scholarly journals Spatiotemporal Dynamics of Cerebral Vascular Permeability in Type 2 Diabetes-Related Cerebral Microangiopathy

2022 ◽  
Vol 12 ◽  
Author(s):  
Ying-Chen Chen ◽  
Bing-Ze Lu ◽  
Yu-Chen Shu ◽  
Yuan-Ting Sun
Keyword(s):  
Type 2 Diabetes ◽  
Vascular Permeability ◽  
Small Vessel Disease ◽  
Spatiotemporal Dynamics ◽  
Perivascular Spaces ◽  
Differential Correlation ◽  
Contrast Enhanced ◽  
Cerebral Microangiopathy ◽  
Cerebral Vascular

AimsDiabetes-related cerebral microangiopathy can manifest as cerebral small vessel disease (CSVD) and exhibit cognitive decline. To find the early change of function in advance, this study examined the spatiotemporal dynamics of cerebral vascular permeability (Ktrans) in the progression of type 2 diabetes mellitus (T2DM).MethodsKtrans was cross-sectionally measured in T2DM and non-diabetes groups with or without CSVD using dynamic contrast-enhanced MRI (DCE-MRI).ResultsIn all patients with T2DM, the Ktrans of white matter (WM) was increased, whereas the Ktrans of gray matter (GM) was increased only in T2DM with CSVD. The involvement of WM was earlier than GM and was before the CSVD features could be visualized on MRI. Among the commonly available four CSVD items of MRI, microbleeds were the most sensitive, indicating the increased permeability in all patients. Increased Ktrans in T2DM was more associated with moderate WM hyperintensity but less with the presence of lacunae or multiple perivascular spaces, in contrast to patients without diabetes. The differential correlation suggested distinct mechanisms underlying diabetes-related CSVD and other CSVDs.ConclusionsThis study highlights the early development of cerebral microangiopathy with increased BBB leakage in T2DM, before the CSVD features can be visualized on MRI. The results may increase the proactivity of clinicians in recognizing the subsequent neurological comorbidities.

scholarly journals Spatiotemporal Dynamics of Cerebral Vascular Permeability in Type 2 Diabetes-Related Cerebral Microangiopathy

2021 ◽  
Author(s):  
Ying-Chen Chen ◽  
Bing-Ze Lu ◽  
Yu-Chen Shu ◽  
Yuan-Ting Sun
Keyword(s):  
Vascular Permeability ◽  
Small Vessel Disease ◽  
Spatiotemporal Dynamics ◽  
Diabetic Patients ◽  
Perivascular Spaces ◽  
Dce Mri ◽  
Differential Correlation ◽  
Contrast Enhanced ◽  
Cerebral Microangiopathy ◽  
Cerebral Vascular

Abstract Objective Diabetes-related cerebral microangiopathy can manifest as cerebral small vessel disease (CSVD) and exhibit cognitive decline. To find the early change of function in advance, this study examined the spatiotemporal dynamics of cerebral permeability (Ktrans) in the progression of diabetes-related CSVD. Methods Cerebral vascular permeability was crossectional measured in diabetic patients with or without CSVD, and non-diabetic patients with or without CSVD by using dynamic contrast-enhanced MRI (DCE-MRI). Results In all diabetic patients, the Ktrans of white matter (WM) was increased. However, the Ktrans of gray matter (GM) was only increased in those with CSVD. This suggested the earlier involvement of WM than GM and indicated the development of diabetes-related cerebral microangiopathy was prior to it could be visualized as features of CSVD on MRI. To broaden the application of cerebral permeability and overcome the limitations of DCE-MRI, the commonly available CSVD items of MRI were used to indicate the increase in Ktrans. Among all CSVD items, the presence of microbleeds was most correlated with the increased permeability in all patients. In contrast to non-diabetic patients, increased Ktrans in diabetes was more associated with moderate WM hyperintensity but less with the presence of lacunae or multiple perivascular spaces. The differential correlation suggested distinct mechanisms underlying diabetes-related CSVD and other CSVDs. Conclusions This study highlights the early development of cerebral microangiopathy in diabetes and broadens the applicability of cerebral permeability. The results may increase the proactivity of clinicians in recognizing the subsequent neurological comorbidities.

scholarly journals Causal Impact of Type 2 Diabetes Mellitus on Cerebral Small Vessel Disease

Stroke ◽  
2018 ◽  
Vol 49 (6) ◽  
pp. 1325-1331 ◽  
Author(s):  
Junfeng Liu ◽  
Loes Rutten-Jacobs ◽  
Ming Liu ◽  
Hugh S. Markus ◽  
Matthew Traylor
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Vessel Disease ◽  
Causal Impact

scholarly journals Evaluating blood-brain barrier permeability in a rat model of type 2 diabetes

2020 ◽  
Author(s):  
Craig Ferris ◽  
Ju Qiao ◽  
Christopher M Lawson ◽  
Kilian FG Rentrup ◽  
Praveen Kulkarni
Keyword(s):  
Type 2 Diabetes ◽  
Blood Brain Barrier ◽  
Small Vessel Disease ◽  
Brain Barrier ◽  
Barrier Permeability ◽  
Blood Brain Barrier Permeability ◽  
Blood Brain ◽  
Brain Barrier Permeability ◽  
The Brain

Abstract Background This is an exploratory study using a novel imaging modality, quantitative ultrashort time-to-echo, contrast enhanced (QUTE-CE) magnetic resonance imaging to evaluate the permeability of the blood brain barrier in a rat model of type 2 diabetes with the presumption that small vessel disease is a contributing factor to neuropathology in diabetes. Methods The BBZDR/Wor rat, a model of type 2 diabetes, and age-matched controls were studied for changes in blood brain barrier permeability. QUTE-CE, a quantitative vascular biomarker, generated angiographic images with over 500,000 voxels that were registered to a 3D MRI rat brain atlas providing site-specific information on blood-brain barrier permeability in 173 different brain areas. Results In this model of diabetes, without the support of insulin treatment, there was global capillary pathology with over 84% of the brain showing a significant increase in blood brain barrier permeability over wild-type controls. Areas of the cerebellum and midbrain dopaminergic system were not significantly affected.Conclusion Small vessel disease as assessed by permeability in the blood brain barrier in type 2 diabetes is pervasive and includes much of the brain. The increase in blood-brain barrier permeability is a likely contributing factor to diabetic encephalopathy and dementia.

scholarly journals Correlation Between Retinal Microvascular Abnormalities and Total Magnetic Resonance Imaging Burden of Cerebral Small Vessel Disease in Patients With Type 2 Diabetes

2021 ◽  
Vol 15 ◽  
Author(s):  
Ying Zhang ◽  
Zhixiang Zhang ◽  
Min Zhang ◽  
Yin Cao ◽  
Wenwei Yun
Keyword(s):  
Magnetic Resonance Imaging ◽  
Type 2 Diabetes ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Diabetic Patients ◽  
Resonance Imaging ◽  
Vessel Disease ◽  
The Relationship

Background and Purpose: Diabetic retinopathy (DR) is one of the common microvascular complications in diabetes. The total magnetic resonance imaging (MRI) burden of cerebral small vessel disease (CSVD) tends to be increased in diabetic patients and is a marker of microvascular disease; however, the relationship between DR and CSVD is unclear. This study aimed to explore the relationship between retinal microvascular abnormalities and the total MRI burden of CSVD in patients with type 2 diabetes.Methods: Data were collected from patients with type 2 diabetes who were hospitalized between December 2019 and November 2020 in Changzhou Second People’s Hospital affiliated to Nanjing Medical University. All patients underwent retinal photography and cerebral MRI. The central retinal artery equivalent (CRAE), the central retinal venous equivalent (CRVE), and arteriole-to-venule ratio (AVR) were calculated using Image J software to determine the retinal vascular calibers for each patient. The total MRI burden score for CSVD was determined, and the relationship between retinal microvascular abnormalities and the total MRI burden of CSVD was analyzed.Results: Of the 151 diabetic patients included in the study, 84 (55.6%) had no diabetic retinopathy (NDR), 27 (17.9%) had mild DR, and 40 (26.5%) had moderate, or severe non-proliferative DR (grouped together for this study as “more than mild DR”). In patients with more than mild DR, the proportion of moderate to severe burden of CSVD was 75%, which was higher than in patients with mild DR (48.1%) or NDR (26.2%). Patients with moderate to severe burden of CSVD were more likely than those with mild burden of CSVD to have narrowed retinal arterioles (105.24 ± 8.42 μm vs. 109.45 ± 7.93 μm), widened retinal venules (201.67 ± 16.25 μm vs. 193.95 ± 13.54 μm), and lower arteriole-to-venule ratio (0.52 ± 0.05 vs. 0.57 ± 0.04) (P < 0.05 for all). The degree of DR (r = 0.465, P < 0.001) and CRVE (r = 0.366, P < 0.001) were positively correlated with the total MRI burden of CSVD. Multivariate logistic regression analysis indicated that, after adjustments were made for age, smoking, alcohol consumption, hypertension, and other factors, more than mild DR (OR, 4.383; P = 0.028), CRAE (OR, 0.490; P = 0.031), and CRVE (OR, 1.475; P = 0.041) were independently associated with moderate to severe burden of CSVD.Conclusion: Retinal microvascular abnormalities in patients with type 2 diabetes are associated with the presence of cerebral small vessel lesions. The degree of DR and retinal vessel changes can be used as predictors of intracranial microcirculation lesions.

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