정상인지기능을 가진 당뇨환자에서 피질하 구조의 완전성
Integrity of the Subcortical Structures in Cognitively Normal Diabetics
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: It has been well known that serum glucose level is associated with cognitive dysfunction. People with type II diabetes have more hippocampal and amygdalar atrophy than non-diabetes. Besides brain atrophy, it is postulated that type II diabetes might affect the white matter structures. This leads to executive dysfunctions, which is important for every day function. The purpose of investigation was to assess the degree of subcortical white matter disruption both at structural and functional levels in diabetics without any subjective cognitive complaints. Methods: Twenty one patients with type II diabetes (mean age 65.0±6.6 yr, mean duration 4.0 ±2.6 yr) and 21 healthy control subjects without any subjective cognitive complaints (mean age 65.0±6.8) participated in this study. We employed diffusion tensor imaging analysis for the assessment of structural integrity of subcortical white matter. We adopted the Executive Interview (EXIT 25) to assess executive functional status. Results: Diabetics showed a tendency to have higher EXIT25 score compared to control group. However, white matter disruption was observed in the areas of left frontal, left deep temporal and bilateral occipital subcortices in diabetics (each Fractional Anisotrophy; FA value, 0.37±0.07, 0.39±0.06, 0.38±0.05, 0.34 ±0.08). Conclusions: These results showed diabetes affected the integrity of white matter in the area of anterior part of the brain, and this might associated with dysfunction of frontal executive function.
Abstract
Background: It has been well known that serum glucose level is associated with cognitive dysfunction. People with type II diabetes have more hippocampal and amygdalar atrophy than non-diabetes. Besides brain atrophy, it is postulated that type II diabetes might affect the white matter structures. This leads to executive dysfunctions, which is important for every day function. The purpose of investigation was to assess the degree of subcortical white matter disruption both at structural and functional levels in diabetics without any subjective cognitive complaints. Methods: Twenty one patients with type II diabetes (mean age 65.0±6.6 yr, mean duration 4.0 ±2.6 yr) and 21 healthy control subjects without any subjective cognitive complaints (mean age 65.0±6.8) participated in this study. We employed diffusion tensor imaging analysis for the assessment of structural integrity of subcortical white matter. We adopted the Executive Interview (EXIT 25) to assess executive functional status. Results: Diabetics showed a tendency to have higher EXIT25 score compared to control group. However, white matter disruption was observed in the areas of left frontal, left deep temporal and bilateral occipital subcortices in diabetics (each Fractional Anisotrophy; FA value, 0.37±0.07, 0.39±0.06, 0.38±0.05, 0.34 ±0.08). Conclusions: These results showed diabetes affected the integrity of white matter in the area of anterior part of the brain, and this might associated with dysfunction of frontal executive function.
참고문헌 (19)
- Brands AM, "Cognitive functioning and brain MRI in patients with Type1 and Type 2 diabetes mellitus; a comparative study", Dement Geriatr Cog Disord, 23, pp.343~350 (2007)
- Stewart R, "Type 2 diabetes mellitus, cognitive impairment and dementia", Diabet Med, 16, pp.93~112 (1999)
- Awad N, "The relationship between impaired glucose tolerance, type 2 diabetes, and cognitive function", J Clin Exp Neuropsychol, 26, pp.1044~1080 (2004)
- Manschot SM, "Brain MRI correlates of impaired cognition in patients with type 2 diabetes mellitus", Diabetes, 55, pp.1106~1113 (2006)
- Hewer W, "Short-term effects of improved glycemic control on cognitive function in patients with Type 2 diabetes", Gerontology, 49, pp.86~92 (2003)
- GJ Biessels, "Cognition and diabetes: a lifespan perspective", Lancet Neurol, 7, pp.184~190 (2008)
- van Harten B, "Cognitive impairment and MRI correlates in the elderly patients with type 2 diabetes mellitus", Age Ageing, 36, pp.164~170 (2007)
- CRCD, "Vaskor classification of white matter changes in MRI" (2007)
- Royall DR, "Bedside assessment of executive cognitive impairment: the executive interview", J Am Geriatr Soc, 40, pp.1221~1226 (1992)
- Royall DR, "Executive dyscontrol. An important factor affecting the level of care received by older retirees", J Am Geriatr Soc, 46, pp.1519~1524 (1998)
- Araki Y, "MRI of the brain in diabetes mellitus", Neuroradiology, 36, pp.101~103 (1994)
- Meyer JW, "MRI-based topographic parcellation of the human cerebral white matter", Neuroimage, 9, pp.1~17 (1999)
- U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, "National Diabetes Fact Sheet: General Information and National Estimates on Diabetes in the United States, 2003" (2004), Centers for Disease Control and Prevention
- Trauernicht AK, "Enalapril prevents impaired nitric oxide synthase-dependent dilatation of cerebral arterioles in diabetic rats", Stroke, 34, pp.2698~2703 (2003)
- Makimattila S, "Brain metabolic alterations in patients with type 1 diabetes-hyperglycemia-induced injury", J Cereb Blood Flow Metab, 24, pp.1393~1399 (2004)
- Royall DR, "Frontal MRI findings associated with impairment on the Executive Interview (EXIT25)", Exp Aging Res, 27, pp.293~308 (2001)
- Jette Stokholm MA, "The executive interview as a screening test for executive dysfunction in patients with mild dementia", J Am Geriatr Soc, 53, pp.1577~1581 (2005)
- O’Sullivan M, "Diffusion tensor MRI correlates with executive dysfunction in patients with ischaemic leukoaraiosis", J Neurol Neurosurg Psychiatry, 75, pp.441~447 (2004)
- Spilt A, "Not all age-related white matter hyperintensities are the same: a magnetization transfer imaging study", Am J Neuroradiol, 27, pp.1964~1968 (2006)