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Huang Y, Zhang X, Cheng M, Yang Z, Liu W, Ai K, Tang M, Zhang X, Lei X, Zhang D. Altered cortical thickness-based structural covariance networks in type 2 diabetes mellitus. Front Neurosci 2024; 18:1327061. [PMID: 38332862 PMCID: PMC10851426 DOI: 10.3389/fnins.2024.1327061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/11/2024] [Indexed: 02/10/2024] Open
Abstract
Cognitive impairment is a common complication of type 2 diabetes mellitus (T2DM), and early cognitive dysfunction may be associated with abnormal changes in the cerebral cortex. This retrospective study aimed to investigate the cortical thickness-based structural topological network changes in T2DM patients without mild cognitive impairment (MCI). Fifty-six T2DM patients and 59 healthy controls underwent neuropsychological assessments and sagittal 3-dimensional T1-weighted structural magnetic resonance imaging. Then, we combined cortical thickness-based assessments with graph theoretical analysis to explore the abnormalities in structural covariance networks in T2DM patients. Correlation analyses were performed to investigate the relationship between the altered topological parameters and cognitive/clinical variables. T2DM patients exhibited significantly lower clustering coefficient (C) and local efficiency (Elocal) values and showed nodal property disorders in the occipital cortical, inferior temporal, and inferior frontal regions, the precuneus, and the precentral and insular gyri. Moreover, the structural topological network changes in multiple nodes were correlated with the findings of neuropsychological tests in T2DM patients. Thus, while T2DM patients without MCI showed a relatively normal global network, the local topological organization of the structural network was disordered. Moreover, the impaired ventral visual pathway may be involved in the neural mechanism of visual cognitive impairment in T2DM patients. This study enriched the characteristics of gray matter structure changes in early cognitive dysfunction in T2DM patients.
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Affiliation(s)
- Yang Huang
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Xin Zhang
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Miao Cheng
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Zhen Yang
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Wanting Liu
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Kai Ai
- Department of Clinical and Technical Support, Philips Healthcare, Xi’an, China
| | - Min Tang
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Xiaoling Zhang
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Xiaoyan Lei
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Dongsheng Zhang
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, China
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Isop LM, Neculau AE, Necula RD, Kakucs C, Moga MA, Dima L. Metformin: The Winding Path from Understanding Its Molecular Mechanisms to Proving Therapeutic Benefits in Neurodegenerative Disorders. Pharmaceuticals (Basel) 2023; 16:1714. [PMID: 38139841 PMCID: PMC10748332 DOI: 10.3390/ph16121714] [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: 09/12/2023] [Revised: 11/25/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
Metformin, a widely prescribed medication for type 2 diabetes, has garnered increasing attention for its potential neuroprotective properties due to the growing demand for treatments for Alzheimer's, Parkinson's, and motor neuron diseases. This review synthesizes experimental and clinical studies on metformin's mechanisms of action and potential therapeutic benefits for neurodegenerative disorders. A comprehensive search of electronic databases, including PubMed, MEDLINE, Embase, and Cochrane library, focused on key phrases such as "metformin", "neuroprotection", and "neurodegenerative diseases", with data up to September 2023. Recent research on metformin's glucoregulatory mechanisms reveals new molecular targets, including the activation of the LKB1-AMPK signaling pathway, which is crucial for chronic administration of metformin. The pleiotropic impact may involve other stress kinases that are acutely activated. The precise role of respiratory chain complexes (I and IV), of the mitochondrial targets, or of the lysosomes in metformin effects remains to be established by further research. Research on extrahepatic targets like the gut and microbiota, as well as its antioxidant and immunomodulatory properties, is crucial for understanding neurodegenerative disorders. Experimental data on animal models shows promising results, but clinical studies are inconclusive. Understanding the molecular targets and mechanisms of its effects could help design clinical trials to explore and, hopefully, prove its therapeutic effects in neurodegenerative conditions.
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Affiliation(s)
- Laura Mihaela Isop
- Department of Fundamental, Prophylactic and Clinical Sciences, Faculty of Medicine, Transilvania University of Brasov, 500036 Brașov, Romania; (L.M.I.)
| | - Andrea Elena Neculau
- Department of Fundamental, Prophylactic and Clinical Sciences, Faculty of Medicine, Transilvania University of Brasov, 500036 Brașov, Romania; (L.M.I.)
| | - Radu Dan Necula
- Department of Medical and Surgical Specialties, Faculty of Medicine, Transilvania University of Brasov, 500036 Brașov, Romania
| | - Cristian Kakucs
- Department of Medical and Surgical Specialties, Faculty of Medicine, Transilvania University of Brasov, 500036 Brașov, Romania
| | - Marius Alexandru Moga
- Department of Medical and Surgical Specialties, Faculty of Medicine, Transilvania University of Brasov, 500036 Brașov, Romania
| | - Lorena Dima
- Department of Fundamental, Prophylactic and Clinical Sciences, Faculty of Medicine, Transilvania University of Brasov, 500036 Brașov, Romania; (L.M.I.)
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Li MZ, Zhang L, Shi ZY, Jiang DC, Yang XY. Magnetic resonance imaging detects cerebral gray and white matter injury correlated with cognitive impairments in diabetic db/db mice. Behav Brain Res 2023; 451:114510. [PMID: 37244436 DOI: 10.1016/j.bbr.2023.114510] [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: 03/15/2023] [Revised: 05/08/2023] [Accepted: 05/25/2023] [Indexed: 05/29/2023]
Abstract
Type-2 diabetes not only causes gray matter injury but also induces widespread white matter damages, which may contribute the cognitive impairments. This study aimed to assess the structural alterations of the gray and white matter in 20-week-old diabetic db/db mice using magnetic resonance imaging including T2-weighted imaging (T2WI) and diffusion tensor imaging (DTI), and to correlate them with the cognitive performance detected by Morris water maze (MWM). The results revealed impaired spatial learning and memory in db/db mice. T2WI detected severe brain atrophy involving the hippocampus and cortex after diabetes. DTI showed reduced fractional anisotropy (FA) in the cortex, hippocampus, corpus callosum/external capsule, and increased radial diffusivity in the corpus callosum/external capsule of the db/db mice. The immunostaining confirmed the MRI findings showing decreased cell density in the cortex, hippocampus, and reduced integrated optical density of Luxol fast blue staining in the corpus callosum/external capsule. The correlational analysis revealed that the T2WI-derived tissue atrophy and DTI-derived FA in the relevant gray matter and white matter significantly correlated with the behavior performance in the MWM test. Collectively, the present in vivo MRI detected varying degrees of structural abnormalities in the gray and white matter of db/db mice, which might be favorable predictors of diabetic cognitive dysfunction. Our findings might provide new clues for identifying gray and white matter damages associated with cognitive decline, which is imperative for the evaluation of potential pharmacological therapies in preclinical phase.
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Affiliation(s)
- Man-Zhong Li
- Department of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China; Beijing Key Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing 100038, China
| | - Lei Zhang
- Department of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China; Beijing Key Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing 100038, China
| | - Zheng-Yuan Shi
- Department of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China; Beijing Key Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing 100038, China
| | - De-Chun Jiang
- Department of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China; Beijing Key Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing 100038, China.
| | - Xin-Yu Yang
- Department of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China; Beijing Key Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing 100038, China.
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Roth R, Busby N, Wilmskoetter J, Schwen Blackett D, Gleichgerrcht E, Johnson L, Rorden C, Newman-Norlund R, Hillis AE, den Ouden DB, Fridriksson J, Bonilha L. Diabetes, brain health, and treatment gains in post-stroke aphasia. Cereb Cortex 2023; 33:8557-8564. [PMID: 37139636 PMCID: PMC10321080 DOI: 10.1093/cercor/bhad140] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/31/2023] [Accepted: 04/01/2023] [Indexed: 05/05/2023] Open
Abstract
In post-stroke aphasia, language improvements following speech therapy are variable and can only be partially explained by the lesion. Brain tissue integrity beyond the lesion (brain health) may influence language recovery and can be impacted by cardiovascular risk factors, notably diabetes. We examined the impact of diabetes on structural network integrity and language recovery. Seventy-eight participants with chronic post-stroke aphasia underwent six weeks of semantic and phonological language therapy. To quantify structural network integrity, we evaluated the ratio of long-to-short-range white matter fibers within each participant's whole brain connectome, as long-range fibers are more susceptible to vascular injury and have been linked to high level cognitive processing. We found that diabetes moderated the relationship between structural network integrity and naming improvement at 1 month post treatment. For participants without diabetes (n = 59), there was a positive relationship between structural network integrity and naming improvement (t = 2.19, p = 0.032). Among individuals with diabetes (n = 19), there were fewer treatment gains and virtually no association between structural network integrity and naming improvement. Our results indicate that structural network integrity is associated with treatment gains in aphasia for those without diabetes. These results highlight the importance of post-stroke structural white matter architectural integrity in aphasia recovery.
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Affiliation(s)
- Rebecca Roth
- Department of Neurology, Emory University, Atlanta, GA 30322, USA
| | - Natalie Busby
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29208, USA
| | - Janina Wilmskoetter
- Department of Rehabilitation Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Deena Schwen Blackett
- Department of Neurology, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Ezequiel Gleichgerrcht
- Department of Neurology, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Lisa Johnson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29208, USA
| | - Chris Rorden
- Department of Psychology, University of South Carolina, Columbia, SC 29208, USA
| | | | - Argye E Hillis
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD 21218 USA
| | - Dirk B den Ouden
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29208, USA
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29208, USA
| | - Leonardo Bonilha
- Department of Neurology, Emory University, Atlanta, GA 30322, USA
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Roy B, Choi SE, Freeby MJ, Kumar R. Microstructural brain tissue changes contribute to cognitive and mood deficits in adults with type 2 diabetes mellitus. Sci Rep 2023; 13:9636. [PMID: 37316507 PMCID: PMC10267112 DOI: 10.1038/s41598-023-35522-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/19/2023] [Indexed: 06/16/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) patients show brain tissue changes in mood and cognitive regulatory sites, but the nature and extent of tissue injury and their associations with symptoms are unclear. Our aim was to examine brain tissue damage in T2DM over controls using mean diffusivity (MD) computed from diffusion tensor imaging (DTI), and assess correlations with mood and cognitive symptoms in T2DM. We collected DTI series (MRI), mood, and cognitive data, from 169 subjects (68 T2DM and 101 controls). Whole-brain MD-maps were calculated, normalized, smoothed, and compared between groups, as well as correlated with mood and cognition scores in T2DM subjects. Type 2 diabetes patients showed altered cognitive and mood functions over control subjects. Multiple brain sites in T2DM patients showed elevated MD values, indicating chronic tissue changes, including the cerebellum, insula, and frontal and prefrontal cortices, cingulate, and lingual gyrus. Associations between MD values and mood and cognition scores appeared in brain sites mediating these functions. Type 2 diabetes patients show predominantly chronic brain tissue changes in areas mediating mood and cognition functions, and tissue changes from those regions correlate with mood and cognitive symptoms suggesting that the microstructural brain changes may account for the observed functional deficits.
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Affiliation(s)
- Bhaswati Roy
- Department of Anesthesiology, David Geffen School of Medicine at UCLA, University of California Los Angeles, 56-141 CHS, 10833 Le Conte Ave, Los Angeles, CA, 90095-1763, USA
| | - Sarah E Choi
- UCLA School of Nursing, University of California Los Angeles, Los Angeles, CA, USA
| | - Matthew J Freeby
- Department of Medicine, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, CA, USA
| | - Rajesh Kumar
- Department of Anesthesiology, David Geffen School of Medicine at UCLA, University of California Los Angeles, 56-141 CHS, 10833 Le Conte Ave, Los Angeles, CA, 90095-1763, USA.
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, CA, USA.
- Department of Bioengineering, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, CA, USA.
- Brain Research Institute, University of California Los Angeles, Los Angeles, CA, USA.
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Li Y, Liu Y, Liu S, Gao M, Wang W, Chen K, Huang L, Liu Y. Diabetic vascular diseases: molecular mechanisms and therapeutic strategies. Signal Transduct Target Ther 2023; 8:152. [PMID: 37037849 PMCID: PMC10086073 DOI: 10.1038/s41392-023-01400-z] [Citation(s) in RCA: 72] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 02/19/2023] [Accepted: 02/28/2023] [Indexed: 04/12/2023] Open
Abstract
Vascular complications of diabetes pose a severe threat to human health. Prevention and treatment protocols based on a single vascular complication are no longer suitable for the long-term management of patients with diabetes. Diabetic panvascular disease (DPD) is a clinical syndrome in which vessels of various sizes, including macrovessels and microvessels in the cardiac, cerebral, renal, ophthalmic, and peripheral systems of patients with diabetes, develop atherosclerosis as a common pathology. Pathological manifestations of DPDs usually manifest macrovascular atherosclerosis, as well as microvascular endothelial function impairment, basement membrane thickening, and microthrombosis. Cardiac, cerebral, and peripheral microangiopathy coexist with microangiopathy, while renal and retinal are predominantly microangiopathic. The following associations exist between DPDs: numerous similar molecular mechanisms, and risk-predictive relationships between diseases. Aggressive glycemic control combined with early comprehensive vascular intervention is the key to prevention and treatment. In addition to the widely recommended metformin, glucagon-like peptide-1 agonist, and sodium-glucose cotransporter-2 inhibitors, for the latest molecular mechanisms, aldose reductase inhibitors, peroxisome proliferator-activated receptor-γ agonizts, glucokinases agonizts, mitochondrial energy modulators, etc. are under active development. DPDs are proposed for patients to obtain more systematic clinical care requires a comprehensive diabetes care center focusing on panvascular diseases. This would leverage the advantages of a cross-disciplinary approach to achieve better integration of the pathogenesis and therapeutic evidence. Such a strategy would confer more clinical benefits to patients and promote the comprehensive development of DPD as a discipline.
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Affiliation(s)
- Yiwen Li
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, 100091, China
| | - Yanfei Liu
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, 100091, China
- The Second Department of Gerontology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
| | - Shiwei Liu
- Department of Nephrology and Endocrinology, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, 100102, China
| | - Mengqi Gao
- Department of Nephrology and Endocrinology, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, 100102, China
| | - Wenting Wang
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, 100091, China
| | - Keji Chen
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, 100091, China.
| | - Luqi Huang
- China Center for Evidence-based Medicine of TCM, China Academy of Chinese Medical Sciences, Beijing, 100010, China.
| | - Yue Liu
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, 100091, China.
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Henn RE, Noureldein MH, Elzinga SE, Kim B, Savelieff MG, Feldman EL. Glial-neuron crosstalk in health and disease: A focus on metabolism, obesity, and cognitive impairment. Neurobiol Dis 2022; 170:105766. [PMID: 35584728 PMCID: PMC10071699 DOI: 10.1016/j.nbd.2022.105766] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/28/2022] [Accepted: 05/11/2022] [Indexed: 12/12/2022] Open
Abstract
Dementia is a complex set of disorders affecting normal cognitive function. Recently, several clinical studies have shown that diabetes, obesity, and components of the metabolic syndrome (MetS) are associated with cognitive impairment, including dementias such as Alzheimer's disease. Maintaining normal cognitive function is an intricate process involving coordination of neuron function with multiple brain glia. Well-orchestrated bioenergetics is a central requirement of neurons, which need large amounts of energy but lack significant energy storage capacity. Thus, one of the most important glial functions is to provide metabolic support and ensure an adequate energy supply for neurons. Obesity and metabolic disease dysregulate glial function, leading to a failure to respond to neuron energy demands, which results in neuronal damage. In this review, we outline evidence for links between diabetes, obesity, and MetS components to cognitive impairment. Next, we focus on the metabolic crosstalk between the three major glial cell types, oligodendrocytes, astrocytes, and microglia, with neurons under physiological conditions. Finally, we outline how diabetes, obesity, and MetS components can disrupt glial function, and how this disruption might impair glia-neuron metabolic crosstalk and ultimately promote cognitive impairment.
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Affiliation(s)
- Rosemary E Henn
- NeuroNetwork for Emerging Therapies, University of Michigan, Ann Arbor, MI, United States of America; Department of Neurology, University of Michigan, Ann Arbor, MI, United States of America.
| | - Mohamed H Noureldein
- NeuroNetwork for Emerging Therapies, University of Michigan, Ann Arbor, MI, United States of America; Department of Neurology, University of Michigan, Ann Arbor, MI, United States of America.
| | - Sarah E Elzinga
- NeuroNetwork for Emerging Therapies, University of Michigan, Ann Arbor, MI, United States of America; Department of Neurology, University of Michigan, Ann Arbor, MI, United States of America.
| | - Bhumsoo Kim
- NeuroNetwork for Emerging Therapies, University of Michigan, Ann Arbor, MI, United States of America; Department of Neurology, University of Michigan, Ann Arbor, MI, United States of America.
| | - Masha G Savelieff
- NeuroNetwork for Emerging Therapies, University of Michigan, Ann Arbor, MI, United States of America.
| | - Eva L Feldman
- NeuroNetwork for Emerging Therapies, University of Michigan, Ann Arbor, MI, United States of America; Department of Neurology, University of Michigan, Ann Arbor, MI, United States of America.
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Singh A, Bodakhe SH. Resveratrol attenuates behavioural impairment associated with learning and memory in HFD-STZ induced diabetic rats. Br J Pharmacol 2022; 179:4673-4691. [PMID: 35710260 DOI: 10.1111/bph.15895] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/10/2022] [Accepted: 04/22/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND PURPOSE Literature have indicated that a high-fat diet (HFD) is a common risk factor for type 2 diabetes mellitus (T2DM) and its associated cognitive-impairments. Mounting evidence supports that, in the diabetic animal model, resveratrol (RSV, SIRT1-modulator) can regulate the fasting glucose and antioxidant levels, as well as the lipid profile, and may alleviate the cognitive-dysfunction associated with diabetes. EXPERIMENTAL APPROACH Albino rats were fed 60% HFD-STZ (45mg/kg,i.p, single dose) to induce T2DM so that the experimental T2DM animal model could be used. After 14 weeks of the animals being in a confirmed diabetic condition, they were divided into various groups and treated with metformin(200mg/kg,i.p.) and RSV(50 and 100 mg/kg,i.p.) for four weeks. A multimodal approach involving oxidative-nitroso-stress, SIRT1, TGF-β1 levels, inflammation, cholinergic activity (serum, hippocampus, cerebral cortex), and a battery of behavioural studies associated with learning-memory were performed during and after the experimental-protocol. KEY RESULTS The administration of RSV significantly attenuated the increased glucose levels (pre, and post-prandial), impaired glucose tolerance, HbA1c, and decreased the body weights of the T2DM rats. Moreover, RSV ameliorated the impaired learning and memory-associated with increased SIRT1 and the decreased TGF-β1, TNF-α, oxidative-nitroso-stress and cholinergic activities in the serum and the brains of the T2DM-animals. CONCLUSION AND IMPLICATION Our investigations demonstrate that SIRT1-modulation can inter-play with TGF-β1 signalling, as well as mitigate hyperglycaemia and subsequent learning-memory impairments, in the T2DM-animals. Moreover, our study showed that novel therapeutic-targets, including TGF-β1, may add to our knowledge of RSV when used in the treatment of impaired memory-associated with diabetes.
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Affiliation(s)
- Amrita Singh
- Department of Pharmacy, Guru Ghasidas Vishwavidyalaya (A Central University), Bilaspur, Chhattisgarh, India.,Department of Pharmacology, ISF College of Pharmacy, Moga, Punjab, India
| | - Surendra H Bodakhe
- Department of Pharmacy, Guru Ghasidas Vishwavidyalaya (A Central University), Bilaspur, Chhattisgarh, India
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Wang LP, Geng J, Liu C, Wang Y, Zhang Z, Yang GY. Diabetes Mellitus-Related Neurobehavioral Deficits in Mice Are Associated With Oligodendrocyte Precursor Cell Dysfunction. Front Aging Neurosci 2022; 14:846739. [PMID: 35693337 PMCID: PMC9177201 DOI: 10.3389/fnagi.2022.846739] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Recent clinical studies demonstrated an increase of the incidence of neurobehavioral disorders in patients with diabetes mellitus. Studies also found an association between severity of diabetes mellitus and the progression of white matter hyperintensity on magnetic resonance imaging, which conferred risk for developing cognitive impairment. Since oligodendrocyte precursor cells participated in the white matter repair and remodeling after ischemic brain injury, we explored whether hyperglycemia induced neurobehavioral deficits were associated with dysfunction of oligodendrocyte precursor cells. Adult male C57BL/6 mice (n = 40) were randomly divided into 4-week diabetes, 8-week diabetes, and control groups. Experimental diabetic mice were induced by streptozotocin injection. Learning and cognitive function, exploratory, anxiety and depression behaviors were assessed by Morris water maze, open field test, elevated plus maze, and tail suspension test, respectively. Immunofluorescence staining of neuron-glial antigen 2 and myelin basic protein were performed. Oligodendrocyte precursor cells were cultured in different glucose level to explore possible mechanism in vitro. The learning and cognitive function of 4-week and 8-week diabetic mice were attenuated compared to the control group (p < 0.05). The diabetic mice had less exploratory behavior compared to the control (p < 0.05). However, the diabetic mice were more likely to show anxiety (p < 0.05) and depression (p < 0.01) compared to the control. Further study demonstrated the number of oligodendrocyte precursor cells and the level of myelin basic protein expression were decreased in diabetic mice and the migration and survival ability were suppressed in the hyperglycemic environment in vitro (p < 0.05). Our results demonstrated that diabetes mellitus induced neurological deficits were associated with the decreased number and dysfunction of oligodendrocyte precursor cells.
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Affiliation(s)
- Li-Ping Wang
- Department of Neurology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Med-X Research Institute and School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Jieli Geng
- Department of Neurology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Jieli Geng,
| | - Chang Liu
- Med-X Research Institute and School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Yuyang Wang
- Department of Rehabilitation Medicine, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
| | - Zhijun Zhang
- Med-X Research Institute and School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Guo-Yuan Yang
- Med-X Research Institute and School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
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10
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Jyoti Dutta B, Singh S, Seksaria S, Das Gupta G, Bodakhe SH, Singh A. Potential role of IP3/Ca 2+ signaling and phosphodiesterases: Relevance to neurodegeneration in Alzheimer's disease and possible therapeutic strategies. Biochem Pharmacol 2022; 201:115071. [PMID: 35525328 DOI: 10.1016/j.bcp.2022.115071] [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: 01/20/2022] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 11/02/2022]
Abstract
Despite large investments by industry and governments, no disease-modifying medications for the treatment of patients with Alzheimer's disease (AD) have been found. The failures of various clinical trials indicate the need for a more in-depth understanding of the pathophysiology of AD and for innovative therapeutic strategies for its treatment. Here, we review the rational for targeting IP3 signaling, cytosolic calcium dysregulation, phosphodiesterases (PDEs), and secondary messengers like cGMP and cAMP, as well as their correlations with the pathophysiology of AD. Various drugs targeting these signaling cascades are still in pre-clinical and clinical trials which support the ideas presented in this article. Further, we describe different molecular mechanisms and medications currently being used in various pre-clinical and clinical trials involving IP3/Ca+2 signaling. We also highlight various isoforms, as well as the functions and pharmacology of the PDEs broadly expressed in different parts of the brain and attempt to unravel the potential benefits of PDE inhibitors for use as novel medications to alleviate the pathogenesis of AD.
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Affiliation(s)
- Bhaskar Jyoti Dutta
- Department of Pharmacology, ISF College of Pharmacy, GT Road, Ghal Kalan, Moga-142001, Punjab, India
| | - Shamsher Singh
- Department of Pharmacology, ISF College of Pharmacy, GT Road, Ghal Kalan, Moga-142001, Punjab, India
| | - Sanket Seksaria
- Department of Pharmacology, ISF College of Pharmacy, GT Road, Ghal Kalan, Moga-142001, Punjab, India
| | - Ghanshyam Das Gupta
- Department of Pharmacology, ISF College of Pharmacy, GT Road, Ghal Kalan, Moga-142001, Punjab, India
| | - Surendra H Bodakhe
- Department of Pharmacy, Guru Ghasidas Vishwavidyalaya (A Central University), Bilaspur - 495009, Chhattisgarh, India
| | - Amrita Singh
- Department of Pharmacology, ISF College of Pharmacy, GT Road, Ghal Kalan, Moga-142001, Punjab, India.
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11
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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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12
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Lei H, Hu R, Luo G, Yang T, Shen H, Deng H, Chen C, Zhao H, Liu J. Altered Structural and Functional MRI Connectivity in Type 2 Diabetes Mellitus Related Cognitive Impairment: A Review. Front Hum Neurosci 2022; 15:755017. [PMID: 35069149 PMCID: PMC8770326 DOI: 10.3389/fnhum.2021.755017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 12/13/2021] [Indexed: 12/16/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is associated with cognitive impairment in many domains. There are several pieces of evidence that changes in neuronal neuropathies and metabolism have been observed in T2DM. Structural and functional MRI shows that abnormal connections and synchronization occur in T2DM brain circuits and related networks. Neuroplasticity and energy metabolism appear to be principal effector systems, which may be related to amyloid beta (Aβ) deposition, although there is no unified explanation that includes the complex etiology of T2DM with cognitive impairment. Herein, we assume that cognitive impairment in diabetes may lead to abnormalities in neuroplasticity and energy metabolism in the brain, and those reflected to MRI structural connectivity and functional connectivity, respectively.
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13
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Yuan CL, Yi R, Dong Q, Yao LF, Liu B. The relationship between diabetes-related cognitive dysfunction and leukoaraiosis. Acta Neurol Belg 2021; 121:1101-1110. [PMID: 33893981 DOI: 10.1007/s13760-021-01676-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 04/10/2021] [Indexed: 12/17/2022]
Abstract
Cognitive dysfunction is a degenerative disease of the central nervous system, which often associates with ageing brain as well as neurodegenerative diseases. A growing body of evidence suggests that patients with diabetes mellitus (DM) have a significantly higher risk of cognitive impairment. In recent years, studies have found that patients with diabetes-related cognitive dysfunction have an increased burden of leukoaraiosis (LA), and larger white matter hyperintensity (WMH) volume. With the recent advancement of technologies, multimodal imaging is widely exploited for the precise evaluation of central nervous system diseases. Emerging studies suggest that LA pathology can be used as a predictive signal of white matter lesions in patients with diabetes-related cognitive dysfunction, providing support for early identification and diagnosis of disease. This article reviews the findings, epidemiological characteristics, pathogenesis, imaging features, prevention and treatment of LA pathophysiology in patients with diabetes-related cognitive dysfunction.
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Affiliation(s)
- Chun-Lan Yuan
- Department of Neurology, The First Affiliated Hospital Of Harbin Medical University, No. 23 Youzheng Street, Harbin, 150001, People's Republic of China
| | - Ran Yi
- Department of Endocrine, The First Affiliated Hospital Of Harbin Medical University, No. 23 Youzheng Street, Harbin, 150001, People's Republic of China
| | - Qi Dong
- Department of Neurology, The First Affiliated Hospital Of Harbin Medical University, No. 23 Youzheng Street, Harbin, 150001, People's Republic of China.
| | - Li-Fen Yao
- Department of Neurology, The First Affiliated Hospital Of Harbin Medical University, No. 23 Youzheng Street, Harbin, 150001, People's Republic of China
| | - Bin Liu
- Department of Neurosurgery, The Fourth Affiliated Hospital Of Harbin Medical University, No. 37 Yiyuan Street, Harbin, 150001, People's Republic of China.
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14
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Xiong Y, Tian T, Fan Y, Yang S, Xiong X, Zhang Q, Zhu W. Diffusion Tensor Imaging Reveals Altered Topological Efficiency of Structural Networks in Type-2 Diabetes Patients With and Without Mild Cognitive Impairment. J Magn Reson Imaging 2021; 55:917-927. [PMID: 34382716 DOI: 10.1002/jmri.27884] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Some patients with type 2 diabetes mellitus (T2DM) progress towards mild cognitive impairment (MCI), while some patients can always maintain normal cognitive function. Network topologic alterations at global and nodal levels between T2DM individuals with and without cognitive impairment may underlie the difference. PURPOSE To investigate the topological alterations of the whole-brain white matter (WM) structural connectome in T2DM patients with and without MCI and characterize its relationship with disease severity. STUDY TYPE Cross-sectional and prospective study. SUBJECTS Forty-four (63.6% females) T2DM patients, 22 with mild cognitive impairment (DM-MCI) and 22 with normal cognition (DM-NC), and 34 (58.8% females) healthy controls (HC). FIELD STRENGTH/SEQUENCE 3 T/diffusion tensor imaging. ASSESSMENT Graph theoretical analysis was used to investigate the topological organization of the structural networks. The global topological properties and nodal efficiency were investigated and compared. Relationship between network metrics and clinical measurements was characterized. STATISTICAL TESTS Student's t-test, chi-square test, ANOVA, partial correlation analyses, and multiple comparisons correction. RESULTS The global topological organization of WM networks was significantly disrupted in T2DM patients with cognitive impairment (reduced global and local efficiency and increased shortest path length) but not in those with normal cognition, compared with controls. The DM-MCI group had significantly decreased network efficiency compared with the DM-NC group. Compared with controls, decreased nodal efficiency was detected in three regions in DM-NC group. More regions with decreased nodal efficiency were found in the DM-MCI group. Altered global network properties and nodal efficiency of some regions were correlated with diabetic duration, HbA1c levels, and cognitive assessment scores. DATA CONCLUSION The more disrupted WM connections and weaker organized network are found in DM-MCI patients relative to DM-NC patients and controls. Network analyses provide information for the neuropathology of cognitive decline in T2DM patients. Altered nodal efficiency may act as potential markers for early detection of T2DM-related MCI. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Ying Xiong
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tian Tian
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Fan
- Beijing Intelligent Brain Cloud Inc., Beijing, China
| | - Shaolin Yang
- Department of Bioengineering, Psychiatry and Radiology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Xiaoxiao Xiong
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qiang Zhang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenzhen Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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15
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Irregular structural networks of gray matter in patients with type 2 diabetes mellitus. Brain Imaging Behav 2021; 14:1477-1486. [PMID: 30977031 DOI: 10.1007/s11682-019-00070-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Type 2 diabetes mellitus (T2DM) induces dementia and cognitive decrements indicating the impairment of the central nervous system. While there is evidence showing abnormalities in white-matter structural networks in T2DM, the topological features of gray matter are still unknown. The study enrolled 30 right-handed T2DM patients and 20 healthy control subjects with matched age, gender, handedness, and education. Graph theoretical analysis of magnetic resonance imaging on gray matter volume was conducted to explore large-scale structural networks of brain. Although retaining small-worldness characteristics, the structural networks of grey matter in the T2DM group exhibited an increased clustering coefficient, prolonged characteristic path, decreased global efficiency, and more vulnerability to random failures or targeted attacks compared with controls. Additionally, the degree of structural networks in both T2DM and control groups was distributed exponentially in truncated power law. Our findings suggest that T2DM disturbed the overall topological features of gray matter networks, which provides a novel insight into the neurobiological mechanisms accounting for the cognitive impairment of T2DM patients.
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16
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Samoilova J, Matveeva M, Tonkih O, Kudlau D, Oleynik O, Kanev A. A Prospective Study: Highlights of Hippocampal Spectroscopy in Cognitive Impairment in Patients with Type 1 and Type 2 Diabetes. J Pers Med 2021; 11:jpm11020148. [PMID: 33669655 PMCID: PMC7922999 DOI: 10.3390/jpm11020148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/10/2021] [Accepted: 02/12/2021] [Indexed: 11/16/2022] Open
Abstract
Diabetes mellitus type 1 and 2 is associated with cognitive impairment. Previous studies have reported a relationship between changes in cerebral metabolite levels and the variability of glycemia. However, the specific risk factors that affect the metabolic changes associated with type 1 and type 2 diabetes in cognitive dysfunction remain uncertain. The aim of the study was to evaluate the specificity of hippocampal spectroscopy in type 1 and type 2 diabetes and cognitive dysfunction. MATERIALS AND METHODS 65 patients with type 1 diabetes with cognitive deficits and 20 patients without, 75 patients with type 2 diabetes with cognitive deficits and 20 patients without have participated in the study. The general clinical analysis and evaluation of risk factors of cognitive impairment were carried out. Neuropsychological testing included the Montreal Scale of Cognitive Dysfunction Assessment (MoCA test). Magnetic resonance spectroscopy (MRS) was performed in the hippocampal area, with the assessment of N-acetylaspartate (NAA), choline (Cho), creatine (Cr), and phosphocreatine (PCr) levels. Statistical processing was performed using the commercially available IBM SPSS software. RESULTS Changes in the content of NAA, choline Cho, phosphocreatine Cr2 and their ratios were observed in type 1 diabetes. More pronounced changes in hippocampal metabolism were observed in type 2 diabetes for all of the studied metabolites. Primary risk factors of neurometabolic changes in patients with type 1 diabetes were episodes of severe hypoglycemia in the history of the disease, diabetic ketoacidosis (DKA), chronic hyperglycemia, and increased body mass index (BMI). In type 2 diabetes, arterial hypertension (AH), BMI, and patient's age are of greater importance, while the level of glycated hemoglobin (HbA1c), duration of the disease, level of education and insulin therapy are of lesser importance. CONCLUSION Patients with diabetes have altered hippocampal metabolism, which may serve as an early predictive marker. The main modifiable factors have been identified, correction of which may slow down the progression of cognitive dysfunction.
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Affiliation(s)
- Julia Samoilova
- Medical Faculty, Siberian State Medical University, 634050 Tomsk, Russia; (J.S.); (O.T.); (O.O.); (A.K.)
| | - Mariia Matveeva
- Medical Faculty, Siberian State Medical University, 634050 Tomsk, Russia; (J.S.); (O.T.); (O.O.); (A.K.)
- Correspondence: ; Tel.: +7-913-8152-552
| | - Olga Tonkih
- Medical Faculty, Siberian State Medical University, 634050 Tomsk, Russia; (J.S.); (O.T.); (O.O.); (A.K.)
| | - Dmitry Kudlau
- Institute of Immunology, Federal Medical and Biological Agency of Russia, 115478 Moscow, Russia;
| | - Oxana Oleynik
- Medical Faculty, Siberian State Medical University, 634050 Tomsk, Russia; (J.S.); (O.T.); (O.O.); (A.K.)
| | - Aleksandr Kanev
- Medical Faculty, Siberian State Medical University, 634050 Tomsk, Russia; (J.S.); (O.T.); (O.O.); (A.K.)
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17
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Li C, Zhang J, Qiu M, Liu K, Li Y, Zuo Z, Yin X, Lai Y, Fang J, Tong H, Guo Y, Wang J, Chen X, Xiong K. Alterations of Brain Structural Network Connectivity in Type 2 Diabetes Mellitus Patients With Mild Cognitive Impairment. Front Aging Neurosci 2021; 12:615048. [PMID: 33613263 PMCID: PMC7891182 DOI: 10.3389/fnagi.2020.615048] [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: 10/08/2020] [Accepted: 12/30/2020] [Indexed: 12/31/2022] Open
Abstract
Patients with type 2 diabetes mellitus (T2DM) are highly susceptible to developing dementia, especially for those with mild cognitive impairment (MCI), but its underlying cause is still unclear. This study aims to investigate the early detection of white matter structural network changes in T2DM patients with MCI and assess the relationship between cognitive impairment and structural network alterations in T2DM patients. In this study, we performed a battery of neuropsychological tests and diffusion tensor MRI in 30 T2MD-MCI patients, 30 T2DM patients with normal cognition (T2DM-NC) and 30 age-, sex-, and education-matched healthy control (HC) individuals. Cognitive performance exhibited obvious differences among the three groups. The structural network was significantly disrupted in both global and regional levels in T2DM patients. The T2DM-MCI group showed more severe impairment of global network efficiency, and lower nodal efficiency and fewer connections within multiple regions like the limbic system, basal ganglia, and several cortical structures. Moreover, a subnetwork impaired in T2DM-MCI patients was characterized by cortical-limbic fibers, and commissural fibers and pathways within the frontal, temporal, and occipital lobes. These altered global and nodal parameters were significantly correlated with cognitive function in T2DM-MCI patients. In particular, executive dysfunction and working memory impairment in T2DM-MCI patients correlated with nodal efficiency in the right opercular part and triangular part of the inferior frontal gyrus, which indicated that white matter disruption in these regions may act as potential biomarkers for T2DM-associated MCI detection. Our investigation provides a novel insight into the neuropathological effects of white matter network disruption on cognition impairments induced by T2DM.
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Affiliation(s)
- Chang Li
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China.,Department of Radiology, Southwest Hospital, Army Medical University, Chongqing, China
| | - Jingna Zhang
- Department of Medical Imaging, College of Biomedical Engineering, Army Medical University, Chongqing, China
| | - Mingguo Qiu
- Department of Medical Imaging, College of Biomedical Engineering, Army Medical University, Chongqing, China
| | - Kaijun Liu
- Department of Gastroenterology, Daping Hospital, Army Medical University, Chongqing, China
| | - Yang Li
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China
| | - Zhiwei Zuo
- Department of Radiology, General Hospital of Western Theater Command, Chengdu, China
| | - Xuntao Yin
- Department of Medical Imaging, Guizhou Provincial People's Hospital, Guiyang, China
| | - Yuqi Lai
- School of Foreign Languages and Cultures, Chongqing University, Chongqing, China
| | - Jingqin Fang
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China.,Chongqing Clinical Research Center for Imaging and Nuclear Medicine, Chongqing, China
| | - Haipeng Tong
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China
| | - Yu Guo
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China
| | - Jian Wang
- Department of Radiology, Southwest Hospital, Army Medical University, Chongqing, China
| | - Xiao Chen
- Chongqing Clinical Research Center for Imaging and Nuclear Medicine, Chongqing, China.,Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, China
| | - Kunlin Xiong
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China.,Chongqing Clinical Research Center for Imaging and Nuclear Medicine, Chongqing, China
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18
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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: 17] [Impact Index Per Article: 5.7] [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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Shen J, Tozer DJ, Markus HS, Tay J. Network Efficiency Mediates the Relationship Between Vascular Burden and Cognitive Impairment: A Diffusion Tensor Imaging Study in UK Biobank. Stroke 2020; 51:1682-1689. [PMID: 32390549 DOI: 10.1161/strokeaha.119.028587] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background and Purpose- Cerebrovascular disease contributes to age-related cognitive decline, but the mechanisms underlying this phenomenon remain incompletely understood. We hypothesized that vascular risk factors would lead to cognitive impairment through the disruption of brain white matter network efficiency. Methods- Participants were 19 346 neurologically healthy individuals from UK Biobank that underwent diffusion MRI and cognitive testing (mean age=62.6). Global efficiency, a measure of network integration, was calculated from white matter networks constructed using deterministic diffusion tractography. First, we determined whether demographics (age, sex, ethnicity, socioeconomic status, and education), vascular risk factors (hypertension, hypercholesterolemia, diabetes mellitus, smoking, body mass index), and white matter hyperintensities were related to global efficiency using multivariate linear regression. Next, we used structural equation modeling to model a multiple regression. The dependent variable was a latent cognition variable using all cognitive data, while independent variables were a latent factor including all vascular risk factors (vascular burden), demographic variables, white matter hyperintensities, and global efficiency. Finally, we used mediation analysis to determine whether global efficiency explained the relationship between vascular burden and cognition. Results- Hypertension and diabetes mellitus were consistently associated with reduced global efficiency even after controlling for white matter hyperintensities. Structural equation models revealed that vascular burden was associated with cognition (P=0.023), but not after adding global efficiency to the model (P=0.09), suggesting a mediation effect. Mediation analysis revealed a significant indirect effect of global efficiency on cognition through vascular burden (P<0.001), suggesting a partial mediation effect. Conclusions- Vascular burden is associated with reduced global efficiency and cognitive impairment in the general population. Network efficiency partially mediates the relationship between vascular burden and cognition. This suggests that treating specific risk factors may prevent reductions in brain network efficiency and preserve cognitive functioning in the aging population.
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Affiliation(s)
- Jun Shen
- From the Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, United Kingdom (J.S., D.J.T., H.S.M., J.T.).,Department of Neurology, Zhongnan Hospital of Wuhan University, China (J.S.)
| | - Daniel J Tozer
- From the Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, United Kingdom (J.S., D.J.T., H.S.M., J.T.)
| | - Hugh S Markus
- From the Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, United Kingdom (J.S., D.J.T., H.S.M., J.T.)
| | - Jonathan Tay
- From the Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, United Kingdom (J.S., D.J.T., H.S.M., J.T.)
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20
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Lu X, Gong W, Wen Z, Hu L, Peng Z, Zha Y. Correlation Between Diabetic Cognitive Impairment and Diabetic Retinopathy in Patients With T2DM by 1H-MRS. Front Neurol 2019; 10:1068. [PMID: 31781013 PMCID: PMC6861416 DOI: 10.3389/fneur.2019.01068] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 09/23/2019] [Indexed: 12/23/2022] Open
Abstract
Objective: To explore the correlation between diabetic cognitive impairment (DCI) and diabetic retinopathy (DR) through examining the cognitive function and the metabolism of the cerebrum in Type 2 diabetes mellitus (T2DM) by 1H-MRS. Methods: Fifty-three patients with T2DM were enrolled for this study. According to the fundus examination, the patients were divided into the DR group (n = 26) and the T2DM without DR group (T2DM group, n = 27). Thirty healthy adults were selected as a control group (HC group, n = 30). Cognitive function was measured by Montreal Cognitive Assessment (MoCA). The peak areas of N-acetylaspartate (NAA), Cho-line (Cho), Creatine (Cr), and Myo-inositol (mI) as well as their ratios were detected by proton magnetic resonance spectroscopy (1H-MRS). The difference analysis between the three groups was performed by one-way ANOVA. When p < 0.05, LSD-t was applied. A partial correlation analysis (with age as a covariate) was used to analyze the correlation between metabolites in the DR group and MoCA scores. Among all T2DM patients, Chi-square test age, gender, education level, BMI, SBP, DBP, FPG, HbA1c, TC, TG, HDL-C, LDL-C, DR, and DCI correlation were measured. Differences were statistically significant while P < 0.05. Results: 1. The scores of MoCA in the DR group or in the T2DM group were significantly less than those in the HC group (F = 3.54, P < 0.05), and the scores of MoCA in the DR group were significantly less than those in the other groups (F = 3.61, P < 0.05). 2. There were significant differences for NAA in the bilateral hippocampus in DR patients, T2DM patients, and healthy controls (P < 0.05). 3. The NAA/Cr was significantly positively correlated with the score of MoCA in DR patients' left hippocampus (r = 0.781, P < 0.01). 4. Chi-square analysis found that there was a correlation between DR and DCI (x2 = 4.6, df = 1, p = 0.032, plt: 0.05). There was no correlation between other influencing factors and DCI (P > 0.05). Conclusion: DCI is closely correlated with the DR in patients with T2DM. Hippocampal brain metabolism may have some changes in two sides of NAA in patients with DR, 1H-MRS may provide effective imaging strategies and methods for the early diagnosis of brain damage and quantitative assessment cognitive function in T2DM.
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Affiliation(s)
- Xuefang Lu
- Department of Radiology, Renmin Hospital, Wuhan, China
| | - Wei Gong
- Department of Radiology, Renmin Hospital, Wuhan, China
| | - Zhi Wen
- Department of Radiology, Renmin Hospital, Wuhan, China
| | - Lanhua Hu
- Department of Radiology, Renmin Hospital, Wuhan, China
| | - Zhoufeng Peng
- Department of Radiology, Renmin Hospital, Wuhan, China
| | - Yunfei Zha
- Department of Radiology, Renmin Hospital, Wuhan, China
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21
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Sanjari Moghaddam H, Ghazi Sherbaf F, Aarabi MH. Brain microstructural abnormalities in type 2 diabetes mellitus: A systematic review of diffusion tensor imaging studies. Front Neuroendocrinol 2019; 55:100782. [PMID: 31401292 DOI: 10.1016/j.yfrne.2019.100782] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 07/27/2019] [Accepted: 08/07/2019] [Indexed: 12/13/2022]
Abstract
Type 2 diabetes mellitus (T2DM) is associated with deficits in the structure and function of the brain. Diffusion tensor imaging (DTI) is a highly sensitive method for characterizing cerebral tissue microstructure. Using PRISMA guidelines, we identified 29 studies which have demonstrated widespread brain microstructural impairment and topological network disorganization in patients with T2DM. Most consistently reported structures with microstructural abnormalities were frontal, temporal, and parietal lobes in the lobar cluster; corpus callosum, cingulum, uncinate fasciculus, corona radiata, and internal and external capsules in the white matter cluster; thalamus in the subcortical cluster; and cerebellum. Microstructural abnormalities were correlated with pathological derangements in the endocrine profile as well as deficits in cognitive performance in the domains of memory, information-processing speed, executive function, and attention. Altogether, the findings suggest that the detrimental effects of T2DM on cognitive functions might be due to microstructural disruptions in the central neural structures.
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Affiliation(s)
| | - Farzaneh Ghazi Sherbaf
- Neuroradiology Division, Tehran University of Medical Sciences, School of Medicine, Tehran, Iran
| | - Mohammad Hadi Aarabi
- Neuroradiology Division, Tehran University of Medical Sciences, School of Medicine, Tehran, Iran.
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22
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Zhang X, Huang-Fu Z, Lang XY, Chun P, Chi YY, Yuan XY, Wang XG. Pathological and cognitive changes in patients with type 2 diabetes mellitus and comorbid MCI and protective hypoglycemic therapies: a narrative review. Rev Neurosci 2019; 30:757-770. [PMID: 31199776 DOI: 10.1515/revneuro-2018-0083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 01/30/2019] [Indexed: 01/04/2023]
Abstract
Type 2 diabetes mellitus (T2DM) is becoming a significant health issue worldwide. Many studies support the hypothesis that patients with T2DM have a higher-than-expected incidence of mild cognitive impairment (MCI) than individuals without diabetes. Based on the results from recent studies, MCI might be associated with the effects of T2DM on glucose metabolism and brain atrophy. As a narrative review, we will illuminate pathological and cognitive changes in patients with T2DM and comorbid MCI and protective hypoglycemic therapies. The early abnormal signs of cognition must be elucidated, and extensive investigations are needed to develop improved therapies for use in the clinic.
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Affiliation(s)
- Xiao Zhang
- The First Affiliated Hospital of Dalian Medical University, Dalian 116000, P.R. China
| | - Zhao Huang-Fu
- The Second Affiliated Hospital of Dalian Medical University, Dalian 116027, P.R. China
| | - Xing-Ying Lang
- Dalian Center for Disease Control and Prevention, Dalian 116021, P.R. China
| | - Pu Chun
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian 16044, P.R. China
| | - Yan-Yan Chi
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian 16044, P.R. China
| | - Xiao-Ying Yuan
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian 16044, P.R. China
| | - Xu-Gang Wang
- Department of Neurology, The Second Affiliated Hospital of Dalian Medical University, Dalian 116027, P.R. China
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23
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Qin C, Liang Y, Tan X, Leng X, Lin H, Zeng H, Zhang C, Yang J, Li Y, Zheng Y, Qiu S. Altered Whole-Brain Functional Topological Organization and Cognitive Function in Type 2 Diabetes Mellitus Patients. Front Neurol 2019; 10:599. [PMID: 31275222 PMCID: PMC6593281 DOI: 10.3389/fneur.2019.00599] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 05/21/2019] [Indexed: 12/18/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is associated with cognitive dysfunction and may even progress to dementia. However, the underlying mechanism of altered functional topological organization and cognitive impairments remains unclear. This study explored the topological properties of functional whole brain networks in T2DM patients with graph theoretical analysis using a resting-state functional magnetic resonance imaging (rs-fMRI) technique. Thirty T2DM patients (aged 51.77 ± 1.42 years) and 30 sex-, age-, and education-matched healthy controls (HCs) (aged 48.87 ± 0.98 years) underwent resting-state functional imaging in a 3.0 T MR scanner in addition to detailed neuropsychological and laboratory tests. Then, graph theoretical network analysis was performed to explore the global and nodal topological alterations in the functional whole brain networks of the T2DM patients. Finally, correlation analyses were performed to investigate the relationship between the altered topological parameters, cognitive performances and clinical variables. Compared to HCs, we found that T2DM patients displayed worse performances in general cognitive function and several cognitive domains, including episodic memory, attention and executive function. In addition, T2DM patients showed a higher small-worldness (σ), a higher normalized clustering coefficient (γ) and a higher local efficiency (Eloc). Moreover, decreased nodal topological properties were mainly distributed in the occipital lobes, frontal lobes, left median cingulate and paracingulate gyri, and left amygdala, while increased nodal topological properties were mainly distributed in the right gyrus rectus, right anterior cingulate and paracingulate gyri, right posterior cingulate gyrus, bilateral caudate nucleus, bilateral cerebellum 3, bilateral cerebellum crus 1, vermis (1, 2) and vermis 3. Some disrupted nodal topological properties were correlated with cognitive performance and HbA1c levels in T2DM patients. This study shows altered functional topological organization in T2DM patients, mainly suggesting a compensation mechanism of the functional whole brain network in the relatively early stage to counteract cognitive impairments.
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Affiliation(s)
- Chunhong Qin
- Department of Radiology, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yi Liang
- Department of Radiology, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xin Tan
- Department of Radiology, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xi Leng
- Department of Radiology, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Huan Lin
- Department of Radiology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Hui Zeng
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chi Zhang
- Department of Radiology, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jinquan Yang
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yifan Li
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yanting Zheng
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shijun Qiu
- Department of Radiology, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangzhou University of Chinese Medicine, Guangzhou, China
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24
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Deteriorated functional and structural brain networks and normally appearing functional–structural coupling in diabetic kidney disease: a graph theory-based magnetic resonance imaging study. Eur Radiol 2019; 29:5577-5589. [DOI: 10.1007/s00330-019-06164-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 02/18/2019] [Accepted: 03/14/2019] [Indexed: 01/25/2023]
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25
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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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26
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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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27
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Huang X, Tong Y, Qi CX, Xu YT, Dan HD, Shen Y. Disrupted topological organization of human brain connectome in diabetic retinopathy patients. Neuropsychiatr Dis Treat 2019; 15:2487-2502. [PMID: 31695385 PMCID: PMC6717727 DOI: 10.2147/ndt.s214325] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 08/03/2019] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE There is increasing neuroimaging evidence that type 2 diabetes patients with retinal microvascular complications show abnormal brain functional and structural architecture and are at an increased risk of cognitive decline and dementia. However, changes in the topological properties of the functional brain connectome in diabetic retinopathy (DR) patients remain unknown. The aim of this study was to explore the topological organization of the brain connectome in DR patients using graph theory approaches. METHODS Thirty-five DR patients (18 males and 17 females) and 38 healthy controls (HCs) (18 males and 20 females), matched for age, sex, and education, underwent resting-state magnetic resonance imaging scans. Graph theory analysis was performed to investigate the topological properties of brain functional connectome at both global and nodal levels. RESULTS Both DR and HC groups showed high-efficiency small-world network in their brain functional networks. Notably, the DR group showed reduction in the clustering coefficient (P=0.0572) and local efficiency (P=0.0151). Furthermore, the DR group showed reduced nodal centralities in the default-mode network (DMN) and increased nodal centralities in the visual network (VN) (P<0.01, Bonferroni-corrected). The DR group also showed abnormal functional connections among the VN, DMN, salience network (SN), and sensorimotor network (SMN). Altered network metrics and nodal centralities were significantly correlated with visual acuity and fasting blood glucose level in DR patients. CONCLUSION DR patients showed abnormal topological organization of the human brain connectome. Specifically, the DR group showed reduction in the clustering coefficient and local efficiency, relative to HC group. Abnormal nodal centralities and functional disconnections were mainly located in the DMN, VN, SN, and SMN in DR patients. Furthermore, the disrupted topological attributes showed correlations with clinical variables. These findings offer important insight into the neural mechanism of visual loss and cognitive deficits in DR patients.
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Affiliation(s)
- Xin Huang
- Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, People's Republic of China
| | - Yan Tong
- Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, People's Republic of China
| | - Chen-Xing Qi
- Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, People's Republic of China
| | - Yang-Tao Xu
- Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, People's Republic of China
| | - Han-Dong Dan
- Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, People's Republic of China
| | - Yin Shen
- Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, People's Republic of China
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28
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Flores-Gómez AA, de Jesús Gomez-Villalobos M, Flores G. Consequences of diabetes mellitus on neuronal connectivity in limbic regions. Synapse 2018; 73:e22082. [PMID: 30457679 DOI: 10.1002/syn.22082] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 10/25/2018] [Accepted: 11/15/2018] [Indexed: 12/18/2022]
Abstract
Diabetes mellitus (DM) is characterized by high levels of blood glucose. In recent years, its prevalence has increased, which was 422 million in the world in 2014. In elderly patients, DM is associated with deficits in memory and learning processes. The cognitive deficits lead to dementia. With the development of animal models in DM, it has been possible to better understand quantitative morphological changes in numerous neuronal structures belonging to the limbic system, such as the prefrontal cortex (PFC), the hippocampus and basolateral amygdala (BLA). These structures are in close relationship with processes of memory and learning. Several reports have demonstrated that chronic hyperglycemia reduces spinogenesis and dendritic arborization in the aforementioned regions along with a decline in memory and learning processes, especially in streptozotocin (STZ)-induced diabetic rats. In the present review, we discuss animal models, the effects of chronic hyperglycemia on dendritic morphology of limbic regions and memory and learning processes, the effect on neural transmission in these regions, the pathologic mechanisms involved, and the relevance of dendritic morphology in diabetes. All of this information can help us to have a better understanding of dementia in diabetes mellitus and propose strategies for its prevention and treatment.
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Affiliation(s)
| | | | - Gonzalo Flores
- Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, México
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29
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Xie Y, Chu A, Feng Y, Chen L, Shao Y, Luo Q, Deng X, Wu M, Shi X, Chen Y. MicroRNA-146a: A Comprehensive Indicator of Inflammation and Oxidative Stress Status Induced in the Brain of Chronic T2DM Rats. Front Pharmacol 2018; 9:478. [PMID: 29867484 PMCID: PMC5960742 DOI: 10.3389/fphar.2018.00478] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 04/23/2018] [Indexed: 12/24/2022] Open
Abstract
Objective: It was demonstrated that inflammation and oxidative stress induced by hyperglycemia were closely associated with alteration of miR-146a. Here, we investigated the role of miR-146a in mediating inflammation and oxidative stress in the brain of chronic T2DM rats. Methods: The chronic T2DM (cT2DM) models were induced by intraperitoneal administration of STZ (35 mg/kg) after being fed a high-fat, high-sugar diet for 6 weeks. H&E staining was conducted to observe the morphological impairment of the rat hippocampus. The expressions of inflammatory mediators (COX-2, TNF-α, IL-1β) and antioxidant proteins (Nrf2, HO-1) were measured by western blot. The levels of MDA and SOD were detected by the respective activity assay kit. The levels of p22phox and miR-146a were examined by quantitative real-time PCR (qRT-PCR). The expressions of IRAK1, TRAF6 and NF-κB p65 were measured by western blot and qRT-PCR. Pearson correlation analysis was performed to investigate the correlations between miR-146a and inflammatory mediators as well as oxidative stress indicators. Results: The expression of miR-146a was negatively correlated with inflammation and oxidative stress status. In the brain tissues of cT2DM rats, it was observed that the expressions of inflammatory mediators (COX-2, TNF-α, IL-1β) and oxidative stress indicators including MDA and p22phox were elevated, which were negatively correlated with the expression of miR-146a. While, the antioxidant proteins (Nrf2, HO-1, SOD) levels decreased in the brain of cT2DM rats, which were positively correlated with the miR-146a level. The expressions of NF-κB p65 and its specific modulators (IRAK1&TRAF6) were elevated in the brain of cT2DM rats, which might be inhibited by miR-146a. Conclusion: Our results implied that increased inflammation and oxidative stress status were associated with brain impairment in cT2DM rats, which were negatively correlated with miR-146a expression. Thus, miR-146a may serve as a negative comprehensive indicator of inflammation and oxidative stress status in the brain of chronic T2DM rats.
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Affiliation(s)
- Yangmei Xie
- Department of Neurology, Jinshan Hospital, Fudan University, Shanghai, China
| | - Aiqun Chu
- Department of General Medicine, Shihua Community Health Service Center, Shanghai, China
| | - Yonghao Feng
- Department of Endocrinology, Jinshan Hospital, Fudan University, Shanghai, China
| | - Long Chen
- Department of Neurology, Jinshan Hospital, Fudan University, Shanghai, China
| | - Yiye Shao
- Department of Neurology, Jinshan Hospital, Fudan University, Shanghai, China
| | - Qiong Luo
- Department of Neurology, Jinshan Hospital, Fudan University, Shanghai, China
| | - Xiaolin Deng
- Department of Neurology, Jinshan Hospital, Fudan University, Shanghai, China
| | - Men Wu
- Department of Endocrinology, Jinshan Hospital, Fudan University, Shanghai, China
| | - Xiaohong Shi
- Department of Endocrinology, Jinshan Hospital, Fudan University, Shanghai, China
| | - Yinghui Chen
- Department of Neurology, Huashan Hospital North, Fudan University, Shanghai, China
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30
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Chen GQ, Zhang X, Xing Y, Wen D, Cui GB, Han Y. Resting-state functional magnetic resonance imaging shows altered brain network topology in Type 2 diabetic patients without cognitive impairment. Oncotarget 2017; 8:104560-104570. [PMID: 29262661 PMCID: PMC5732827 DOI: 10.18632/oncotarget.21282] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Accepted: 08/25/2017] [Indexed: 01/19/2023] Open
Abstract
We analyzed topology of brain functional networks in type 2 diabetes mellitus (T2DM) patients without mild cognitive impairment. We recruited T2DM patients without mild cognitive impairment (4 males and 8 females) and healthy control subjects (8 males and 16 females) to undergo cognitive testing and resting-state functional magnetic resonance imaging. Graph theoretical analysis of functional brain networks revealed abnormal small-world architecture in T2DM patients as compared to control subjects. The functional brain networks of T2DM patients showed increased path length, decreased global efficiency and disrupted long-distance connections. Moreover, reduced nodal characteristics were distributed in the frontal, parietal and temporal lobes, while increased nodal characteristics were distributed in the frontal, occipital lobes, and basal ganglia in the T2DM patients. The disrupted topological properties correlated with cognitive performance of T2DM patients. These findings demonstrate altered topological organization of functional brain networks in T2DM patients without mild cognitive impairment.
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Affiliation(s)
- Guan-Qun Chen
- Department of Neurology, XuanWu Hospital, Capital Medical University, Beijing, China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China.,National Clinical Research Center for Geriatric Disorders, Beijing, China
| | - Xin Zhang
- Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Yue Xing
- Radiological Sciences, Division of Clinical Neuroscience, Queen's Medical Centre, University of Nottingham, Nottingham, United Kingdom.,Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Dong Wen
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China.,The Key Laboratory of Software Engineering of Hebei Province, Yanshan University, Qinhuangdao, China
| | - Guang-Bin Cui
- Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Ying Han
- Department of Neurology, XuanWu Hospital, Capital Medical University, Beijing, China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China.,National Clinical Research Center for Geriatric Disorders, Beijing, China.,Beijing Institute of Geriatrics, Beijing, China.,PKUCare Rehabilitation Hospital, Beijing, China
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31
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Venkat P, Chopp M, Chen J. Blood-Brain Barrier Disruption, Vascular Impairment, and Ischemia/Reperfusion Damage in Diabetic Stroke. J Am Heart Assoc 2017; 6:e005819. [PMID: 28572280 PMCID: PMC5669184 DOI: 10.1161/jaha.117.005819] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Poornima Venkat
- Department of Neurology Research, Henry Ford Hospital, Detroit, MI
| | - Michael Chopp
- Department of Neurology Research, Henry Ford Hospital, Detroit, MI
- Department of Physics, Oakland University, Rochester, MI
| | - Jieli Chen
- Department of Neurology Research, Henry Ford Hospital, Detroit, MI
- Neurological & Gerontology Institute, Neurology, Tianjin Medical University General Hospital, Tianjin, China
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32
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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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Cermenati G, Giatti S, Audano M, Pesaresi M, Spezzano R, Caruso D, Mitro N, Melcangi RC. Diabetes alters myelin lipid profile in rat cerebral cortex: Protective effects of dihydroprogesterone. J Steroid Biochem Mol Biol 2017; 168:60-70. [PMID: 28167298 DOI: 10.1016/j.jsbmb.2017.02.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 01/31/2017] [Accepted: 02/02/2017] [Indexed: 12/31/2022]
Abstract
Due to the emerging association of diabetes with several psychiatric and neurodegenerative events, the evaluation of the effects of this pathology on the brain function has now a high priority in biomedical research. In particular, the effects of diabetes on myelin compartment have been poorly taken into consideration. To this purpose, we performed a deep lipidomic analysis of cortical myelin in the streptozotocin-induced diabetic rat model. In male rats three months of diabetes induced an extensive alterations in levels of phosphatidylcholines and phosphatidylethanolamines (the main species present in myelin membranes), plasmalogens as well as phosphatidylinositols and phosphatidylserines. In addition, the levels of cholesterol and myelin basic protein were also decreased. Because these lipids exert important functional and structural roles in the myelin compartment, our data indicate that cerebral cortex myelin is severely compromised in diabetic status. Treatment for one-month with a metabolite of progesterone, dihydroprogesterone, restored the lipid and protein myelin profiles to the levels observed in non-diabetic animals. These data suggest the potential of therapeutic efficacy of DHP to restore myelin in the diabetic brain.
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Affiliation(s)
- Gaia Cermenati
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milano, Italy
| | - Silvia Giatti
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milano, Italy
| | - Matteo Audano
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milano, Italy
| | - Marzia Pesaresi
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milano, Italy
| | - Roberto Spezzano
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milano, Italy
| | - Donatella Caruso
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milano, Italy
| | - Nico Mitro
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milano, Italy.
| | - Roberto Cosimo Melcangi
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milano, Italy.
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