scholarly journals Increased Brain Iron Deposition in the Putamen in Patients with Type 2 Diabetes Mellitus Detected by Quantitative Susceptibility Mapping

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Jing Li ◽  
Qihao Zhang ◽  
Nan Zhang ◽  
Lingfei Guo
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Central Nervous System ◽  
Type 2 Diabetes Mellitus ◽  
Cognitive Assessment ◽  
Iron Deposition ◽  
Brain Iron ◽  
Quantitative Susceptibility Mapping ◽  
Brain Iron Deposition

Background. The underlying brain structural changes in type 2 diabetes mellitus (T2DM) patients have attracted increasing attention. The insulin-resistant state causes iron overload in neurons and leads to lesions in the central nervous system. Quantitative susceptibility mapping (QSM) can provide a noninvasive quantitative analysis of brain iron deposition. We aimed to compare the difference of brain iron deposition in the gray matter nucleus between T2DM patients and healthy elderly individuals using QSM. Methods. Thirty-two T2DM patients and thirty-two age- and gender-matched healthy controls (HCs) were enrolled in this research. Twenty-three patients and twenty-six HCs underwent cognitive assessments. Brain QSM maps were computed from multiecho GRE data using morphology-enabled dipole inversion with automatic uniform cerebrospinal fluid zero reference algorithm (MEDI+0). ITK-SNAP was used to measure the susceptibility values reflecting the content of iron in the regions of interest (ROIs). Results. The study included thirty-two T2DM patients (20 males and 12 females; mean age of 61.09±9.99 years) and 32 HCs (14 males and 18 females; mean age of 59.09±9.77 years). These participants had no significant difference in age or gender (P>0.05). Twenty-three patients with T2DM (11 males and 12 females; mean age, 64.65±8.44 years) and twenty-six HCs (14 males and 12 females; mean age, 62.30±6.13 years) received an assessment of cognitive function. T2DM patients exhibited an obviously (t=3.237, P=0.003) lower Montreal Cognitive Assessment (MoCA) score (26.78±2.35; HCs, 28.42±0.64; normal standard ≥26) and a higher Stroop color-word test (SCWT)-C score [87(65,110); HC, 63(60,76.75), Z=−2.232, P=0.003] than HCs. The mean susceptibility values in the putamen appeared obviously higher in T2DM patients than in HCs (t=−3.994, P<0.001). The susceptibility values and cognitive assessment scores showed no obvious association (P>0.05). However, an obvious correlation was observed between the changes in the susceptibility values in the putamen and the thalamus/dentate nucleus (r=0.404, P<0.001; r=0.423, P<0.001). Conclusion. T2DM patients showed increased susceptibility values in the putamen and had declines in executive functions, but the linear association between them was not statistically significant. Changes in susceptibility values in the putamen indicated increased iron deposition and might be used as a quantitative imaging marker of central nervous system injury in T2DM patients. QSM might be able to help probe micro neuronal damage in gray matter and provide information on diabetic encephalopathy.

scholarly journals Diabetes control, dyslipidemia, hsCRP and mild cognitive impairment in non-elderly people with type 2 diabetes mellitus

2019 ◽  
Vol 7 (2) ◽  
pp. 372
Author(s):  
Naveen Kumar ◽  
Veer Bahadur Singh ◽  
Babu Lal Meena ◽  
Deepak Kumar ◽  
Harish Kumar ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Assessment ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Low Density

Background: Mild Cognitive Impairment (MCI) a transitional stage between normal aging and dementia has been observed more in people with diabetes when compared with general population. The risk factors for MCI in type 2 diabetes mellitus (T2DM) have been defined in elderly patients and aging may itself contribute to declining in cognitive functions. As the large number people with T2DM are under 60years, the prevalence of MCI and factors contributing to it are not much studied. So, this study aimed to find out the factors contributing to MCI in non-elderly T2DM patients.Methods: In this cross-sectional study, 257 patients with T2DM underwent cognitive assessment by Montreal cognitive assessment test and the cognitive levels were correlated with their glycosylated hemoglobin, lipid profile, and highly sensitive C-reactive protein (hsCRP).Results: The prevalence of mild cognitive impairment (MCI) was 64.2%.  MCI significantly correlated with duration of diabetes, socioeconomic status, HbA1c, serum triglycerides, low-density lipoprotein, very low-density lipoprotein and hsCRP levels. The factors that were statistically insignificant were body mass index and high-density lipoprotein levels.Conclusions: Cognitive impairment is seen even in non-elderly T2DM patients. It should be considered along with the other complications of diabetes and individuals with T2DM should be screened for cognitive impairment to prevent progression to dementia.

scholarly journals Type 2 diabetes mellitus: A central nervous system etiology

2010 ◽  
Vol 1 (1) ◽  
pp. 31 ◽  
Author(s):  
PeterJ Jannetta ◽  
LynnH Fletcher ◽  
PeterM Grondziowski ◽  
KennethF Casey ◽  
RaymondF Sekula
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Central Nervous System ◽  
Nervous System ◽  
Type 2 Diabetes Mellitus

scholarly journals Perinatal changes in plasma of type 2 diabetes mellitus pregnancies who delivered newborns with cardiomyopathy, depression of the central nervous system, or hepatomegaly

2020 ◽  
Author(s):  
Arthur T. Kopylov ◽  
Olga Papysheva ◽  
Iveta Gribova ◽  
Anna L. Kaysheva ◽  
Galina Kotaysch ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Central Nervous System ◽  
Nervous System ◽  
Type 2 Diabetes Mellitus ◽  
Maternal Diabetes ◽  
Controlled Study ◽  
Cross Sectional ◽  
Peripheral Blood Plasma

Abstract Background Maternal diabetes either pregestational or gestational is the main risk factor contributing in development of diabetic fetopathy (DF) in newborns. There are no generalized signs of DF up to late gestational age due to insufficient sensitivity of the currently employed instrumental methods for diagnosis. Methods This is a cross-sectional prospective controlled study. Here, we reported proteomic investigation for several cases of severe types of diabetic fetopathy (cardiomyopathy (CRDM, n = 37), central nervous system depression (CNSD, n = 35) and hepatomegaly (HPMG, n = 35)) diagnosed during 30–35 gestational weeks and confirmed upon delivery by from patients with type 2 diabetes mellitus (T2DM). Control groups were comprised from women in whom T2DM had been ruled out (n = 40) and group of pregnancies with T2DM who delivered healthy newborns (n = 40). Results We found a composition of serum-based non-trivial markers capable that are strongly associated with the certain type of fetopathy or anatomical malfunctions in the affected newborns. Significant impact on mRNA splicing and DNA reparation has been determined by emerging alterations in CDCL5. Patients of CNSD groups were characterized by utmost depletion (ca. 7% of baseline) of DFP3 neurotrophic factor needed for the proper specialization of cardiomyocytes and oligodendrocytes. Corrupted regulation of non-canonical Wnt-signaling guided by PEDF (in CNSD and HPMG groups) and DAAM2 (in CRDM and HPMG groups) was also proposed. In addition, deficiency in retinoic acid and thyroxine transport was revealed by dramatic increase of TTHY in CNDS group. Conclusions We examined peripheral blood plasma and determined a small proportion of proteins indicating the pre-existing signs of DF. Most of the examined markers are participants of critical processes at different stages of embryogenesis and regulate various phases of morphogenesis. There are proteins regulating splicing and DNA repair, differentiation of neurons and their switching to the post-mitotic state. Therefore, reconstruction of the molecular interplay between the defined in proteins is decisive to appreciate cryptic violations in fetal development on the background of diabetic conditions

scholarly journals Increased Brain Iron Detection by Voxel-Based Quantitative Susceptibility Mapping in Type 2 Diabetes Mellitus Patients With an Executive Function Decline

2021 ◽  
Vol 14 ◽  
Author(s):  
Jing Li ◽  
Qihao Zhang ◽  
Nan Zhang ◽  
Lingfei Guo
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Executive Function ◽  
Cognitive Function ◽  
Significant Relationship ◽  
Brain Iron ◽  
Quantitative Susceptibility Mapping ◽  
Left Thalamus ◽  
The Right

PurposeBrain iron accumulation has been suggested as a pathomechanism in patients with type 2 diabetes mellitus (T2DM) with cognitive impairment. This research aims to examine the total-brain pattern of iron accumulation in relation to executive function decline in patients with T2DM by voxel-based quantitative susceptibility mapping (QSM) analysis.Materials and MethodsA total of 32 patients with T2DM and 34 age- and sex-matched healthy controls (HCs) were enrolled in this study. All participants underwent brain magnetic resonance examination, and 48 individuals underwent cognitive function assessments. Imaging data were collected with three-dimensional fast low-angle shot sequences to achieve magnitude as well as phase images. Using voxel-based QSM analysis, we compared the voxel-wise susceptibility values of the whole brain among groups and explored whether the susceptibility values had correlations with cognitive data.ResultsAmong the 66 participants, cognitive function was estimated in 23 patients with T2DM (11 males and 12 females; average age, 64.65 ± 8.44 years) and 25 HCs (13 males and 12 females; average age, 61.20 ± 7.62 years). T2DM patients exhibited significantly (t = 4.288, P &lt; 0.001) lower Montreal Cognitive Assessment (MoCA) scores [T2DM, 27 (27, 28); HCs, 29 (28, 29); normal standard ≥ 26)] and higher Trail-making Test (TMT)-A/TMT-B scores [71 (51, 100)/185 (149, 260)] than HCs [53 (36.5, 63.5)/150 (103, 172.5)] (Z = 2.612, P = 0.009; Z = 2.797, P = 0.005). Subjects with T2DM showed significantly higher susceptibility values than HCs in the caudate/putamen/pallidum, frontal inferior triangular gyrus, and precentral gyrus on the right hemisphere. In contrast (HC &gt; T2DM), no region showed a significant difference in susceptibility values between the groups. The correlation analysis between susceptibility values and cognitive function scores was tested by voxel-based susceptibility value with sex and age as covariates. After multiple comparison correction, in T2DM patients, the left thalamus showed a significant relationship with TMT-A (R2 = 0.53, P = 0.001). The right thalamus and left thalamus showed a significant relationship with TMT-B (R2 = 0.35, P = 0.019; and R2 = 0.38, P = 0.017, respectively). In HCs, the cluster of right precentral/middle frontal gyrus/inferior frontal gyrus/inferior triangular gyrus showed a significant relationship with TMT-B (R2 = 0.59, P = 0.010). No relationship was found between the susceptibility values with MoCA in the brain region in both two groups.ConclusionPatients with T2DM presented declined cognitive assessments and elevated iron deposition in the striatum and frontal lobe, suggesting that executive function decline in T2DM might be associated with the cerebral iron burden and that changes in susceptibility values may represent a latent quantitative imaging marker for early assessment of cognitive decline in patients with T2DM.

scholarly journals Quantitative susceptibility mapping of brain iron deposition in patients with type 2 diabetes mellitus

2020 ◽  
Author(s):  
Jing Li ◽  
Qihao Zhang ◽  
Nan Zhang ◽  
Lingfei Guo
Keyword(s):  
Dentate Nucleus ◽  
Iron Deposition ◽  
Healthy Controls ◽  
Brain Iron ◽  
Quantitative Susceptibility Mapping ◽  
Age And Gender ◽  
Left Thalamus ◽  
And Gender ◽  
Brain Iron Deposition

Abstract Background Noninvasive quantitative susceptibility mapping (QSM) analysis was applied to assess brain iron deposition in the gray matter nucleus in type 2 diabetes mellitus (T2DM) patients and healthy elderly individuals.Methods Thirty-two T2DM patients and thirty-two age- and gender-matched healthy controls (HCs) were enrolled in this research. All participants underwent brain magnetic resonance examinations. Twenty-three DM patients and twenty-six healthy controls received cognitive function assessments. Imaging data were collected with three-dimensional fast low-angle shot sequences to obtain magnitude and phase images; with preprocessed QSM data, ITK-SNAP helped to measure the susceptibility values reflecting the content of iron in the regions of interest (ROIs).Results The study included thirty-two T2DM patients (20 males and 12 females; mean age of 61.09 ± 9.99 years) and 32 HCs (14 males and 18 females; mean age of 59.09 ± 9.77 years). These participants were age- and gender-matched, with no significant difference (P > 0.05). T2DM patients exhibited an obviously (P < 0.05) lower MoCA score (26.78 ± 2.35; normal standard, ≥ 27) and higher SCWT score (157 (128,188); HC, 123 (112,152)) than HCs. The mean susceptibility values in the left putamen and right putamen as well as dentate nucleus in the left thalamus appeared obviously higher in T2DM patients than in HCs (P < 0.05). In all participants, the susceptibility values in the left dentate nucleus were significantly higher than those in the right side (P < 0.05). The susceptibility values and cognitive assessment scores showed no obvious association (P > 0.05). However, an obvious correlation exists between the changes in the susceptibility values across hemispheres in the dentate nucleus and the putamen (left, r = 0.439, P = 0.000; right, r = 0.260, P = 0.038).Conclusion T2DM patients showed increased iron deposition in the putamen, dentate nucleus and left thalamus. Cerebral iron deposition exacerbates cognitive decline in T2DM patients. Changes in susceptibility values in these regions are likely to be quantitative imaging markers of central nervous system injury in T2DM patients, and QSM may benefit their detection and evaluation.

scholarly journals Montreal Cognitive Assessment Is Superior to Standardized Mini-Mental Status Exam in Detecting Mild Cognitive Impairment in the Middle-Aged and Elderly Patients with Type 2 Diabetes Mellitus

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Kannayiram Alagiakrishnan ◽  
Nancy Zhao ◽  
Laurie Mereu ◽  
Peter Senior ◽  
Ambikaipakan Senthilselvan
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Assessment ◽  
Predictive Values ◽  
Mini Mental Status Exam ◽  
Mental Status Exam

Aim. This study compares the usefulness of Montreal Cognitive Assessment (MoCA) to Standardized Mini-Mental Status Exam (SMMSE) for diagnosing mild cognitive impairment (MCI) in Type 2 diabetes mellitus (DM) population.Methods. This prospective pilot study enrolled 30 community dwelling adults with Type 2 DM aged 50 years and above. Subjects were assessed using both the SMMSE and MoCA for MCI. In all subjects, depression and dementia were ruled out using the DSM IV criteria, and a functional assessment was done. MCI was diagnosed using the standard test, the European consortium criteria. Sensitivity and specificity analysis, positive and negative predictive values, likelihood ratios and Kappa statistic were calculated.Results. In comparison to consortium criteria, the sensitivity and specificity of MoCA were 67% and 93% in identifying individuals with MCI, and SMMSE were 13% and 93%, respectively. The positive and negative predictive values for MoCA were 84% and 56%, and for SMMSE were 66% and 51%, respectively. Kappa statistics showed moderate agreement between MoCA and consortium criteria (kappa = 0.4) and a low agreement between SMMSE and consortium criteria (kappa = 0.07).Conclusion. In this pilot study, MoCA appears to be a better screening tool than SMMSE for MCI in the diabetic population.

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