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Sola T, Sola FM, Jehkonen M. The Effects of Type 2 Diabetes on Cognitive Performance: A Review of Reviews. Int J Behav Med 2024:10.1007/s12529-024-10274-6. [PMID: 38467963 DOI: 10.1007/s12529-024-10274-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Multiple systematic reviews have found that type 2 diabetes is associated with cognitive decrements. However, these reviews are heterogeneous in terms of methodology, quality and results, making it difficult for researchers and clinicians to build an informed overall picture. We therefore conducted a review of systematic reviews on the association between type 2 diabetes and cognitive decrements in relation to healthy controls. METHODS Following a pre-registered research protocol, we searched four major databases. Nine systematic reviews met our inclusion criteria: seven were meta-analyses and two were narrative syntheses. We assessed the risk of bias in each review and reported all effect sizes and confidence intervals obtained. RESULTS Type 2 diabetes was associated with cognitive decrements in all reviews, with small or negligible effect sizes obtained in the largest meta-analyses. The most studied cognitive domains were attention, executive functions, memory, processing speed and working memory. All reviews had methodological issues and were rated as having a high or an unclear risk of bias. CONCLUSIONS Type 2 diabetes appears to be associated with lower cognitive performance in several cognitive domains and in different age groups. However, high-quality meta-analyses on the subject are still needed. Future reviews must follow the PRISMA guidelines and take into account the risk of bias of the original studies through sensitivity analyses and the heterogeneity of the studies by conducting subgroup analyses for example according to age group and disease duration. The meta-analyses that aim to study the entire type 2 diabetes population without excluding severe comorbidities, should assess concept formation and reasoning, construction and motor performance, perception, and verbal functions and language skills in addition to the cognitive domains that have been most frequently analysed in the reviews conducted so far.
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Affiliation(s)
- Teppo Sola
- Psychology, Tampere University, Tampere, Finland.
- Tampere University Hospital, Tampere, Finland.
| | | | - Mervi Jehkonen
- Psychology, Tampere University, Tampere, Finland
- Tampere University Hospital, Tampere, Finland
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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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The dysfunction of mGluRIIs is involved in the disorder of hippocampal neural network in diabetic mice model. Exp Brain Res 2022; 240:2491-2498. [PMID: 35994067 DOI: 10.1007/s00221-022-06433-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 08/02/2022] [Indexed: 11/04/2022]
Abstract
Cognitive dysfunction is a high incidence of diabetes mellitus (DM). However, the relationship between DM-induced cognitive defect and neuronal network oscillations is still unknown. In this study, adult male C57BL/6 J mice were intraperitoneally injected with streptozotocin (STZ) to duplicate DM. After 12 weeks, local field potentials were recorded in the perforant fiber pathway (PP) and dentate gyrus (DG) regions. Data showed that mice in the STZ group exhibited impairment of spatial learning and memory by the Morris Water Maze test. The low gamma (LG) and high gamma (HG) power were increased in the PP and DG areas of the STZ group. Moreover, the phase synchronization and the information flow at theta and LG rhythms between the PP and DG areas were decreased, and the theta-LG phase-amplitude coupling strength was markedly reduced in the PP region, DG region, and the PP-DG pathway in the STZ group. Additionally, the concentration of glutamate was increased by the high-performance liquid chromatography. Moreover, the NR2B and PSD95 expressions were markedly reduced, and the Akt/GSK-3β pathway was inhibited. Interestingly, the expressions of mGluRIIs (mGluR2 and mGluR3) were significantly decreased. The reduction of mGluRIIs may limit their function, such as restricting presynaptic glutamate release and reversing the dysfunction of NR2B via Akt/GSK-3β signaling pathway. In conclusion, our data suggest that DM alters the hippocampal neural network partly related to the dysfunction of mGluRIIs.
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Myrtus communis subsp. communis improved cognitive functions in ovariectomized diabetic rats. Gene 2020; 744:144616. [PMID: 32222531 DOI: 10.1016/j.gene.2020.144616] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 02/25/2020] [Accepted: 03/23/2020] [Indexed: 12/15/2022]
Abstract
AIM The purpose of this study was to investigate the possible effects of Myrtus communis subsp. communis (MC) on cognitive impairment in ovariectomized diabetic rats. MATERIAL AND METHOD Female Sprague-Dawley rats were divided into 5 groups consisting of 15 rats each; Control (C), Diabetes (D), Ovariectomy and diabetes (OVX + D), Ovariectomy, diabetes and donepezil (OVX + D + Don), Ovariectomy, diabetes and Myrtus communis subsp. communis (OVX + D + MC). Blood glucose measurements were made at the beginning and end of the experiments. The animals underwent the novel object recognition test (NORT) and their performance was evaluated. In hippocampal tissues; amyloid beta (Aβ) and neprilysin levels, acetylcholinesterase (AChE), and choline acetyltransferase (ChAT) activities, polysialylated neural cell adhesion molecule (PSA-NCAM), α7 subunit of neuronal nicotinic acetylcholine receptor (α7-nAChR) and brain derived neurotrophic factor (BDNF) gene expressions were examined. RESULTS Animals with ovariectomy and diabetes showed increased levels of blood glucose, AChE activity and Aβ levels, and decreased neprilysin levels, ChAT activity, α7-nAChR, PSA-NCAM and BDNF gene expressions in parallel with a decrease in NORT performance score. On the other hand, in the MC-treated OVX + D group, there was a significant decrease observed in blood glucose levels and AChE activities while there was improvement in NORT performances and an increase in hippocampal ChAT activity, neprilysin levels, α7-nAChR, PSA-NCAM and BDNF expressions. CONCLUSION These results suggest that MC extract could improve cognitive and neuronal functions with its anticholinesterase and antihyperglycemic properties.
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Wang J, Yuan Y, Cai R, Huang R, Tian S, Lin H, Guo D, Wang S. Association between Plasma Levels of PAI-1, tPA/PAI-1 Molar Ratio, and Mild Cognitive Impairment in Chinese Patients with Type 2 Diabetes Mellitus. J Alzheimers Dis 2018; 63:835-845. [PMID: 29689724 DOI: 10.3233/jad-171038] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Jiaqi Wang
- Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, PR China
- Medical School of Southeast University, Nanjing, PR China
| | - Yang Yuan
- Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, PR China
| | - Rongrong Cai
- Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, PR China
- Medical School of Southeast University, Nanjing, PR China
| | - Rong Huang
- Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, PR China
- Medical School of Southeast University, Nanjing, PR China
| | - Sai Tian
- Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, PR China
- Medical School of Southeast University, Nanjing, PR China
| | - Hongyan Lin
- Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, PR China
- Medical School of Southeast University, Nanjing, PR China
| | - Dan Guo
- Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, PR China
- Medical School of Southeast University, Nanjing, PR China
| | - Shaohua Wang
- Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, PR China
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Huang R, Wang P, Han J, Xia W, Cai R, Sun H, Sun J, Wang S. Decreased Serum IGF-1/IGFBP-3 Molar Ratio is Associated with Executive Function Behaviors in Type 2 Diabetic Patients with Mild Cognitive Impairment. J Alzheimers Dis 2016; 47:85-94. [PMID: 26402757 DOI: 10.3233/jad-150071] [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] [Indexed: 12/20/2022]
Abstract
BACKGROUND Insulin-like growth factor (IGF)-1, through insulin/IGF-1 signaling pathway, is involved in the pathogenesis of type 2 diabetes mellitus (T2DM) and Alzheimer's disease. OBJECTIVE This study aimed to assess the association of serum IGF-1 and IGF binding protein (IGFBP)-3 levels with cognition status and to determine whether IGF-1 rs972936 polymorphism is associated with T2DM with mild cognitive impairment (MCI). METHODS A total of 150 T2DM patients, 75 satisfying the MCI diagnostic criteria and 75 exhibiting healthy cognition, were enrolled in this study. The cognitive function of the subjects was extensively assessed. Serum IGF-1 and IGFBP-3 levels were measured through enzyme-linked immunosorbent assay; IGF-1/IGFBP-3 molar ratio was calculated. Single nucleotide polymorphisms of the IGF-1-(rs972936) gene were analyzed. RESULTS Serum IGF-1/IGFBP-3 molar ratio in MCI patients was significantly lower than that in the control group (p = 0.003). Significant negative correlations were found between IGF-1/IGFBP-3 molar ratio and Trail Making Test A and B (TMT-A and TMT-B) scores (p = 0.003; p < 0.001, respectively), which indicated executive function. Further multiple step-wise regression analysis revealed that the TMT-A or TMT-B score was significantly associated only with serum IGF-1/IGFBP-3 molar ratio (p = 0.016; p < 0.001, respectively). No significant difference was found in the genotype or allele distribution of IGF-1 rs972936 polymorphism between MCI and control groups. CONCLUSIONS A low serum IGF-1/IGFBP-3 molar ratio is associated with the pathogenesis of MCI, particularly executive function in T2DM populations. Further investigation with a large population size should be conducted to confirm this observed association.
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Affiliation(s)
- Rong Huang
- Medical School of Southeast University, Nanjing, PR China; Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, PR China
| | - Pin Wang
- Medical School of Southeast University, Nanjing, PR China
| | - Jing Han
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, PR China
| | - Wenqing Xia
- Medical School of Southeast University, Nanjing, PR China
| | - Rongrong Cai
- Medical School of Southeast University, Nanjing, PR China
| | - Haixia Sun
- Medical School of Southeast University, Nanjing, PR China
| | - Jie Sun
- Medical School of Southeast University, Nanjing, PR China
| | - Shaohua Wang
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, PR China
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Alrefaie Z, Alhayani A. Vitamin D3 improves decline in cognitive function and cholinergic transmission in prefrontal cortex of streptozotocin-induced diabetic rats. Behav Brain Res 2015; 287:156-62. [DOI: 10.1016/j.bbr.2015.03.050] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 03/16/2015] [Accepted: 03/20/2015] [Indexed: 01/11/2023]
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Salak Djokić B, Spitznagel MB, Pavlović D, Janković N, Parojčić A, Ilić V, Nikolić Djurović M. Diabetes mellitus and cognitive functioning in a Serbian sample. J Clin Exp Neuropsychol 2014; 37:37-48. [DOI: 10.1080/13803395.2014.985190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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