associated with insulin resistance. This study aimed to investigate whether ECHDC3 variants selectively regulate brain WM microstructures and episodic memory in patients with type 2 diabetes mellitus (T2DM). We enrolled 106 patients with T2DM and 111 healthy controls. A voxel-wise general linear model was employed to explore the interaction effect between ECHDC3 rs11257311 polymorphism and T2DM diagnosis on fractional anisotropy (FA). A linear modulated mediation analysis was conducted to examine the potential of FA value to mediate the influence of T2DM on episodic memory in an ECHDC3-dependent manner. We observed a noteworthy interaction between genotype and diagnosis on FA in the right inferior temporal WM, right anterior limb of the internal capsule, right frontal WM, and the right hippocampus. Modulated mediation analysis revealed a significant ECHDC3 modulation on the T2DM → right hippocampal FA → short-term memory pathway, with only rs11257311 G risk homozygote demonstrating significant mediation effect. Together, our findings provide evidence of ECHDC3 modulating the effect of T2DM on right hippocampal microstructural impairment and short-term memory decline, which might be a neuro-mechanism for T2DM related episodic memory impairment.
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Affiliation(s)
- Qiyu Zhao
- Department of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Xin Du
- Department of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Feng Liu
- Department of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Yang Zhang
- Department of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Wen Qin
- Department of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China.
| | - Quan Zhang
- Department of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China.
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Li R, Geng T, Li L, Lu Q, Li R, Chen X, Ou Y, Liu S, Lin X, Tian Q, Qiu Z, Zhu K, Tang Z, Yang K, Pan A, Liu G. Associations of Glucose Metabolism Status with Brain Macrostructure and Microstructure: Findings from the UK Biobank. J Clin Endocrinol Metab 2023; 109:e234-e242. [PMID: 37497611 DOI: 10.1210/clinem/dgad442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 07/11/2023] [Accepted: 07/26/2023] [Indexed: 07/28/2023]
Abstract
CONTEXT Evidence linking glucose metabolism status with brain macro- and microstructure is limited and inconsistent. OBJECTIVE We aim to investigate the associations of glucose metabolism status with brain macrostructure and microstructure, including brain volumes, subcortical gray matter volumes, and white matter microstructural metrics. METHODS This study enrolled 29 251 participants from the UK Biobank. Glucose metabolism status was classified into normal glucose metabolism (NGM), prediabetes, type 2 diabetes (T2D) with HbA1c <7%, and T2D with HbA1c ≥7%. Brain macrostructural metrics included volumes of total and subcortical gray matter, white matter, white matter hyperintensity (WMH), cerebrospinal fluid, and brain stem. Brain microstructural metrics included fractional anisotropy (FA) and mean diffusivity in white matter tracts. Multivariable linear regression models were used to estimate β values and 95% CI. RESULTS After multivariable adjustment including demographic and lifestyle factors, medical history, and total intracranial volume, those with prediabetes had smaller total and subcortical gray matter volumes than participants with NGM, while atrophy of total and subcortical gray matter was more pronounced in those with T2D (all P trend < .05). Moreover, participants with T2D had larger volumes of white matter and WMH (both P trend < .05). For brain microstructure, participants with prediabetes had lower FA values in commissural fibers (β -0.04; 95% CI -0.08, -0.003). Global and tract-specific microstructural abnormalities of white matter were observed in participants with T2D, especially for T2D with HbA1c ≥ 7% (all P trend < .05), except for FA values in projection fibers. CONCLUSION These findings suggest that interventions for hyperglycemia at an earlier stage may help protect brain health.
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Affiliation(s)
- Ruyi Li
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tingting Geng
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China
| | - Lin Li
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qi Lu
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rui Li
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xue Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yunjing Ou
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sen Liu
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoyu Lin
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qingying Tian
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zixin Qiu
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kai Zhu
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ziyue Tang
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kun Yang
- Department of Endocrinology, Affiliated Dongfeng Hospital, Hubei University of Medicine, Shiyan, China
| | - An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gang Liu
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Thieleking R, Medawar E, Villringer A, Beyer F, Witte AV. Neurocognitive predictors of food memory in healthy adults - A preregistered analysis. Neurobiol Learn Mem 2023; 205:107813. [PMID: 37625779 DOI: 10.1016/j.nlm.2023.107813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 07/18/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023]
Abstract
Memory processes have long been known to determine food choices (Rozin & Zellner, 1985) but recognition memory of food and its cognitive, homeostatic and neuroanatomical predictors are still largely understudied. 60 healthy, overweight, non-restrictive eating adults (20 females) took part in a food wanting and subsequent food recognition and lure discrimination task at four time points after a standardized breakfast shake. With advanced tractography of 3 T diffusion-weighted imaging data, we investigated the influence of the uncinate fasciculus' (UF) brain microstructure on the interplay of food wanting and memory processes. The analysis was preregistered in detail and conducted with Bayesian multilevel regression modeling. Target recognition (d') and lure discrimination (LDI) performance of food tended to be higher than of art images while single image food memory accuracy evidently dominated art memory. On this single item level, wanting enhanced recognition accuracy and caloric content enhanced food memory accuracy. The enhancement by reward anticipation was most pronounced during memory encoding. Subjective hunger level did not predict performance on the memory task. The microstructure of the UF did neither evidently affect memory performance outcomes nor moderate the wanting enhancement of the recognition accuracy. Interestingly, female participants outperformed males on the memory task, and individuals with stronger neuroticism showed poorer memory performance. We shed light on to date understudied processes in food decision-making: reward anticipation influenced recognition accuracy and food memory was enhanced by higher caloric content, both effects might shape food decisions. Our findings indicate that brain microstructure does not affect food decision processes in adult populations with overweight. We suggest extending investigation of this interplay to brain activity as well as to populations with eating behaviour disorders.
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Affiliation(s)
- Ronja Thieleking
- Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany.
| | - Evelyn Medawar
- Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany.
| | - Arno Villringer
- Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany; Cognitive Neurology, University of Leipzig Medical Center, 04103 Leipzig, Germany.
| | - Frauke Beyer
- Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany; Cognitive Neurology, University of Leipzig Medical Center, 04103 Leipzig, Germany.
| | - A Veronica Witte
- Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany; Cognitive Neurology, University of Leipzig Medical Center, 04103 Leipzig, Germany.
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Shekarchian M, Peeri M, Azarbayjani MA. Physical activity in a swimming pool attenuates memory impairment by reducing glutamate and inflammatory cytokines and increasing BDNF in the brain of mice with type 2 diabetes. Brain Res Bull 2023; 201:110725. [PMID: 37543294 DOI: 10.1016/j.brainresbull.2023.110725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 07/01/2023] [Accepted: 08/02/2023] [Indexed: 08/07/2023]
Abstract
Type 2 diabetes is a risk factor for the development of cognitive impairment. Increasing evidence suggests that regular exercise is beneficial for the treatment of clinical symptoms in diabetic patients. The current study aimed to evaluate whether increasing physical activity through swimming training can reduce memory impairment in an animal model of type 2 diabetes. Diabetes and non-diabetes mice underwent swimming training for four weeks, and then working, spatial, and recognition memory were evaluated using three behavioral tests. Body weight, glucose, and insulin resistance were monitored. We also measured inflammatory cytokines (interleukin (IL)- 6, IL-1β, and tumor-necrosis-factor (TNF)-α), an anti-inflammatory cytokine (IL-10), and brain-derived-neurotrophic-factor (BDNF), and glutamate levels in the hippocampus or prefrontal cortex of mice. The findings showed that diabetes increased body weight, glucose, and insulin resistance, impaired working, spatial and recognition memory, increased levels of IL-6, IL-1β, TNF-α, and glutamate levels, and decreased BDNF in the hippocampus of diabetic mice. While higher physical activity was associated with reduced body weight, glucose, and insulin resistance, attenuated memory impairment, IL-6, IL-1β, TNF-α, and glutamate, and increased BDNF levels in the hippocampus and prefrontal cortex of diabetic mice. This study shows that swimming training can normalize body weight and glucose-insulin axis and reduce inflammation and glutamate in the hippocampus and enhance the neurotrophic system in both the hippocampus and prefrontal cortex of diabetic mice. This study also suggests that higher physical activity through swimming training can improve cognitive impairment in a mouse model of type 2 diabetes.
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Affiliation(s)
- Mandana Shekarchian
- Department of Exercise Physiology, Central Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Maghsoud Peeri
- Department of Exercise Physiology, Central Tehran Branch, Islamic Azad University, Tehran, Iran.
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Song J. Amygdala activity and amygdala-hippocampus connectivity: Metabolic diseases, dementia, and neuropsychiatric issues. Biomed Pharmacother 2023; 162:114647. [PMID: 37011482 DOI: 10.1016/j.biopha.2023.114647] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 04/04/2023] Open
Abstract
With rapid aging of the population worldwide, the number of people with dementia is dramatically increasing. Some studies have emphasized that metabolic syndrome, which includes obesity and diabetes, leads to increased risks of dementia and cognitive decline. Factors such as insulin resistance, hyperglycemia, high blood pressure, dyslipidemia, and central obesity in metabolic syndrome are associated with synaptic failure, neuroinflammation, and imbalanced neurotransmitter levels, leading to the progression of dementia. Due to the positive correlation between diabetes and dementia, some studies have called it "type 3 diabetes". Recently, the number of patients with cognitive decline due to metabolic imbalances has considerably increased. In addition, recent studies have reported that neuropsychiatric issues such as anxiety, depressive behavior, and impaired attention are common factors in patients with metabolic disease and those with dementia. In the central nervous system (CNS), the amygdala is a central region that regulates emotional memory, mood disorders, anxiety, attention, and cognitive function. The connectivity of the amygdala with other brain regions, such as the hippocampus, and the activity of the amygdala contribute to diverse neuropathological and neuropsychiatric issues. Thus, this review summarizes the significant consequences of the critical roles of amygdala connectivity in both metabolic syndromes and dementia. Further studies on amygdala function in metabolic imbalance-related dementia are needed to treat neuropsychiatric problems in patients with this type of dementia.
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Affiliation(s)
- Juhyun Song
- Department of Anatomy, Chonnam National University Medical School, Hwasun 58128, Jeollanam-do, Republic of Korea.
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Sola T, Pimiä E, Lahti E, Lahtela J, Jehkonen M. Type 2 diabetes and cognitive performance in middle age: a cross-sectional study. J Clin Exp Neuropsychol 2023; 45:423-432. [PMID: 37642462 DOI: 10.1080/13803395.2023.2246668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 08/03/2023] [Indexed: 08/31/2023]
Abstract
INTRODUCTION Type 2 diabetes has been associated with cognitive decrements already in middle-age. However, the sample sizes of the studies have been small and the neuropsychological tests used have been heterogeneous. In addition, only a few studies have matched the groups in terms of age, education and gender. In this cross-sectional matched pairs study, we investigated the cognitive performance of Finnish middle-aged type 2 diabetes patients compared to healthy individuals. METHOD A neuropsychological test battery consisting of 16 tests and 21 outcome measures was applied to 28 patients and 28 age-, education- and gender-matched healthy individuals. Various exclusion criteria were applied to minimize the risk of cognitive dysfunction due to factors other than diabetes. RESULTS We did not find between-group differences in any of the neuropsychological tests measuring attention, concept formation and reasoning, construction and motor performance, executive functions, memory, processing speed or working memory. In addition, there were no group differences in the frequency or severity of subjective cognitive symptoms, or in anxiety, depression, burnout, fatigue or alcohol use disorder symptoms. The effect sizes in this study were mostly negligible or small, with the mean effect size being -0.12. CONCLUSIONS In a carefully matched sample of middle-aged type 2 diabetes patients and healthy individuals, we found no significant effects and no meaningful evidence of cognitive differences between the groups.
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Affiliation(s)
- Teppo Sola
- Faculty of Social Sciences, Tampere University, Tampere, Finland
- Tays Research Services, Wellbeing Services County of Pirkanmaa, Tampere University Hospital, Tampere, Finland
| | - Elina Pimiä
- Tays Research Services, Wellbeing Services County of Pirkanmaa, Tampere University Hospital, Tampere, Finland
- Diabetes Outpatient Clinic, Wellbeing Services County of Pirkanmaa, City of Tampere Diabetes Outpatient Clinic, Tampere, Finland
| | - Elina Lahti
- Tays Research Services, Wellbeing Services County of Pirkanmaa, Tampere University Hospital, Tampere, Finland
| | - Jorma Lahtela
- Tays Research Services, Wellbeing Services County of Pirkanmaa, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Mervi Jehkonen
- Faculty of Social Sciences, Tampere University, Tampere, Finland
- Tays Research Services, Wellbeing Services County of Pirkanmaa, Tampere University Hospital, Tampere, Finland
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Gray and white matter abnormality in patients with T2DM-related cognitive dysfunction: a systemic review and meta-analysis. Nutr Diabetes 2022; 12:39. [PMID: 35970833 PMCID: PMC9378704 DOI: 10.1038/s41387-022-00214-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 07/05/2022] [Accepted: 07/15/2022] [Indexed: 12/03/2022] Open
Abstract
Aims/hypothesis Brain structure abnormality in patients with type 2 diabetes mellitus (T2DM)-related cognitive dysfunction (T2DM-CD) has been reported for decades in magnetic resonance imaging (MRI) studies. However, the reliable results were still unclear. This study aimed to make a systemic review and meta-analysis to find the significant and consistent gray matter (GM) and white matter (WM) alterations in patients with T2DM-CD by comparing with the healthy controls (HCs). Methods Published studies were systemically searched from PubMed, MEDLINE, Cochrane Library and Web of Science databases updated to November 14, 2021. Studies reporting abnormal GM or WM between patients with T2DM-CD and HCs were selected, and their significant peak coordinates (x, y, z) and effect sizes (z-score or t-value) were extracted to perform a voxel-based meta-analysis by anisotropic effect size-signed differential mapping (AES-SDM) 5.15 software. Results Total 15 studies and 16 datasets (1550 participants) from 7531 results were involved in this study. Compared to HCs, patients with T2DM-CD showed significant and consistent decreased GM in right superior frontal gyrus, medial orbital (PFCventmed. R, BA 11), left superior temporal gyrus (STG. L, BA 48), and right calcarine fissure / surrounding cortex (CAL. R, BA 17), as well as decreased fractional anisotropy (FA) in right inferior network, inferior fronto-occipital fasciculus (IFOF. R), right inferior network, longitudinal fasciculus (ILF. R), and undefined area (32, −60, −42) of cerebellum. Meta-regression showed the positive relationship between decreased GM in PFCventmed.R and MoCA score, the positive relationship between decreased GM in STG.L and BMI, as well as the positive relationship between the decreased FA in IFOF.R and age or BMI. Conclusions/interpretation T2DM impairs the cognitive function by affecting the specific brain structures. GM atrophy in PFCventmed. R (BA 11), STG. L (BA 48), and CAL. R (BA 17), as well as WM injury in IFOF. R, ILF. R, and undefined area (32, −60, −42) of cerebellum. And those brain regions may be valuable targets for future researches. Age, BMI, and MoCA score have a potential influence on the altered GM or WM in T2DM-CD.
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Guan B, Xu Y, Chen YC, Xing C, Xu L, Shang S, Xu JJ, Wu Y, Yan Q. Reorganized Brain Functional Network Topology in Presbycusis. Front Aging Neurosci 2022; 14:905487. [PMID: 35693344 PMCID: PMC9177949 DOI: 10.3389/fnagi.2022.905487] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 04/27/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose Presbycusis is characterized by bilateral sensorineural hearing loss at high frequencies and is often accompanied by cognitive decline. This study aimed to identify the topological reorganization of brain functional network in presbycusis with/without cognitive decline by using graph theory analysis approaches based on resting-state functional magnetic resonance imaging (rs-fMRI). Methods Resting-state fMRI scans were obtained from 30 presbycusis patients with cognitive decline, 30 presbycusis patients without cognitive decline, and 50 age-, sex-, and education-matched healthy controls. Graph theory was applied to analyze the topological properties of brain functional networks including global and nodal metrics, modularity, and rich-club organization. Results At the global level, the brain functional networks of all participants were found to possess small-world properties. Also, significant group differences in global network metrics were observed among the three groups such as clustering coefficient, characteristic path length, normalized characteristic path length, and small-worldness. At the nodal level, several nodes with abnormal betweenness centrality, degree centrality, nodal efficiency, and nodal local efficiency were detected in presbycusis patients with/without cognitive decline. Changes in intra-modular connections in frontal lobe module and inter-modular connections in prefrontal subcortical lobe module were found in presbycusis patients exposed to modularity analysis. Rich-club nodes were reorganized in presbycusis patients, while the connections among them had no significant group differences. Conclusion Presbycusis patients exhibited topological reorganization of the whole-brain functional network, and presbycusis patients with cognitive decline showed more obvious changes in these topological properties than those without cognitive decline. Abnormal changes of these properties in presbycusis patients may compensate for cognitive impairment by mobilizing additional neural resources.
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Affiliation(s)
- Bing Guan
- Department of Otolaryngology, Head and Neck Surgery, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Yixi Xu
- Department of Otolaryngology, Head and Neck Surgery, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Chunhua Xing
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Li Xu
- Department of Otolaryngology, Head and Neck Surgery, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Song'an Shang
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Jin-Jing Xu
- Department of Otolaryngology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yuanqing Wu
- Department of Otolaryngology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
- *Correspondence: Yuanqing Wu
| | - Qi Yan
- Department of Otolaryngology, Head and Neck Surgery, Clinical Medical College, Yangzhou University, Yangzhou, China
- Qi Yan
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Wang J, Ma L, Liu G, Bai W, Ai K, Zhang P, Hu W, Zhang J. Tractography in Type 2 Diabetes Mellitus With Subjective Memory Complaints: A Diffusion Tensor Imaging Study. Front Neurosci 2022; 15:800420. [PMID: 35462734 PMCID: PMC9019711 DOI: 10.3389/fnins.2021.800420] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 12/31/2021] [Indexed: 12/12/2022] Open
Abstract
The brain white matter (WM) structural injury caused by type 2 diabetes mellitus (T2DM) has been linked to cognitive impairment. However, the focus was mainly on the mild cognitive impairment (MCI) stage in most previous studies, with little attention made to subjective memory complaints (SMC). The main purpose of the current study was to investigate the characteristics of WM injury in T2DM patients and its correlation with SMC symptoms. In a group of 66 participants (33 HC and 33 T2DM-S), pointwise differences along WM tracts were identified using the automated fiber quantification (AFQ) approach. Then we investigated the utility of DTI properties along major WM tracts as features to distinguish patients with T2DM-S from HC via the support vector machine (SVM). Based on AFQ analysis, 10 primary fiber tracts that represent the subtle alterations of WM in T2DM-S were identified. Lower fractional anisotropy (FA) in the right SLF tract (r = −0.538, p = 0.0013), higher radial diffusivity (RD) in the thalamic radiation (TR) tract (r = 0.433, p = 0.012), and higher mean diffusivity (MD) in the right inferior fronto-occipital fasciculus (IFOF) tract (r = 0.385, p = 0.0029) were significantly associated with a long period of disease. Decreased axial diffusivity (AD) in the left arcuate was associated with HbA1c (r = −0.368, p = 0.049). In addition, we found a significant negative correlation between delayed recall and abnormal MD in the left corticospinal tract (r = −0.546, p = 0.001). The FA of the right SLF tracts and bilateral arcuate can be used to differentiate the T2DM-S and the HC at a high accuracy up to 88.45 and 87.8%, respectively. In conclusion, WM microstructure injury in T2DM may be associated with SMC, and these abnormalities identified by DTI can be used as an effective biomarker.
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Affiliation(s)
- Jun Wang
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
| | - Laiyang Ma
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
| | - Guangyao Liu
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
| | - Wenjuan Bai
- Department of Endocrine, Lanzhou University Second Hospital, Lanzhou, China
| | - Kai Ai
- Department of Clinical Science, Philips Healthcare, Xi’an, China
| | - Pengfei Zhang
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
| | - Wanjun Hu
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
| | - Jing Zhang
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
- *Correspondence: Jing Zhang,
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Moran C, Than S, Callisaya M, Beare R, Srikanth V. New Horizons-Cognitive Dysfunction Associated With Type 2 Diabetes. J Clin Endocrinol Metab 2022; 107:929-942. [PMID: 34788847 DOI: 10.1210/clinem/dgab797] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Indexed: 11/19/2022]
Abstract
The prevalence of type 2 diabetes (T2D) and cognitive dysfunction increases with age. As society ages, clinicians will be increasingly tasked with managing older people who have both T2D and cognitive dysfunction. T2D is associated with an increased risk of cognitive dysfunction and hence there is increasing interest in whether T2D is a causal factor in the pathogenesis of cognitive decline and dementia. Recent advances in the use of sensitive measures of in vivo brain dysfunction in life-course studies can help understand potential mechanistic pathways and also help guide recommendations for clinical practice. In this article we will describe new horizons in the understanding of cognitive dysfunction associated with T2D. Coming from a clinical perspective, we discuss potential mechanisms and pathways linking the 2 conditions and the contribution of multimodal neuroimaging and study designs to advancing understanding in the field. We also highlight the important issues on the horizon that will need addressing in clinical identification, management, and risk reduction for people with coexistent T2D and cognitive dysfunction.
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Affiliation(s)
- Chris Moran
- Academic Unit, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, 3199 Victoria, Australia
- Department of Geriatric Medicine, Peninsula Health, Melbourne, 3199 Victoria, Australia
- Department of Geriatric Medicine, Alfred Health, Melbourne, 3004 Victoria, Australia
| | - Stephanie Than
- Academic Unit, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, 3199 Victoria, Australia
- Department of Geriatric Medicine, Peninsula Health, Melbourne, 3199 Victoria, Australia
| | - Michele Callisaya
- Academic Unit, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, 3199 Victoria, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, 7000 Tasmania, Australia
| | - Richard Beare
- Academic Unit, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, 3199 Victoria, Australia
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, 3052 Victoria, Australia
| | - Velandai Srikanth
- Academic Unit, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, 3199 Victoria, Australia
- Department of Geriatric Medicine, Peninsula Health, Melbourne, 3199 Victoria, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, 7000 Tasmania, Australia
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Huang L, Zhang Q, Tang T, Yang M, Chen C, Tao J, Liang S. Abnormalities of Brain White Matter in Type 2 Diabetes Mellitus: A Meta-Analysis of Diffusion Tensor Imaging. Front Aging Neurosci 2021; 13:693890. [PMID: 34421572 PMCID: PMC8378805 DOI: 10.3389/fnagi.2021.693890] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/05/2021] [Indexed: 11/13/2022] Open
Abstract
Aims: The study aimed to conduct a meta-analysis to determine the abnormalities of white matter in patients with type 2 diabetes mellitus (T2DM) by identifying the consistency of diffusion tensor imaging (DTI). Method: The literature for DTI comparing patients with T2DM with controls published before October 30, 2020, were reviewed in PubMed, Web of Science, Embase, CNKI, and Wan Fang databases. The meta-analysis was performed using the activation likelihood estimation (ALE) method, including 12 reports and 381 patients with T2DM. Results: The meta-analysis identified 10 white matter regions that showed a consistent reduction of fractional anisotropy (FA) in patients with T2DM, including genu of the corpus callosum, the body of corpus callosum, bilateral anterior corona radiata, bilateral superior corona radiata, bilateral cingulum, and bilateral superior fronto-occipital fasciculus. Conclusion: This study revealed the abnormal characteristics of white matter in T2DM, which would be helpful to understand the underlying neuropathological and physiological mechanisms of T2DM and provide evidence for clinical diagnosis and treatment.
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Affiliation(s)
- Li Huang
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China.,Rehabilitation Industry Institute, Fujian University of Traditional Chinese Medicine, Fuzhou, China.,College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Qingqing Zhang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Tong Tang
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China.,Rehabilitation Industry Institute, Fujian University of Traditional Chinese Medicine, Fuzhou, China.,College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Minguang Yang
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China.,Rehabilitation Industry Institute, Fujian University of Traditional Chinese Medicine, Fuzhou, China.,Traditional Chinese Medicine Rehabilitation Research Center of State Administration of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Cong Chen
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China.,Rehabilitation Industry Institute, Fujian University of Traditional Chinese Medicine, Fuzhou, China.,Traditional Chinese Medicine Rehabilitation Research Center of State Administration of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jing Tao
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China.,Traditional Chinese Medicine Rehabilitation Research Center of State Administration of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Shengxiang Liang
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China.,Rehabilitation Industry Institute, Fujian University of Traditional Chinese Medicine, Fuzhou, China.,Traditional Chinese Medicine Rehabilitation Research Center of State Administration of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
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12
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Alotaibi A, Tench C, Stevenson R, Felmban G, Altokhis A, Aldhebaib A, Dineen RA, Constantinescu CS. Investigating Brain Microstructural Alterations in Type 1 and Type 2 Diabetes Using Diffusion Tensor Imaging: A Systematic Review. Brain Sci 2021; 11:brainsci11020140. [PMID: 33499073 PMCID: PMC7911883 DOI: 10.3390/brainsci11020140] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/15/2021] [Accepted: 01/17/2021] [Indexed: 12/13/2022] Open
Abstract
Type 1 and type 2 diabetes mellitus have an impact on the microstructural environment and cognitive functions of the brain due to its microvascular/macrovascular complications. Conventional Magnetic Resonance Imaging (MRI) techniques can allow detection of brain volume reduction in people with diabetes. However, conventional MRI is insufficiently sensitive to quantify microstructural changes. Diffusion Tensor Imaging (DTI) has been used as a sensitive MRI-based technique for quantifying and assessing brain microstructural abnormalities in patients with diabetes. This systematic review aims to summarise the original research literature using DTI to quantify microstructural alterations in diabetes and the relation of such changes to cognitive status and metabolic profile. A total of thirty-eight published studies that demonstrate the impact of diabetes mellitus on brain microstructure using DTI are included, and these demonstrate that both type 1 diabetes mellitus and type 2 diabetes mellitus may affect cognitive abilities due to the alterations in brain microstructures.
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Affiliation(s)
- Abdulmajeed Alotaibi
- Division of Clinical Neuroscience, Nottingham University Hospitals NHS Trust, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (C.T.); (R.S.); (G.F.); (A.A.); (R.A.D.); (C.S.C.)
- School of Applied Medical Sciences, King Saud bin Abdul-Aziz University for Health Sciences, Riyadh 14611, Saudi Arabia;
- Correspondence: ; Tel.: +44-115-823-1443; Fax: +44-115-9709738
| | - Christopher Tench
- Division of Clinical Neuroscience, Nottingham University Hospitals NHS Trust, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (C.T.); (R.S.); (G.F.); (A.A.); (R.A.D.); (C.S.C.)
| | - Rebecca Stevenson
- Division of Clinical Neuroscience, Nottingham University Hospitals NHS Trust, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (C.T.); (R.S.); (G.F.); (A.A.); (R.A.D.); (C.S.C.)
| | - Ghadah Felmban
- Division of Clinical Neuroscience, Nottingham University Hospitals NHS Trust, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (C.T.); (R.S.); (G.F.); (A.A.); (R.A.D.); (C.S.C.)
- School of Applied Medical Sciences, King Saud bin Abdul-Aziz University for Health Sciences, Riyadh 14611, Saudi Arabia;
| | - Amjad Altokhis
- Division of Clinical Neuroscience, Nottingham University Hospitals NHS Trust, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (C.T.); (R.S.); (G.F.); (A.A.); (R.A.D.); (C.S.C.)
- School of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh 11564, Saudi Arabia
| | - Ali Aldhebaib
- School of Applied Medical Sciences, King Saud bin Abdul-Aziz University for Health Sciences, Riyadh 14611, Saudi Arabia;
| | - Rob A. Dineen
- Division of Clinical Neuroscience, Nottingham University Hospitals NHS Trust, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (C.T.); (R.S.); (G.F.); (A.A.); (R.A.D.); (C.S.C.)
- NIHR Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK
| | - Cris S. Constantinescu
- Division of Clinical Neuroscience, Nottingham University Hospitals NHS Trust, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (C.T.); (R.S.); (G.F.); (A.A.); (R.A.D.); (C.S.C.)
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13
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Lowry E, Puthusseryppady V, Johnen AK, Renoult L, Hornberger M. Cognitive and neuroimaging markers for preclinical vascular cognitive impairment. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2021; 2:100029. [PMID: 36324708 PMCID: PMC9616378 DOI: 10.1016/j.cccb.2021.100029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 09/30/2021] [Accepted: 10/03/2021] [Indexed: 12/22/2022]
Abstract
Explores the cognitive correlates of midlife risk factors of pre-clinical vascular cognitive impairment. Midlife cardiovascular risks associated with reduces neural integrity in parietal to anterior structures and may identify at-risk individuals. Novel experimental investigation testing fronto-parietal structures is required to increase specificity and sensitivity to pre-clinical VCI and inform clinical testing and diagnostic pathways of at-risk individuals.
Detection of incipient cognitive impairment and dementia pathophysiology is critical to identify preclinical populations and target potentially disease modifying interventions towards them. There are currently concerted efforts for such detection for Alzheimer's disease (AD). By contrast, the examination of cognitive markers and their relationship to biomarkers for Vascular Cognitive Impairment (VCI) is far less established, despite VCI being highly prevalent and often concomitantly presenting with AD. Critically, vascular risk factors are currently associated with the most viable treatment options via pharmacological and non-pharmacological intervention, hence early identification of vascular factors have important implications for modifying dementia disease trajectories. The aim of this review is to examine the current evidence of cognitive marker correlates to VCI pathology. We begin by examining midlife risk factors that predict VCI. Next, discuss preclinical cognitive hallmarks of VCI informed by insights from neuropsychological assessment, network connectivity and ERP/EEG experimental findings. Finally, we discuss limitations of current cognitive assessments and the need for future cognitive test development to inform diagnostic assessment. As well as, intervention outcome measures for preclinical VCI. In turn, these tests will inform earlier detection of vascular changes and allow implementation of disease intervention approaches.
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Affiliation(s)
- Ellen Lowry
- School of Psychology, University of East Anglia, Norwich NR4 7TJ, United Kingdom
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, United Kingdom
| | | | - Ann-Kathrin Johnen
- School of Psychology, University of East Anglia, Norwich NR4 7TJ, United Kingdom
| | - Louis Renoult
- School of Psychology, University of East Anglia, Norwich NR4 7TJ, United Kingdom
| | - Michael Hornberger
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, United Kingdom
- Corresponding author at: Norwich Medical School, 2.04 Bob Champion Research and Education Building, University of East Anglia, Norwich NR4 7TJ, United Kingdom.
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14
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Zhou C, Li J, Dong M, Ping L, Lin H, Wang Y, Wang S, Gao S, Yu G, Cheng Y, Xu X. Altered White Matter Microstructures in Type 2 Diabetes Mellitus: A Coordinate-Based Meta-Analysis of Diffusion Tensor Imaging Studies. Front Endocrinol (Lausanne) 2021; 12:658198. [PMID: 34012420 PMCID: PMC8127836 DOI: 10.3389/fendo.2021.658198] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/07/2021] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE Type 2 diabetes mellitus (T2DM) is often accompanied by cognitive decline and depressive symptoms. Numerous diffusion tensor imaging (DTI) studies revealed microstructural white matter (WM) abnormalities in T2DM but the findings were inconsistent. The present study aimed to conduct a coordinate-based meta-analysis (CBMA) to identify statistical consensus of DTI studies in T2DM. METHODS We performed a systematic search on relevant studies that reported fractional anisotropy (FA) differences between T2DM patients and healthy controls (HC). The anisotropic effect size seed-based d mapping (AES-SDM) approach was used to explore WM alterations in T2DM. A meta-regression was then used to analyze potential influences of sample characteristics on regional FA changes. RESULTS A total of eight studies that comprised 245 patients and 200 HC, along with 52 coordinates were extracted. The meta-analysis identified FA reductions in three clusters including the left inferior network, the corpus callosum (CC), and the left olfactory cortex. Besides, FA in the CC was negatively correlated with body mass index (BMI) in the patients group. CONCLUSIONS T2DM could lead to subtle WM microstructural alterations, which might be associated with cognitive deficits or emotional distress symptoms. This provides a better understanding of the pathophysiology of neurodegeneration and complications in T2DM. SYSTEMATIC REVIEW REGISTRATION Registered at PROSPERO (http://www.crd.york.ac.uk/PROSPERO), registration number: CRD42020218737.
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Affiliation(s)
- Cong Zhou
- School of Mental Health, Jining Medical University, Jining, China
- *Correspondence: Cong Zhou,
| | - Jie Li
- Department of Psychiatry, Jining Psychiatric Hospital, Jining, China
| | - Man Dong
- School of Mental Health, Jining Medical University, Jining, China
| | - Liangliang Ping
- Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen, China
| | - Hao Lin
- School of Mental Health, Jining Medical University, Jining, China
| | - Yuxin Wang
- School of Mental Health, Jining Medical University, Jining, China
| | - Shuting Wang
- School of Mental Health, Jining Medical University, Jining, China
| | - Shuo Gao
- School of Mental Health, Jining Medical University, Jining, China
| | - Ge Yu
- School of Mental Health, Jining Medical University, Jining, China
| | - Yuqi Cheng
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xiufeng Xu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China
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15
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Lawson CM, Rentrup KFG, Cai X, Kulkarni PP, Ferris CF. Using multimodal MRI to investigate alterations in brain structure and function in the BBZDR/Wor rat model of type 2 diabetes. Animal Model Exp Med 2020; 3:285-294. [PMID: 33532703 PMCID: PMC7824967 DOI: 10.1002/ame2.12140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 09/13/2020] [Accepted: 09/21/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND This is an exploratory study using multimodal magnetic resonance imaging (MRI) to interrogate the brain of rats with type 2 diabetes (T2DM) as compared to controls. It was hypothesized there would be changes in brain structure and function that reflected the human disorder, thus providing a model system by which to follow disease progression with noninvasive MRI. METHODS The transgenic BBZDR/Wor rat, an animal model of T2MD, and age-matched controls were studied for changes in brain structure using voxel-based morphometry, alteration in white and gray matter microarchitecture using diffusion weighted imaging with indices of anisotropy, and functional coupling using resting-state BOLD functional connectivity. Images from each modality were registered to, and analyzed, using a 3D MRI rat atlas providing site-specific data on over 168 different brain areas. RESULTS There was an overall reduction in brain volume focused primarily on the somatosensory cortex, cerebellum, and white matter tracts. The putative changes in white and gray matter microarchitecture were pervasive affecting much of the brain and not localized to any region. There was a general increase in connectivity in T2DM rats as compared to controls. The cerebellum presented with strong functional coupling to pons and brainstem in T2DM rats but negative connectivity to hippocampus. CONCLUSION The neuroradiological measures collected in BBBKZ/Wor rats using multimodal imaging methods did not reflect those reported for T2DB patients in the clinic. The data would suggest the BBBKZ/Wor rat is not an appropriate imaging model for T2DM.
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Affiliation(s)
| | | | - Xuezhu Cai
- Center for Translational NeuroImagingNortheastern UniversityBostonMAUSA
| | | | - Craig F. Ferris
- Center for Translational NeuroImagingNortheastern UniversityBostonMAUSA
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16
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Osama A, Khalil TH, Negm M, AbdEl-Razek R, AbouElhamd H. Association between microstructural white matter abnormalities and cognitive functioning in patients with type 2 diabetes mellitus: a diffusion tensor imaging study. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2020. [DOI: 10.1186/s41983-020-00232-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Diffusion tensor imaging (DTI) technique is important for exploring more sensitive imaging-based biomarkers in prevention and early treatment of cognitive dysfunction induced by type 2 diabetes mellitus (DM).
Objectives
To predict early cognitive dysfunction and detection of microstructural white matter changes in patients with type 2 DM by diffusion tensor imaging.
Patients and methods
A case-control study included thirty patients aged ≥ 18 years old of both sexes with type 2 DM and 30 controls. All subjects underwent to Montreal Cognitive Assessment (MoCA) “Arabic version”: to detect mild cognitive impairment (MCI) and diffusion tensor imaging study (DTI).
Results
Mild cognitive impairment is related to type 2 DM (56.7% of diabetic group), reduced fractional anisotropy (FA) values, and elevated mean diffusivity (MD) values were related to cognitive impairment evaluated through Montreal Cognitive Assessment (MoCA) in patients with type 2 DM.
Conclusion
The integrity of the white matter measured using DTI vary in MCI diabetics compared with non-MCI diabetics. Such changes have major implications on the cognitive function.
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17
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Disturbances in brain energy metabolism in insulin resistance and diabetes and Alzheimer's disease - Learnings from brain imaging biomarkers. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2020; 154:111-130. [PMID: 32739001 DOI: 10.1016/bs.irn.2020.02.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Medical imaging techniques, such as structural and functional magnetic resonance imaging and positron emission tomography, have been used to gain a better understanding of the alterations of the metabolic processes in the brain relating to type 2 diabetes melltius, insulin resistance and Alzheimer's disease. These studies have shown that there are several similarities in the effects that these seemingly disparate diseases have on the brain, and that some of the abnormalities are reversed by metabolic interventions. This review provides an overview of the overlap between these diseases using medical imaging, focusing on glucose metabolism, mitochondrial function and lipid metabolism.
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18
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Xu J, Chen F, Liu T, Wang T, Zhang J, Yuan H, Wang M. Brain Functional Networks in Type 2 Diabetes Mellitus Patients: A Resting-State Functional MRI Study. Front Neurosci 2019; 13:239. [PMID: 30941007 PMCID: PMC6433793 DOI: 10.3389/fnins.2019.00239] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 02/28/2019] [Indexed: 11/13/2022] Open
Abstract
Background Previous diabetes mellitus studies of cognitive impairments in the early stages have focused on changes in brain structure and function, and more recently the focus has shifted to the relationships between encephalic regions and diversification of network topology. However, studies examining network topology in diabetic brain function are still limited. Methods The study included 102 subjects; 55 type 2 diabetes mellitus (T2DM) patients plus 47 healthy controls. All subjects were examined by resting-state functional magnetic resonance imaging (rs-fMRI) scan. According to Automated Anatomical Labeling, the brain was divided into 90 anatomical regions, and every region corresponds to a brain network analysis node. The whole brain functional network was constructed by thresholding the correlation matrices of the 90 brain regions, and the topological properties of the network were computed based on graph theory. Then, the topological properties of the network were compared between different groups by using a non-parametric test. Finally, the associations between differences in topological properties and the clinical indicators were analyzed. Results The brain functional networks of both T2DM patients and healthy controls were found to possess small-world characteristics, i.e., normalized clustering coefficient (γ) > 1, and normalized characteristic path length (λ) close to 1. No significant differences were found in the small-world characteristics (σ). Second, the T2DM patient group displayed significant differences in node properties in certain brain regions. Correlative analytic results showed that the node degree of the right inferior temporal gyrus (ITG) and the node efficiencies of the right ITG and superior temporal gyrus of T2DM patients were positively correlated with body mass index. Conclusion The brain network of T2DM patients has the same small-world characteristics as normal people, but the normalized clustering coefficient is higher and the normalized characteristic path length is lower than that of the normal control group, indicating that the brain function network of the T2DM patients has changed. The changes of node properties were mostly concentrated in frontal lobe, temporal lobe and posterior cingulate gyrus. The abnormal changes in these indices in T2DM patients might be explained as a compensatory behavior to reduce cognitive impairments, which is achieved by mobilizing additional neural resources, such as the excessive activation of the network and the efficient networking of multiple brain regions.
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Affiliation(s)
- Jian Xu
- Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, China.,School of Information Engineering, Hubei University for Nationalities, Enshi, China
| | - Fuqin Chen
- Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, China
| | - Taiyuan Liu
- Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou, China
| | - Ting Wang
- Department of Computer Science, Chengdu University of Information Technology, Chengdu, China
| | - Junran Zhang
- Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, China
| | - Huijuan Yuan
- Department of Endocrinology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Meiyun Wang
- Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou, China
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19
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Abstract
Objectives: Type 2 diabetes mellitus has been linked with cognitive decrement and an increased risk of dementia in older people. Less is known about whether diabetes affects cognition at younger ages. The objective of this meta-analysis was to examine possible differences (effect sizes) in cognitive performance between middle-aged type 2 diabetic patients and healthy controls. Secondary aim was to examine whether age is related to the magnitude of effect sizes. Methods: Electronic databases and lists of references of selected articles were used to search for studies examining type 2 diabetes and cognition in patients under age 65 compared to healthy controls. Twelve studies met the inclusion criteria. Standardized mean differences (Hedges's g) were calculated for main cognitive domains and their subdomains. Association between age and effect sizes was evaluated with meta-regression analyses. Publication bias and methodological quality of the studies were assessed. Results: Patients performed worse than controls in several cognitive functions. The largest differences were found in information processing speed (g = -0.68), attention/concentration (g = -0.55), executive functions (g = -0.51), and working memory (g = -0.51). There was no significance difference in visual memory (g = -0.15). Age was significantly related to the effect size in information processing speed, language, verbal memory and visual memory. However, the direction of association varied across these cognitive domains. Conclusions: The results suggest that cognitive decrement in diabetes is not restricted to older people, but may begin to appear in middle age. More attention should be paid to early recognition and treatment of diabetes-related cognitive decrement in healthcare systems. (JINS, 2019, 25, 215-229).
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20
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Zhang Y, Cao Y, Xie Y, Liu L, Qin W, Lu S, Zhang Q. Altered brain structural topological properties in type 2 diabetes mellitus patients without complications. J Diabetes 2019; 11:129-138. [PMID: 30039563 DOI: 10.1111/1753-0407.12826] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 06/19/2018] [Accepted: 07/13/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a risk factor for cognitive dysfunction, and white matter (WM) microstructural impairments play a critical role in T2DM-related cognitive decline. Disruptions to the WM have been detected in T2DM patients before clinical diagnosis of cognitive dysfunction. Herein, we investigated changes in brain structural topological properties and their correlation with behavior in T2DM patients without complications. METHODS Diffusion tensor imaging (DTI) structural network topological analysis was performed on T2DM patients and healthy controls. Intergroup differences in global and nodal parameters were analyzed, and correlations between the network parameters and behavioral performance were tested. RESULTS Type 2 diabetes mellitus patients exhibited preserved small-world properties, but altered nodal properties, including decreased efficiency in the right hippocampus, right amygdala, left pallidum, left postcentral gyrus, and right pole of the superior temporal gyrus, and increased degree in the right inferior frontal gyrus. Correlations were also found between the altered global and nodal parameters and behavioral performance. CONCLUSIONS The results verified the existence of WM structural network changes and the association between structural properties and cognitive state in T2DM patients before the occurrence of complications. Research of structural properties may contribute to our understanding of the intrinsic links between T2DM and cognition.
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Affiliation(s)
- Yang Zhang
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Yujuan Cao
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Yingjie Xie
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Linlin Liu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Wen Qin
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Shan Lu
- Department of Radiology, Tianjin Medical University Metabolic Diseases Hospital, Tianjin, China
| | - Quan Zhang
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
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21
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Rosenberg J, Lechea N, Pentang GN, Shah NJ. What magnetic resonance imaging reveals - A systematic review of the relationship between type II diabetes and associated brain distortions of structure and cognitive functioning. Front Neuroendocrinol 2019; 52:79-112. [PMID: 30392901 DOI: 10.1016/j.yfrne.2018.10.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 10/11/2018] [Accepted: 10/22/2018] [Indexed: 12/19/2022]
Abstract
Due to its increasing prevalence, Type 2 diabetes mellitus (T2DM) represents a major health challenge for modern society. Despite it being of fundamental interest, only a few MRI studies have conducted statistical analyses to draw scientifically valid conclusions about the complex interplay of T2DM and its associated clinical, structural, functional, metabolite, as well as cognitive distortions. Therefore, a systematic review of 68 manuscripts, following the PRISMA guidelines, was conducted. Notably, although the associations between imaging, clinical, and cognitive variables are not fully homogeneous, findings show a clear trend towards a link between altered brain structure and a decline in cognitive processing ability. The results of the review highlight the heterogeneity of the methods used across manuscripts in terms of assessed clinical variables, imaging, and data analysis methods. This is particularly significant as, if the subjects' criteria are not carefully considered, results are easily prone to confounding factors.
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Affiliation(s)
- Jessica Rosenberg
- Institute of Neuroscience and Medicine (INM-4), Medical Imaging Physics, Forschungszentrum Jülich GmbH, 52425 Jülich, Germany; JARA - Translational Brain Medicine & INM-11, RWTH Aachen University, 52074 Aachen, Germany; Department of Neurology, University Clinic Aachen, 52074 Aachen, Germany.
| | - Nazim Lechea
- Institute of Neuroscience and Medicine (INM-4), Medical Imaging Physics, Forschungszentrum Jülich GmbH, 52425 Jülich, Germany
| | - Gael N Pentang
- Institute of Neuroscience and Medicine (INM-4), Medical Imaging Physics, Forschungszentrum Jülich GmbH, 52425 Jülich, Germany
| | - Nadim J Shah
- Institute of Neuroscience and Medicine (INM-4), Medical Imaging Physics, Forschungszentrum Jülich GmbH, 52425 Jülich, Germany; JARA - Translational Brain Medicine & INM-11, RWTH Aachen University, 52074 Aachen, Germany; Department of Neurology, University Clinic Aachen, 52074 Aachen, Germany; Department of Electrical and Computer Systems Engineering, and Monash Biomedical Imaging, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
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22
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Lee Y, Smofsky A, Nykoliation P, Allain SJ, Lewis-Daly L, Schwartz J, Pollack JH, Tarride JE, McIntyre RS. Cognitive Impairment Mediates Workplace Impairment in Adults With Type 2 Diabetes Mellitus: Results From the Motivaction Study. Can J Diabetes 2018; 42:289-295. [DOI: 10.1016/j.jcjd.2017.06.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 06/26/2017] [Accepted: 06/27/2017] [Indexed: 12/15/2022]
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23
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Liu J, Rutten-Jacobs L, Liu M, Markus HS, Traylor M. Causal Impact of Type 2 Diabetes Mellitus on Cerebral Small Vessel Disease: A Mendelian Randomization Analysis. Stroke 2018; 49:1325-1331. [PMID: 29686024 PMCID: PMC5976219 DOI: 10.1161/strokeaha.117.020536] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 03/06/2018] [Accepted: 03/12/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND PURPOSE The relationship between type 2 diabetes mellitus (T2D) and cerebral small vessel disease (CSVD) is unclear. We aimed to examine the causal effect of T2D, fasting glucose levels, and higher insulin resistance on CSVD using Mendelian randomization. METHODS Five CSVD phenotypes were studied; 2 were clinical outcomes associated with CSVD (lacunar stroke: n=2191/27 297 and intracerebral hemorrhage [ICH]: n=2254/8195 [deep and lobar ICH]), whereas 3 were radiological markers of CSVD (white matter hyperintensities: n=8429; fractional anisotropy [FA]: n=8357; and mean diffusivity: n=8357). We applied 2 complementary analyses to evaluate the association of T2D with CSVD. First, we used summarized data from genome-wide association study to calculate the effects of T2D-related variants on CSVD with inverse-variance weighted and weighted median approaches. Second, we performed a genetic risk score approach to test the effects of T2D-associated variants on white matter hyperintensities, FA, and mean diffusivity using individual-level data in UK Biobank. RESULTS T2D was associated with higher risk of lacunar stroke (odds ratio [OR], 1.15; 95% confidence interval [CI], 1.04-1.28; P=0.007) and lower mean FA (OR, 0.78; 95% CI, 0.66-0.92; P=0.004) but not white matter hyperintensities volume (OR, 1.01; 95% CI, 0.97-1.04; P=0.626), higher mean diffusivity (OR, 1.04; 95% CI, 0.89-1.23; P=0.612), ICH (OR, 1.07; 95% CI, 0.95-1.20; P=0.269), lobar ICH (OR, 1.07; 95% CI, 0.89-1.28; P=0.466), or deep ICH (OR, 1.16; 95% CI, 0.99-1.36; P=0.074). Weighted median and penalized median weighted analysis showed similar effect estimates of T2D on lacunar stroke and FA, but with wider CIs, meaning they were not significant. The genetic score on individual-level data was significantly associated with FA (OR, 0.63; 95% CI, 0.45-0.89; P=0.008) after adjusting for potential confounders. CONCLUSIONS Our Mendelian randomization study provides evidence to suggest that T2D may be causally associated with CSVD, in particular with lacunar stroke and FA.
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Affiliation(s)
- Junfeng Liu
- From the Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Chengdu, P. R. China (J.L., M.L.)
- Department of Clinical Neurosciences, Stroke Research Group, University of Cambridge, United Kingdom (J.L., L.R.-J., H.S.M., M.T.)
| | - Loes Rutten-Jacobs
- Department of Clinical Neurosciences, Stroke Research Group, University of Cambridge, United Kingdom (J.L., L.R.-J., H.S.M., M.T.)
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany (L.R.-J.)
| | - Ming Liu
- From the Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Chengdu, P. R. China (J.L., M.L.)
| | - Hugh S Markus
- Department of Clinical Neurosciences, Stroke Research Group, University of Cambridge, United Kingdom (J.L., L.R.-J., H.S.M., M.T.)
| | - Matthew Traylor
- Department of Clinical Neurosciences, Stroke Research Group, University of Cambridge, United Kingdom (J.L., L.R.-J., H.S.M., M.T.)
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Alfaro FJ, Gavrieli A, Saade-Lemus P, Lioutas VA, Upadhyay J, Novak V. White matter microstructure and cognitive decline in metabolic syndrome: a review of diffusion tensor imaging. Metabolism 2018; 78:52-68. [PMID: 28920863 PMCID: PMC5732847 DOI: 10.1016/j.metabol.2017.08.009] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 08/18/2017] [Accepted: 08/22/2017] [Indexed: 12/13/2022]
Abstract
Metabolic syndrome is a cluster of cardiovascular risk factors defined by the presence of abdominal obesity, glucose intolerance, hypertension and/or dyslipidemia. It is a major public health epidemic worldwide, and a known risk factor for the development of cognitive dysfunction and dementia. Several studies have demonstrated a positive association between the presence of metabolic syndrome and worse cognitive outcomes, however, evidence of brain structure pathology is limited. Diffusion tensor imaging has offered new opportunities to detect microstructural white matter changes in metabolic syndrome, and a possibility to detect associations between functional and structural abnormalities. This review analyzes the impact of metabolic syndrome on white matter microstructural integrity, brain structure abnormalities and their relationship to cognitive function. Each of the metabolic syndrome components exerts a specific signature of white matter microstructural abnormalities. Metabolic syndrome and its components exert both additive/synergistic, as well as, independent effects on brain microstructure thus accelerating brain aging and cognitive decline.
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Affiliation(s)
- Freddy J Alfaro
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Palmer 127, Boston, MA 02215, USA.
| | - Anna Gavrieli
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Palmer 127, Boston, MA 02215, USA.
| | - Patricia Saade-Lemus
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Palmer 127, Boston, MA 02215, USA.
| | - Vasileios-Arsenios Lioutas
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Palmer 127, Boston, MA 02215, USA.
| | - Jagriti Upadhyay
- Department of Endocrinology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA 02215,USA.
| | - Vera Novak
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Palmer 127, Boston, MA 02215, USA.
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Moran C, Beare R, Phan T, Starkstein S, Bruce D, Romina M, Srikanth V. Neuroimaging and its Relevance to Understanding Pathways Linking Diabetes and Cognitive Dysfunction. J Alzheimers Dis 2017; 59:405-419. [DOI: 10.3233/jad-161166] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Chris Moran
- Department of Medicine, Peninsula Health, Peninsula Clinical School, Monash University, Melbourne, VIC, Australia
- Aged Care Services, Caulfield Hospital, Alfred Health, Melbourne, VIC, Australia
- Stroke and Ageing Research Group, Vascular Brain Ageing Division, Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
- Neurosciences, Monash Medical Centre, Monash Health, Melbourne, VIC, Australia
| | - Richard Beare
- Department of Medicine, Peninsula Health, Peninsula Clinical School, Monash University, Melbourne, VIC, Australia
- Stroke and Ageing Research Group, Vascular Brain Ageing Division, Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
- Neurosciences, Monash Medical Centre, Monash Health, Melbourne, VIC, Australia
| | - Thanh Phan
- Stroke and Ageing Research Group, Vascular Brain Ageing Division, Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
- Neurosciences, Monash Medical Centre, Monash Health, Melbourne, VIC, Australia
| | - Sergio Starkstein
- Fremantle Hospital, WA, Australia
- University of Western Australia, WA, Australia
| | - David Bruce
- Fremantle Hospital, WA, Australia
- University of Western Australia, WA, Australia
| | - Mizrahi Romina
- Research Imaging Centre, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Velandai Srikanth
- Department of Medicine, Peninsula Health, Peninsula Clinical School, Monash University, Melbourne, VIC, Australia
- Stroke and Ageing Research Group, Vascular Brain Ageing Division, Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
- Neurosciences, Monash Medical Centre, Monash Health, Melbourne, VIC, Australia
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van Bussel FCG, Backes WH, Hofman PAM, van Oostenbrugge RJ, van Boxtel MPJ, Verhey FRJ, Steinbusch HWM, Schram MT, Stehouwer CDA, Wildberger JE, Jansen JFA. Cerebral Pathology and Cognition in Diabetes: The Merits of Multiparametric Neuroimaging. Front Neurosci 2017; 11:188. [PMID: 28424581 PMCID: PMC5380729 DOI: 10.3389/fnins.2017.00188] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 03/21/2017] [Indexed: 12/19/2022] Open
Abstract
Type 2 diabetes mellitus is associated with accelerated cognitive decline and various cerebral abnormalities visible on MRI. The exact pathophysiological mechanisms underlying cognitive decline in diabetes still remain to be elucidated. In addition to conventional images, MRI offers a versatile set of novel contrasts, including blood perfusion, neuronal function, white matter microstructure, and metabolic function. These more-advanced multiparametric MRI contrasts and the pertaining parameters are able to reveal abnormalities in type 2 diabetes, which may be related to cognitive decline. To further elucidate the nature of the link between diabetes, cognitive decline, and brain abnormalities, and changes over time thereof, biomarkers are needed which can be provided by advanced MRI techniques. This review summarizes to what extent MRI, especially advanced multiparametric techniques, can elucidate the underlying neuronal substrate that reflects the cognitive decline in type 2 diabetes.
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Affiliation(s)
- Frank C G van Bussel
- Department of Radiology, Maastricht University Medical CenterMaastricht, Netherlands.,School for Mental Health and Neuroscience, Maastricht University Medical CenterMaastricht, Netherlands
| | - Walter H Backes
- Department of Radiology, Maastricht University Medical CenterMaastricht, Netherlands.,School for Mental Health and Neuroscience, Maastricht University Medical CenterMaastricht, Netherlands
| | - Paul A M Hofman
- Department of Radiology, Maastricht University Medical CenterMaastricht, Netherlands.,School for Mental Health and Neuroscience, Maastricht University Medical CenterMaastricht, Netherlands
| | - Robert J van Oostenbrugge
- School for Mental Health and Neuroscience, Maastricht University Medical CenterMaastricht, Netherlands.,Department of Neurology, Maastricht University Medical CenterMaastricht, Netherlands.,Cardiovascular Research Institute Maastricht, Maastricht University Medical CenterMaastricht, Netherlands
| | - Martin P J van Boxtel
- School for Mental Health and Neuroscience, Maastricht University Medical CenterMaastricht, Netherlands.,Department of Psychiatry and Neuropsychology, Maastricht University Medical CenterMaastricht, Netherlands
| | - Frans R J Verhey
- School for Mental Health and Neuroscience, Maastricht University Medical CenterMaastricht, Netherlands.,Department of Psychiatry and Neuropsychology, Maastricht University Medical CenterMaastricht, Netherlands
| | - Harry W M Steinbusch
- School for Mental Health and Neuroscience, Maastricht University Medical CenterMaastricht, Netherlands.,Department of Psychiatry and Neuropsychology, Maastricht University Medical CenterMaastricht, Netherlands
| | - Miranda T Schram
- Cardiovascular Research Institute Maastricht, Maastricht University Medical CenterMaastricht, Netherlands.,Department of Internal Medicine, Maastricht University Medical CenterMaastricht, Netherlands
| | - Coen D A Stehouwer
- Cardiovascular Research Institute Maastricht, Maastricht University Medical CenterMaastricht, Netherlands.,Department of Internal Medicine, Maastricht University Medical CenterMaastricht, Netherlands
| | - Joachim E Wildberger
- Department of Radiology, Maastricht University Medical CenterMaastricht, Netherlands.,Cardiovascular Research Institute Maastricht, Maastricht University Medical CenterMaastricht, Netherlands
| | - Jacobus F A Jansen
- Department of Radiology, Maastricht University Medical CenterMaastricht, Netherlands.,School for Mental Health and Neuroscience, Maastricht University Medical CenterMaastricht, Netherlands
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27
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Xie Y, Zhang Y, Qin W, Lu S, Ni C, Zhang Q. White Matter Microstructural Abnormalities in Type 2 Diabetes Mellitus: A Diffusional Kurtosis Imaging Analysis. AJNR Am J Neuroradiol 2017; 38:617-625. [PMID: 27979796 DOI: 10.3174/ajnr.a5042] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 10/18/2016] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND PURPOSE Increasing DTI studies have demonstrated that white matter microstructural abnormalities play an important role in type 2 diabetes mellitus-related cognitive impairment. In this study, the diffusional kurtosis imaging method was used to investigate WM microstructural alterations in patients with type 2 diabetes mellitus and to detect associations between diffusional kurtosis imaging metrics and clinical/cognitive measurements. MATERIALS AND METHODS Diffusional kurtosis imaging and cognitive assessments were performed on 58 patients with type 2 diabetes mellitus and 58 controls. Voxel-based intergroup comparisons of diffusional kurtosis imaging metrics were conducted, and ROI-based intergroup comparisons were further performed. Correlations between the diffusional kurtosis imaging metrics and cognitive/clinical measurements were assessed after controlling for age, sex, and education in both patients and controls. RESULTS Altered diffusion metrics were observed in the corpus callosum, the bilateral frontal WM, the right superior temporal WM, the left external capsule, and the pons in patients with type 2 diabetes mellitus compared with controls. The splenium of the corpus callosum and the pons had abnormal kurtosis metrics in patients with type 2 diabetes mellitus. Additionally, altered diffusion metrics in the right prefrontal WM were significantly correlated with disease duration and attention task performance in patients with type 2 diabetes mellitus. CONCLUSIONS With both conventional diffusion and additional kurtosis metrics, diffusional kurtosis imaging can provide additional information on WM microstructural abnormalities in patients with type 2 diabetes mellitus. Our results indicate that WM microstructural abnormalities occur before cognitive decline and may be used as neuroimaging markers for predicting the early cognitive impairment in patients with type 2 diabetes mellitus.
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Affiliation(s)
- Y Xie
- From the Department of Radiology and Tianjin Key Laboratory of Functional Imaging (Y.X., Y.Z., W.Q., Q.Z.), Tianjin Medical University General Hospital, Tianjin, China
| | - Y Zhang
- From the Department of Radiology and Tianjin Key Laboratory of Functional Imaging (Y.X., Y.Z., W.Q., Q.Z.), Tianjin Medical University General Hospital, Tianjin, China
| | - W Qin
- From the Department of Radiology and Tianjin Key Laboratory of Functional Imaging (Y.X., Y.Z., W.Q., Q.Z.), Tianjin Medical University General Hospital, Tianjin, China
| | - S Lu
- Departments of Radiology (S.L.)
| | - C Ni
- Cardiology (C.N.), Tianjin Medical University Metabolic Diseases Hospital, Tianjin, China
| | - Q Zhang
- From the Department of Radiology and Tianjin Key Laboratory of Functional Imaging (Y.X., Y.Z., W.Q., Q.Z.), Tianjin Medical University General Hospital, Tianjin, China
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28
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Frøkjær JB, Graversen C, Brock C, Khodayari-Rostamabad A, Olesen SS, Hansen TM, Søfteland E, Simrén M, Drewes AM. Integrity of central nervous function in diabetes mellitus assessed by resting state EEG frequency analysis and source localization. J Diabetes Complications 2017; 31:400-406. [PMID: 27884662 DOI: 10.1016/j.jdiacomp.2016.11.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 09/24/2016] [Accepted: 11/02/2016] [Indexed: 12/12/2022]
Abstract
Diabetes mellitus (DM) is associated with structural and functional changes of the central nervous system. We used electroencephalography (EEG) to assess resting state cortical activity and explored associations to relevant clinical features. Multichannel resting state EEG was recorded in 27 healthy controls and 24 patients with longstanding DM and signs of autonomic dysfunction. The power distribution based on wavelet analysis was summarized into frequency bands with corresponding topographic mapping. Source localization analysis was applied to explore the electrical cortical sources underlying the EEG. Compared to controls, DM patients had an overall decreased EEG power in the delta (1-4Hz) and gamma (30-45Hz) bands. Topographic analysis revealed that these changes were confined to the frontal region for the delta band and to central cortical areas for the gamma band. Source localization analysis identified sources with reduced activity in the left postcentral gyrus for the gamma band and in right superior parietal lobule for the alpha1 (8-10Hz) band. DM patients with clinical signs of autonomic dysfunction and gastrointestinal symptoms had evidence of altered resting state cortical processing. This may reflect metabolic, vascular or neuronal changes associated with diabetes.
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Affiliation(s)
- Jens B Frøkjær
- Mech-Sense, Department of Radiology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
| | - Carina Graversen
- Mech-Sense, Department of Gastroenterology & Hepatology, Aalborg University Hospital, Aalborg, Denmark
| | - Christina Brock
- Mech-Sense, Department of Gastroenterology & Hepatology, Aalborg University Hospital, Aalborg, Denmark
| | | | - Søren S Olesen
- Mech-Sense, Department of Gastroenterology & Hepatology, Aalborg University Hospital, Aalborg, Denmark
| | - Tine M Hansen
- Mech-Sense, Department of Radiology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Eirik Søfteland
- Department of Medicine, Haukeland University Hospital and Institute of Medicine, University of Bergen, Bergen, Norway
| | - Magnus Simrén
- Institute of Medicine, Department of Internal Medicine & Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Asbjørn M Drewes
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Mech-Sense, Department of Gastroenterology & Hepatology, Aalborg University Hospital, Aalborg, Denmark
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29
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The relationship between recognition memory for emotion-laden words and white matter microstructure in normal older individuals. Neuroreport 2016; 27:1345-1349. [DOI: 10.1097/wnr.0000000000000704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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30
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Cholerton B, Baker LD, Montine TJ, Craft S. Type 2 Diabetes, Cognition, and Dementia in Older Adults: Toward a Precision Health Approach. Diabetes Spectr 2016; 29:210-219. [PMID: 27899872 PMCID: PMC5111529 DOI: 10.2337/ds16-0041] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
IN BRIEF There has been a concurrent dramatic rise in type 2 diabetes and dementia in the United States, and type 2 diabetes shares common genetic and environmental risk factors and underlying pathology with both vascular and Alzheimer's dementias. Given the ability to identify this at-risk population and a variety of potential targeted treatments, type 2 diabetes represents a promising focus for a precision health approach to reduce the impact of cognitive decline and dementia in older adults.
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Affiliation(s)
| | - Laura D. Baker
- Sticht Center on Aging, Department of Internal Medicine, Wake Forest University, Winston-Salem, NC
| | | | - Suzanne Craft
- Sticht Center on Aging, Department of Internal Medicine, Wake Forest University, Winston-Salem, NC
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31
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Kancherla S, Kohler WJ, van der Merwe Y, Chan KC. In Vivo Evaluation of the Visual Pathway in Streptozotocin-Induced Diabetes by Diffusion Tensor MRI and Contrast Enhanced MRI. PLoS One 2016; 11:e0165169. [PMID: 27768755 PMCID: PMC5074510 DOI: 10.1371/journal.pone.0165169] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 10/07/2016] [Indexed: 02/07/2023] Open
Abstract
Visual function has been shown to deteriorate prior to the onset of retinopathy in some diabetic patients and experimental animal models. This suggests the involvement of the brain's visual system in the early stages of diabetes. In this study, we tested this hypothesis by examining the integrity of the visual pathway in a diabetic rat model using in vivo multi-modal magnetic resonance imaging (MRI). Ten-week-old Sprague-Dawley rats were divided into an experimental diabetic group by intraperitoneal injection of 65 mg/kg streptozotocin in 0.01 M citric acid, and a sham control group by intraperitoneal injection of citric acid only. One month later, diffusion tensor MRI (DTI) was performed to examine the white matter integrity in the brain, followed by chromium-enhanced MRI of retinal integrity and manganese-enhanced MRI of anterograde manganese transport along the visual pathway. Prior to MRI experiments, the streptozotocin-induced diabetic rats showed significantly smaller weight gain and higher blood glucose level than the control rats. DTI revealed significantly lower fractional anisotropy and higher radial diffusivity in the prechiasmatic optic nerve of the diabetic rats compared to the control rats. No apparent difference was observed in the axial diffusivity of the optic nerve, the chromium enhancement in the retina, or the manganese enhancement in the lateral geniculate nucleus and superior colliculus between groups. Our results suggest that streptozotocin-induced diabetes leads to early injury in the optic nerve when no substantial change in retinal integrity or anterograde transport along the visual pathways was observed in MRI using contrast agent enhancement. DTI may be a useful tool for detecting and monitoring early pathophysiological changes in the visual system of experimental diabetes non-invasively.
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Affiliation(s)
- Swarupa Kancherla
- NeuroImaging Laboratory, University of Pittsburgh, Pittsburgh, PA, United States of America
- UPMC Eye Center, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - William J. Kohler
- NeuroImaging Laboratory, University of Pittsburgh, Pittsburgh, PA, United States of America
- UPMC Eye Center, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Yolandi van der Merwe
- NeuroImaging Laboratory, University of Pittsburgh, Pittsburgh, PA, United States of America
- UPMC Eye Center, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States of America
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, United States of America
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, United States of America
- Louis J. Fox Center for Vision Restoration, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Kevin C. Chan
- NeuroImaging Laboratory, University of Pittsburgh, Pittsburgh, PA, United States of America
- UPMC Eye Center, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States of America
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, United States of America
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, United States of America
- Louis J. Fox Center for Vision Restoration, University of Pittsburgh, Pittsburgh, PA, United States of America
- Center for the Neural Basis of Cognition, University of Pittsburgh and Carnegie Mellon University, Pittsburgh, PA, United States of America
- Department of Electrical and Electronic Engineering, The University of Hong Kong, Hong Kong, China
- * E-mail:
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32
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van Bussel FCG, Backes WH, Hofman PAM, van Boxtel MPJ, Schram MT, Stehouwer CDA, Wildberger JE, Jansen JFA. Altered Hippocampal White Matter Connectivity in Type 2 Diabetes Mellitus and Memory Decrements. J Neuroendocrinol 2016; 28:12366. [PMID: 26791354 DOI: 10.1111/jne.12366] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 12/23/2015] [Accepted: 01/14/2016] [Indexed: 01/06/2023]
Abstract
Type 2 diabetes mellitus is associated with cognitive decrements. Specifically affected cognitive domains are learning and memory, for which the hippocampus plays an essential role. The pathophysiological mechanism remains to be revealed. The present study examined whether local hippocampal microstructure and white matter connectivity are related to type 2 diabetes and memory performance. Forty participants with type 2 diabetes and 38 participants without type 2 diabetes underwent detailed cognitive assessment and 3-Tesla diffusion magnetic resonance imaging (MRI). Diffusion MRI was performed to assess microstructure (fractional anisotropy and mean diffusivity) and white matter connectivity (tract volume) of the hippocampus, which were compared between participants with and without type 2 diabetes. No differences in hippocampal microstructure were observed. Participants with type 2 diabetes had fewer white matter connections between the hippocampus and frontal lobe (P = 0.017). Participants who scored lower on memory function, regardless of type 2 diabetes, had fewer white matter connections between the hippocampus and temporal lobe (P = 0.017). Taken together, type 2 diabetes and memory decrements appear to be associated with altered hippocampal white matter connectivity.
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Affiliation(s)
- F C G van Bussel
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Center, Maastricht, The Netherlands
| | - W H Backes
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Center, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
| | - P A M Hofman
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Center, Maastricht, The Netherlands
| | - M P J van Boxtel
- School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - M T Schram
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - C D A Stehouwer
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - J E Wildberger
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
| | - J F A Jansen
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Center, Maastricht, The Netherlands
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Nε-(carboxymethyl)-lysine, White Matter, and Cognitive Function in Diabetes Patients. Can J Neurol Sci 2016; 43:518-22. [PMID: 26889714 DOI: 10.1017/cjn.2015.398] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To study the relationship of Nε-(carboxymethyl)-lysine level (CML) with microstructure changes of white matter (WM), and cognitive impairment in patients with type 2 diabetes mellitus (T2DM) and to discuss the potential mechanism underlying T2DM-associated cognitive impairment. METHODS The study was performed in T2DM patients (n=22) with disease course ≥5 years and age ranging from 65 to 75 years old. A control group consisted of 25 sex- and age-matched healthy volunteers. Fractional anisotropy (FA) of several WM regions was analyzed by diffusion tensor imaging scan. Plasma CML levels were measured by enzyme-linked immunosorbent assay, and cognitive function was assessed by Mini-Mental State Examination and Montreal cognitive assessment (MoCA). RESULTS The total Mini-Mental State Examination score in the patient group (25.72±3.13) was significantly lower than the control group (28.16±2.45) (p<0.05). In addition, the total MoCA score in the patient group (22.15±3.56) was significantly lower than the control group 25.63±4.12) (p<0.01). In the patient group, FA values were significantly decreased in the corpus callosum, cingulate fasciculus, inferior fronto-occipital fasciculus, parietal WM, hippocampus, and temporal lobes relative to corresponding regions of healthy controls (p<0.05). Plasma CML level was negatively correlated with average FA values in the global brain (r=-0.58, p<0.01) and MoCA scores (r=-0.47, p<0.05). CONCLUSIONS In T2DM, WM microstructure changes occur in older patients, and elevations in CML may play a role in the development of cognitive impairment.
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Sadanand S, Balachandar R, Bharath S. Memory and executive functions in persons with type 2 diabetes: a meta-analysis. Diabetes Metab Res Rev 2016; 32:132-42. [PMID: 25963303 DOI: 10.1002/dmrr.2664] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 02/08/2015] [Accepted: 05/05/2015] [Indexed: 12/29/2022]
Abstract
Literature suggests that persons with type 2 diabetes mellitus (T2DM) are at risk for cognitive impairment, hence dementia. Common domains reported to be affected in those with T2DM are memory and executive functions. The extent of influence of T2DM on these domains has varied among studies. A systematic review and meta-analysis was carried out to understand whether sub-domains contributed to the variations observed in published research. We searched 'PubMed', 'ScienceDirect', 'SciVerseHub', 'Psychinfo', 'Proquest' 'Ebsco' and 'J-gate Plus' databases for published studies on cognition and T2DM among persons aged 50 years and older. Memory, executive functions and processing speed domain and sub-domain scores were extracted; effect sizes (Cohen's d) were calculated and analysed. Eight hundred seventeen articles were found. After various levels of filtering, 15 articles met the inclusion criteria for quantitative analyses. The analyses indicated that in comparison to controls, persons with T2DM showed decrements in episodic memory (d = -0.51), logical memory (d = -0.24), sub-domain of executive functions which included phonemic fluency (d = -0.35) and cognitive flexibility (d = 0.52), and speed of processing (d = -0.22). We found no difference in the sub-domains of verbal short-term memory and working memory. The meta-analysis revealed a detrimental effect of T2DM on cognitive sub-domains, namely, episodic memory and cognitive flexibility. There was a trend for the logical memory, phonemic fluency and processing speed to be affected. The analysis indicates that T2DM is a detrimental factor on certain cognitive sub-domains, rendering the person vulnerable to subsequent dementia. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Shilpa Sadanand
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Rakesh Balachandar
- Department of Clinical Neuroscience, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Srikala Bharath
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
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Hou YC, Yang SH, Wu YT, Lai CH. Alterations of neocortico-limbic association fibers and correlation with diet in prediabetes diagnosed by impaired fasting glucose. J Magn Reson Imaging 2016; 43:1500-6. [PMID: 26756544 DOI: 10.1002/jmri.25127] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 12/01/2015] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To assess the existence of alterations in the micro-integrity of the fasciculus in prediabetic subjects. The issue of micro-integrity in white matter tracts has not been adequately addressed in prediabetes. MATERIALS AND METHODS Sixty-four prediabetic subjects and 54 controls were enrolled. All participants completed 24-hour diet records and 3-day diet records and received diffusion tensor imaging at 3T. The data for white matter micro-integrity were analyzed and compared between prediabetic subjects and controls with age and gender as covariates. In addition, voxel-wise regression between white matter micro-integrity, diet, and preprandial glucose levels were used to explore the relationship between white matter micro-integrity and diet or serum glucose levels. RESULTS We found that prediabetic subjects had significant reductions in the micro-integrity of bilateral anterior thalamic radiation, left inferior longitudinal fasciculus, and left superior longitudinal fasciculus (corrected P < 0.05). In addition, total carbohydrate intake amount and preprandial serum glucose levels were negatively correlated with the micro-integrity in the left inferior longitudinal fasciculus and left anterior thalamic radiation (r: -0.47, corrected P < 0.05). CONCLUSION Restrictive alterations in the white matter micro-integrity of the anterior thalamic radiation and inferior and superior longitudinal fasciculi might represent the initial "hot spots" for white matter tract alterations, which might play a role in the development of prediabetes. J. Magn. Reson. Imaging 2016;43:1500-1506.
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Affiliation(s)
- Yi-Cheng Hou
- Department of Nutrition, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan, ROC
| | - Shwu-Huey Yang
- School of Nutrition and Health Sciences, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan, ROC
| | - Yu-Te Wu
- Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan, ROC.,Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan, ROC.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Chien-Han Lai
- Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan, ROC.,Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan, ROC.,Department of Psychiatry, Cheng Hsin General Hospital, Taipei City, Taiwan, ROC
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Del Bene A, Ciolli L, Borgheresi L, Poggesi A, Inzitari D, Pantoni L. Is type 2 diabetes related to leukoaraiosis? an updated review. Acta Neurol Scand 2015; 132:147-55. [PMID: 25772411 DOI: 10.1111/ane.12398] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2015] [Indexed: 02/04/2023]
Abstract
A significantly increased interest has been dedicated to the study of the effects of diabetes mellitus (DM) on the brain. DM is associated with an increased risk of stroke and cognitive decline. In patients with DM, neuroimaging discloses with high-frequency structural changes, such as cerebral atrophy, infarcts and white matter lesions, also called leukoaraiosis (LA), an expression of small vessel disease. A previous review showed a relation between DM and both cerebral atrophy and lacunar infarcts, while the question about the relation between DM and LA remained unanswered. In this review, we provide an update on data on this last association. In the reviewed studies, we examined the presence of DM, other disease characteristics, such as duration and complications, and laboratory markers of the disease such as blood glycated hemoglobin (HbA1c), insulin resistance, insulin concentrations and their association with LA. About 40% of the reviewed studies reported a statistically significant association between DM and LA. Long-standing DM and a poor glycemic control were associated with severe LA. Studies using innovative MRI techniques, such as diffusion tensor imaging (DTI), reported a significant association between microstructural white matter alterations and DM. This review highlights more firmly than previously reported the existence of a relation between DM and both presence and severity of LA. These results are possibly due to more sensitive and advanced imaging techniques recently used to study the extent of LA. However, because of the heterogeneous methodology used in the reviewed studies, a definitive conclusion cannot be drawn.
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Affiliation(s)
- A. Del Bene
- NEUROFARBA Department; Neuroscience Section; University of Florence; Florence Italy
| | - L. Ciolli
- NEUROFARBA Department; Neuroscience Section; University of Florence; Florence Italy
| | - L. Borgheresi
- NEUROFARBA Department; Neuroscience Section; University of Florence; Florence Italy
| | - A. Poggesi
- NEUROFARBA Department; Neuroscience Section; University of Florence; Florence Italy
| | - D. Inzitari
- NEUROFARBA Department; Neuroscience Section; University of Florence; Florence Italy
| | - L. Pantoni
- Stroke Unit and Neurology; Azienda Ospedaliero Universitaria Careggi; Florence Italy
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Kullmann S, Schweizer F, Veit R, Fritsche A, Preissl H. Compromised white matter integrity in obesity. Obes Rev 2015; 16:273-81. [PMID: 25676886 DOI: 10.1111/obr.12248] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 11/14/2014] [Accepted: 12/01/2014] [Indexed: 12/13/2022]
Abstract
Obesity is associated with both structural and functional changes of the central nervous system. While gray matter alterations in obesity point to a consistent reduction with increasing body mass index (BMI), volumetric changes in white matter are more complex and less conclusive. Hence, more recently, diffusion tensor imaging (DTI) has been employed as a highly sensitive tool to investigate microstructural changes in white matter structure. Parameters of diffusivity and anisotropy are used to evaluate white matter and fibre integrity as well as axonal and myelin degeneration. Fractional anisotropy (FA) is the most commonly used parameter as it is the best estimate of fibre integrity. The focus of this review was on the relationship between obesity and brain alterations assessed by DTI. Altogether, these studies have shown a loss of white matter integrity with obesity-related factors, especially in tracts within the limbic system and those connecting the temporal and frontal lobe. More specifically, multiple studies found an inverse association between BMI and FA in the corpus callosum, fornix, cingulum and corona radiata in elderly and young adults as well as children. Furthermore, significant interactions were observed between BMI and age, pointing to accelerated ageing of white matter structure in obese.
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Affiliation(s)
- S Kullmann
- Institute for Diabetes Research and Metabolic Diseases, Helmholtz Center Munich, University of Tübingen, Tübingen, Germany; German Center for Diabetes Research, Neuherberg, Germany; Institute of Medical Psychology and Behavioral Neurobiology, fMEG Center, University of Tübingen, Tübingen, Germany
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Brundel M, Kappelle LJ, Biessels GJ. Brain imaging in type 2 diabetes. Eur Neuropsychopharmacol 2014; 24:1967-81. [PMID: 24726582 DOI: 10.1016/j.euroneuro.2014.01.023] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 01/23/2014] [Indexed: 02/08/2023]
Abstract
Type 2 diabetes mellitus (T2DM) is associated with cognitive dysfunction and dementia. Brain imaging may provide important clues about underlying processes. This review focuses on the relationship between T2DM and brain abnormalities assessed with different imaging techniques: both structural and functional magnetic resonance imaging (MRI), including diffusion tensor imaging and magnetic resonance spectroscopy, as well as positron emission tomography and single-photon emission computed tomography. Compared to people without diabetes, people with T2DM show slightly more global brain atrophy, which increases gradually over time compared with normal aging. Moreover, vascular lesions are seen more often, particularly lacunar infarcts. The association between T2DM and white matter hyperintensities and microbleeds is less clear. T2DM has been related to diminished cerebral blood flow and cerebrovascular reactivity, particularly in more advanced disease. Diffusion tensor imaging is a promising technique with respect to subtle white matter involvement. Thus, brain imaging studies show that T2DM is associated with both degenerative and vascular brain damage, which develops slowly over the course of many years. The challenge for future studies will be to further unravel the etiology of brain damage in T2DM, and to identify subgroups of patients that will develop distinct progressive brain damage and cognitive decline.
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Affiliation(s)
- Manon Brundel
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, The Netherlands.
| | - L Jaap Kappelle
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, The Netherlands
| | - Geert Jan Biessels
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, The Netherlands
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Santhakumari R, Reddy IY, Archana R. EFFECT OF TYPE 2 DIABETES MELLITUS ON BRAIN METABOLITES BY USING PROTON MAGNETIC RESONANCE SPECTROSCOPY-A SYSTEMATIC REVIEW. INTERNATIONAL JOURNAL OF PHARMA AND BIO SCIENCES 2014; 5:1118-1123. [PMID: 25568610 PMCID: PMC4283136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Cerebral metabolism will be affected in T2DM either by chronic hyperglycemia or by chronic hypoxia. Proton magnetic resonance spectroscopy (1H-MRS) of the brain provides detailed information about the structure, dynamics, reaction state and chemical environment of molecules. It also measures the levels of brain metabolites such as myo-inositol (mI), N acetyl aspartate (NAA), creatine (Cr), choline (Cho), glutamate (Glu), glutamine (Gln) and gamma amino butyric acid (GABA). Several studies suggest that people with type 2 diabetes mellitus (T2DM) are at an increased risk of cognitive impairment in comparison with the general population. The altered metabolites may cause cognitive dysfunction in T2DM. This review article concludes that in T2DM, metabolite levels were altered in different regions of brain.
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Affiliation(s)
- Rajani Santhakumari
- Department of Physiology, MediCiti Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Indla Yogananda Reddy
- Department of Physiology, MediCiti Institute of Medical Sciences, Hyderabad, Telangana, India
| | - R Archana
- Department of Physiology, Saveetha Medical College, Chennai, Tamilnadu, India
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40
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Yau PL, Kang EH, Javier DC, Convit A. Preliminary evidence of cognitive and brain abnormalities in uncomplicated adolescent obesity. Obesity (Silver Spring) 2014; 22:1865-71. [PMID: 24891029 PMCID: PMC4114991 DOI: 10.1002/oby.20801] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 04/29/2014] [Accepted: 05/13/2014] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To ascertain whether pediatric obesity without clinically significant insulin resistance (IR) impacts brain structure and function. METHODS Thirty obese and 30 matched lean adolescents, all without clinically significant IR or a diagnosis of metabolic syndrome (MetS), received comprehensive endocrine, neuropsychological, and MRI evaluations. RESULTS Relative to lean adolescents, obese non-IR adolescents had significantly lower academic achievement (i.e., arithmetic and spelling) and tended to score lower on working memory, attention, psychomotor efficiency, and mental flexibility. In line with our prior work on adolescent MetS, memory was unaffected in uncomplicated obesity. Reductions in the thickness of the orbitofrontal and anterior cingulate cortices as well as reductions of microstructural integrity in major white matter tracts without gross volume changes were also uncovered. CONCLUSIONS It was documented, for the first time, that adolescents with uncomplicated obesity already have subtle brain alterations and lower performance in selective cognitive domains. When interpreting these preliminary data in the context of our prior reports of similar, but more extensive brain findings in obese adolescents with MetS and T2DM, it was concluded that "uncomplicated" obesity may also result in subtle brain alterations, suggesting a possible dose effect with more severe metabolic dysregulation giving rise to greater abnormalities.
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Affiliation(s)
- Po Lai Yau
- Psychiatry, New York University School of Medicine, New York, NY 10016, United States
| | - Esther H. Kang
- Psychiatry, New York University School of Medicine, New York, NY 10016, United States
| | - David C. Javier
- Psychiatry, New York University School of Medicine, New York, NY 10016, United States
| | - Antonio Convit
- Psychiatry, New York University School of Medicine, New York, NY 10016, United States
- Medicine, New York University School of Medicine, New York, NY 10016, United States
- Radiology, New York University School of Medicine, New York, NY 10016, United States
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962, United States
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Biessels GJ, Reijmer YD. Brain changes underlying cognitive dysfunction in diabetes: what can we learn from MRI? Diabetes 2014; 63:2244-52. [PMID: 24931032 DOI: 10.2337/db14-0348] [Citation(s) in RCA: 208] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Diabetes is associated with cognitive dysfunction and an increased risk of dementia. This article addresses findings with brain MRI that may underlie cognitive dysfunction in diabetes. Studies in adults with type 1 diabetes show regional reductions in brain volume. In those with a diabetes onset in childhood, these volume reductions are likely to reflect the sum of changes that occur during brain development and changes that occur later in life due to exposure to diabetes-related factors. Type 2 diabetes is associated with global brain atrophy and an increased burden of small-vessel disease. These brain changes occur in the context of aging and often also in relation to an adverse vascular risk factor profile. Advanced imaging techniques detect microstructural lesions in the cerebral gray and white matter of patients with diabetes that affect structural and functional connectivity. Challenges are to further unravel the etiology of these cerebral complications by integrating findings from different imaging modalities and detailed clinical phenotyping and by linking structural MRI abnormalities to histology. A better understanding of the underlying mechanisms is necessary to establish interventions that will improve long-term cognitive outcomes for patients with type 1 and type 2 diabetes.
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Affiliation(s)
- Geert Jan Biessels
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center, Utrecht, the Netherlands
| | - Yael D Reijmer
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center, Utrecht, the NetherlandsJ. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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Mansur RB, Cha DS, Woldeyohannes HO, Soczynska JK, Zugman A, Brietzke E, McIntyre RS. Diabetes mellitus and disturbances in brain connectivity: a bidirectional relationship? Neuromolecular Med 2014; 16:658-68. [PMID: 24974228 DOI: 10.1007/s12017-014-8316-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 06/19/2014] [Indexed: 12/26/2022]
Abstract
Diabetes mellitus (DM) is associated with deficits across multiple cognitive domains. The observed impairments in cognitive function are hypothesized to be subserved by alterations in brain structure and function. Several lines of evidence indicate that alterations in glial integrity and function, as well as abnormal synchrony within brain circuits and associated networks, are observed in adults with DM. Microangiopathy and alterations in insulin homeostasis appear to be principal effector systems, although a unitary explanation subsuming the complex etiopathology of white matter in DM is unavailable. A contemporary model of disease pathophysiology for several mental disorders, including but not limited to mood disorders, posits abnormalities in the synchronization of cellular systems in circuits. The observation that similar abnormalities occur in diabetic populations provides the basis for hypothesizing the convergence of pathoetiological factors. Herein, we propose that abnormal structure, function and chemical composition as well as synchrony within and between circuits is an accompaniment of DM and is shared in common with several mental disorders.
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Affiliation(s)
- Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, 399 Bathurst Street, MP 9-325, Toronto, ON, M5T 2S8, Canada,
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Monette MCE, Baird A, Jackson DL. A meta-analysis of cognitive functioning in nondemented adults with type 2 diabetes mellitus. Can J Diabetes 2014; 38:401-8. [PMID: 24933107 DOI: 10.1016/j.jcjd.2014.01.014] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 11/28/2013] [Accepted: 01/27/2014] [Indexed: 01/21/2023]
Abstract
OBJECTIVE The current investigation sought to determine the pattern and magnitude of cognitive functioning deficits in persons with type 2 diabetes mellitus without dementia using meta-analysis to consolidate findings in the literature. METHODS MedLine and PsychInfo databases were searched to identify studies of cognitive functioning in persons with type 2 diabetes. Effect sizes (Cohen's d) were calculated for the differences in cognitive functioning between subjects with type 2 diabetes and controls without diabetes on classified cognitive abilities. Average d values were calculated for all cognitive abilities across studies. RESULTS Twenty-five studies meeting the inclusion criteria were identified. Persons with type 2 diabetes performed significantly lower than controls without diabetes (p<0.05) on all cognitive abilities evaluated, with effect sizes ranging from -0.14 to -0.37. The largest effect sizes were processing speed (with motor task demands), M -0.37 (95% CI, -0.41 to -0.32), and divided attention/shifting, M -0.36 (95% CI, -0.42 to -0.31). CONCLUSIONS Type 2 diabetes leads to mild to moderate deficits in all measured cognitive abilities. There was a lack of published studies investigating type 2 diabetes-associated variables; therefore, additional meta-analyses investigating the impact of these variables on cognitive functioning in type 2 diabetes could not be performed. As such, data from individual studies must be reported consistently to allow for investigation of variables that may affect the relationship between type 2 diabetes and cognitive functioning. Given the present findings, clinicians working with patients with type 2 diabetes should be alerted to the possibility of cognitive changes that could impact type 2 diabetes treatment management or require referral for neuropsychological assessment.
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Affiliation(s)
| | - Anne Baird
- Department of Psychology, University of Windsor, Windsor, Ontario
| | - Dennis L Jackson
- Department of Psychology, University of Windsor, Windsor, Ontario
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44
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Aortic stiffness is associated with white matter integrity in patients with type 1 diabetes. Eur Radiol 2014; 24:2031-7. [DOI: 10.1007/s00330-014-3179-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Revised: 03/19/2014] [Accepted: 04/07/2014] [Indexed: 10/25/2022]
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Foley JM, Salat DH, Stricker NH, Zink TA, Grande LJ, McGlinchey RE, Milberg WP, Leritz EC. Interactive effects of apolipoprotein E4 and diabetes risk on later myelinating white matter regions in neurologically healthy older aged adults. Am J Alzheimers Dis Other Demen 2014; 29:222-35. [PMID: 24381137 PMCID: PMC4356251 DOI: 10.1177/1533317513517045] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Possession of the apolipoprotein E4 (APOE4) allele and diabetes risk are independently related to reduced white matter (WM) integrity that may contribute to the development of Alzheimer's disease (AD). The purpose of this study is to examine the interactive effects of APOE4 and diabetes risk on later myelinating WM regions among healthy elderly individuals at risk of AD. A sample of 107 healthy elderly (80 APOE4-/27 APOE4+) individuals underwent structural magnetic resonance imaging/diffusion tensor imaging (DTI). Data were prepared using Tract-Based Spatial Statistics, and a priori regions of interest (ROIs) were extracted from T1-based WM parcellations. Regions of interest included later myelinating frontal/temporal/parietal WM regions and control regions measured by fractional anisotropy (FA). There were no APOE group differences in DTI for any ROI. Within the APOE4 group, we found negative relationships between hemoglobin A1c/fasting glucose and APOE4 on FA for all later myelinating WM regions but not for early/middle myelinating control regions. Results also showed APOE4/diabetes risk interactions for WM underlying supramarginal, superior temporal, precuneus, superior parietal, and superior frontal regions. Results suggest interactive effects of APOE4 and diabetes risk on later myelinating WM regions, which supports preclinical detection of AD among this particularly susceptible subgroup.
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Affiliation(s)
- Jessica M. Foley
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - David H. Salat
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
| | - Nikki H. Stricker
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Tyler A. Zink
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Laura J. Grande
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Regina E. McGlinchey
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - William P. Milberg
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Elizabeth C. Leritz
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
- Division of Aging, Brigham & Women’s Hospital, Boston, MA, USA
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Emotional and neutral verbal memory impairment in Multiple Sclerosis. J Neurol Sci 2014; 341:28-31. [PMID: 24713509 DOI: 10.1016/j.jns.2014.03.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 03/09/2014] [Accepted: 03/18/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND A defective emotional enhancement of verbal memory (VM) performances has been reported in different neurological diseases. OBJECTIVES To assess the emotional enhancement of VM in 22 Clinically Isolated Syndrome (CIS) suggestive of Multiple Sclerosis (MS) and 49 Relapsing (RR) MS patients in comparison to 32 Healthy Controls (HC). METHODS Immediate and delayed recall of VM was assessed using the Selective Reminding Test (SRT). A list of 12 emotionally significant words was used to evaluate the Emotional (E) variants of the SRT. Depressive symptoms were assessed by the Beck Depression Inventory. RESULTS The prevalence of depression did not differ between RRMS and CIS patients. Both patient groups showed poorer (p<0.01) VM performances in comparison to HC in all the SRT tasks, but no difference was found between the two patient groups. Emotionally salient words were more (p<0.0001) recalled than neutral words in HC and CIS, but not in RRMS patients, while performing the immediate recall tasks. Delayed recall was not affected by emotional stimuli in both CIS and RR MS groups. The presence of depressive symptoms did not influence the VM performances. CONCLUSIONS Our results demonstrate a defective emotional enhancement of VM in definite MS and, although to a lesser extent, in CIS patients.
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Abstract
Type 2 diabetes mellitus (T2D) and Alzheimer disease (AD) are major public health burdens associated with aging. As the age of the population rapidly increases, a sheer increase in the incidence of these diseases is expected. Research has identified T2D as a risk factor for cognitive impairment and potentially AD, but the neurobiological pathways that are affected are only beginning to be understood. The rapid advances in neuroimaging in the past decade have added significant understanding to how T2D affects brain structure and function and possibly lead to AD. This article provides a review of studies that have utilized structural and functional neuroimaging to identify neural pathways that link T2D to impaired cognitive performance and potentially AD. A primary focus of this article is the potential for neuroimaging to assist in understanding the mechanistic pathways that may provide translational opportunities for clinical intervention.
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Affiliation(s)
- John P. Ryan
- University of Pittsburgh, Department of Psychiatry
- Address correspondence to: John Ryan, Department of Psychiatry, 3811 O’Hara St., Pittsburgh, PA 15213., , Phone: 412-246-5692, Fax: 412-586-9111
| | - David F. Fine
- Geriatric Psychiatry Neuroimaging Lab, University of Pittsburgh
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Hoogenboom WS, Marder TJ, Flores VL, Huisman S, Eaton HP, Schneiderman JS, Bolo NR, Simonson DC, Jacobson AM, Kubicki M, Shenton ME, Musen G. Cerebral white matter integrity and resting-state functional connectivity in middle-aged patients with type 2 diabetes. Diabetes 2014; 63:728-38. [PMID: 24203723 PMCID: PMC3900542 DOI: 10.2337/db13-1219] [Citation(s) in RCA: 113] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Early detection of brain abnormalities at the preclinical stage can be useful for developing preventive interventions to abate cognitive decline. We examined whether middle-aged type 2 diabetic patients show reduced white matter integrity in fiber tracts important for cognition and whether this abnormality is related to preestablished altered resting-state functional connectivity in the default mode network (DMN). Diabetic and nondiabetic participants underwent diffusion tensor imaging, functional magnetic resonance imaging, and cognitive assessment. Multiple diffusion measures were calculated using streamline tractography, and correlations with DMN functional connectivity were determined. Diabetic patients showed lower fractional anisotropy (FA) (a measure of white matter integrity) in the cingulum bundle and uncinate fasciculus. Control subjects showed stronger functional connectivity than patients between the posterior cingulate and both left fusiform and medial frontal gyri. FA of the cingulum bundle was correlated with functional connectivity between the posterior cingulate and medial frontal gyrus for combined groups. Thus, middle-aged patients with type 2 diabetes show white matter abnormalities that correlate with disrupted functional connectivity in the DMN, suggesting that common mechanisms may underlie structural and functional connectivity. Detecting brain abnormalities in middle age enables implementation of therapies to slow progression of neuropathology.
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Affiliation(s)
- Wouter S. Hoogenboom
- Clinical, Behavioral, and Outcomes Research, Joslin Diabetes Center, Boston, MA
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA
| | - Thomas J. Marder
- Clinical, Behavioral, and Outcomes Research, Joslin Diabetes Center, Boston, MA
| | - Veronica L. Flores
- Clinical, Behavioral, and Outcomes Research, Joslin Diabetes Center, Boston, MA
| | - Susanne Huisman
- Clinical, Behavioral, and Outcomes Research, Joslin Diabetes Center, Boston, MA
- Faculty of Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Hana P. Eaton
- Clinical, Behavioral, and Outcomes Research, Joslin Diabetes Center, Boston, MA
| | - Jason S. Schneiderman
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA
- Unit for Experimental Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Nicolas R. Bolo
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA
- Harvard Medical School, Boston, MA
| | - Donald C. Simonson
- Harvard Medical School, Boston, MA
- Division of Endocrinology, Diabetes, and Hypertension, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
| | - Alan M. Jacobson
- Clinical, Behavioral, and Outcomes Research, Joslin Diabetes Center, Boston, MA
- Harvard Medical School, Boston, MA
- Research Institute, Winthrop-University Hospital, Mineola, NY
| | - Marek Kubicki
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Martha E. Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA
- Harvard Medical School, Boston, MA
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Brockton, MA
| | - Gail Musen
- Clinical, Behavioral, and Outcomes Research, Joslin Diabetes Center, Boston, MA
- Harvard Medical School, Boston, MA
- Corresponding author: Gail Musen,
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Yau PL, Kluger A, Borod JC, Convit A. Neural substrates of verbal memory impairments in adults with type 2 diabetes mellitus. J Clin Exp Neuropsychol 2014; 36:74-87. [PMID: 24417611 DOI: 10.1080/13803395.2013.869310] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Verbal memory impairment is well documented in type 2 diabetes mellitus (T2DM) but, to date, the neural substrates remain unclear. The present study evaluated verbal memory and ascertained the degree of frontal and temporal lobe involvement in the anticipated verbal memory impairment among adults with T2DM. METHOD Forty-six late-middle-aged and elderly adults with T2DM and 50 age-, sex-, and education-matched adults without T2DM underwent medical evaluation, verbal memory assessment, and brain magnetic resonance imaging (MRI) evaluations. RESULTS As anticipated, participants with T2DM had clear verbal memory impairments. Consistent with prior reports, we found volume reductions restricted to the hippocampus. Our diffusion tensor imaging analysis revealed that participants with T2DM had extensive cerebral gray and white matter microstructural abnormalities predominantly in the left hemisphere, with a larger concentration present in the temporal lobe. In contrast, we uncovered mostly nonspecific microstructural abnormalities in the absence of tissue loss in the frontal lobe. Of great importance, we present the first evidence among participants with T2DM linking verbal memory impairment and compromised microstructural integrity of the left parahippocampal gyrus, a key memory-relevant structure. CONCLUSIONS Our results suggest that the hippocampus and parahippocampal gyrus may be particularly vulnerable to the deleterious effects of T2DM. The parahippocampal gyrus in particular may play a crucial role in the verbal memory impairments frequently reported in T2DM. Future studies should employ methods such as resting state functional magnetic resonance imaging and diffusion tensor imaging tractography to better characterize network connectivity, which may help further characterize the verbal memory impairment frequently reported in T2DM.
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Affiliation(s)
- Po Lai Yau
- a Department of Psychiatry , New York University School of Medicine , New York , NY , USA
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Karlsson HK, Tuulari JJ, Hirvonen J, Lepomäki V, Parkkola R, Hiltunen J, Hannukainen JC, Soinio M, Pham T, Salminen P, Nuutila P, Nummenmaa L. Obesity is associated with white matter atrophy: a combined diffusion tensor imaging and voxel-based morphometric study. Obesity (Silver Spring) 2013; 21:2530-7. [PMID: 23512884 DOI: 10.1002/oby.20386] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Revised: 12/17/2012] [Accepted: 01/07/2013] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Little is known about the mechanisms by which obesity influences brain structure. In this study, the obesity-related changes in brain white and gray matter integrity were examined. DESIGN AND METHODS 23 morbidly obese subjects and 22 nonobese volunteers were studied using voxel-based analysis of diffusion tensor imaging and of T1-weighted MRI images. Full-volume statistical parametric mapping analysis was used to compare fractional anisotropy (FA) and mean diffusivity (MD) values as well as gray (GM) and white matter (WM) density between these groups. RESULTS Obese subjects had lower FA and MD values and lower focal and global GM and WM volumes than control subjects did. The focal structural changes were observed in brain regions governing reward seeking, inhibitory control, and appetite. Regression analysis showed that FA and MD values as well as GM and WM density were negatively associated with body fat percentage. Moreover, the volume of abdominal subcutaneous fat was negatively associated with GM density in most regions. CONCLUSION These findings imply that changes in GM and WM in obesity may be due to metabolic factors. Atrophy in regions involved in reward processing and appetite control may further promote abnormal reward seeking and eating behavior.
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