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 < 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 > 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 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 Test-Retest Reliability of Isokinetic Knee Strength Measurements in Type 2 Diabetes Mellitus Patients

2021 ◽  
Vol 13 (3) ◽  
pp. 1343
Author(s):  
José Carmelo Adsuar ◽  
Jose Parraca ◽  
Armando Raimundo ◽  
Miguel Angel Garcia-Gordillo ◽  
Patricia Polero ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Peak Torque ◽  
Total Sample ◽  
Good For ◽  
The Right ◽  
Test Retest Reliability ◽  
Standard Error Of Measurement

Background: Reliability studies are used to verify the evaluation accuracy of a given device. Strength is an important factor for the development of daily activities and its correct management is fundamental. The objective of this study was to examine the reliability of a concentric strength test in people with type 2 diabetes mellitus (T2DM). Methods: Twenty-seven individuals with T2DM performed three repetitions of extension-flexion in concentric-concentric action at 60°/s, for both legs, using an isokinetic dynamometer. For the reliability analysis, we performed an intra-session test retest. Results: The total sample and men sub-group intra-class correlation coefficient (ICC) values were excellent for peak torque and work. In the women sub-group, ICC values were excellent for extensors in both peak torque and work; however, concerning flexor, the ICC values were good for peak torque while, for work, they were good for the right leg and moderate for the left leg. Standard error of measurement (SEM) percentage oscillated from 3.85% to 6.80%, with the smallest real difference (SRD) percentage being from 10.66% to 18.86% for peak torque. Furthermore, the SEM (%) was around 5.5% and SRD (%) was around 15% for work. Conclusions: The isokinetic dynamometry had “good” to “excellent” relative reliability for peak torque (0.862–0.983) and work (0.744–0.982) of extension-flexion in concentric-concentric action at 60°/s. In addition, our study showed that, in general, an SRD < 20% could indicate a true change in strength regarding this protocol in T2DM.

scholarly journals Modifiers of cognitive function and brain structure in middle-aged and elderly individuals with type 2 diabetes mellitus

2009 ◽  
Vol 1280 ◽  
pp. 186-194 ◽  
Author(s):  
Hannah Bruehl ◽  
Oliver T. Wolf ◽  
Victoria Sweat ◽  
Aziz Tirsi ◽  
Stephen Richardson ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cognitive Function ◽  
Brain Structure ◽  
Middle Aged ◽  
Elderly Individuals

scholarly journals A patient who does not like insulin

ABOUTOPEN ◽  
2018 ◽  
Vol 4 (1) ◽  
pp. 122-125
Author(s):  
Paola Ubaldi
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
General Population ◽  
Bone Metastases ◽  
Cancer Symptoms ◽  
The Past ◽  
The Right ◽  
Hypoglycemic Therapy

Hypoglycemic therapy over the past 20 years has expanded considerably with the use of new classes of more effective and safer medicines. Alongside the aging of the general population, the survival of diabetic subjects has significantly increased, thus exposing them to a greater risk of developing co-morbidities. This represents a challenge for the diabetologist, who must acquire ever broader concepts for the management of a complex and multi-organ disease. We report the case of a 72-year-old woman with type 2 diabetes mellitus and pulmonary adenocarcinoma of the right upper lobe with brain and bone metastases who, subjected to innovative and integrated treatments agreed between specialists of different disciplines, is still alive and free of cancer symptoms 23 months after diagnosis (Diabetology)

Cognitive function, dementia and type 2 diabetes mellitus in the elderly

2011 ◽  
Vol 7 (2) ◽  
pp. 108-114 ◽  
Author(s):  
Mark W. J. Strachan ◽  
Rebecca M. Reynolds ◽  
Riccardo E. Marioni ◽  
Jacqueline F. Price
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cognitive Function ◽  
The Elderly
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