van Harten Barbera, Oosterman Joukje, Muslimovic Dino, van Loon Bert-Jan Potter, Scheltens Philip, Weinstein Henry C
Department of Neurology, St Lucas Andreas Hospital, Jan Tooropstraat 164, 1061 AE Amsterdam, Netherlands.
Age Ageing. 2007 Mar;36(2):164-70. doi: 10.1093/ageing/afl180.
exact mechanisms underlying cognitive dysfunction in diabetes mellitus (DM) remain unclear. Imaging studies of the brain could help to identify possible structural brain lesions underlying cognitive dysfunction.
to describe a detailed neuropsychological profile in patients functioning independently with type 2 DM. Secondly, correlations were studied between cognitive impairment and brain lesions on magnetic resonance imaging (MRI), i.e. periventricular hyperintensities (PVH), deep white matter lesions (DWML), medial temporal lobe atrophy (MTA), cerebral atrophy and lacunar infarcts. In addition, the influence of relevant disease variables of DM was studied.
92 patients with type 2 DM (mean age 73.2 +/- 5.7 years, mean duration 13.8 +/- 10.8 years) and 44 control subjects (mean age 72.9 +/- 5.3 years) were included and underwent an extensive neuropsychological test battery and an MRI of the brain.
neuropsychological scores were worse for each cognitive domain except for memory functions after adjustment for hypertension in a group of elderly patients with type 2 DM compared to healthy control subjects. Only PVH were independently associated with motor speed, whereas all other MRI measures were not independently associated with cognitive impairment. Interactions between the different MRI measures were not present. Glycosylated haemoglobin (HbA(1c)) and duration of DM were significantly associated with cognitive dysfunction.
the data of this cross-sectional study show that type 2 DM is associated with diminished cognitive function in different cognitive domains, while memory is less affected after adjustment for hypertension. The association of cognitive impairment with MRI measures is equivocal, whereas HbA(1c) and duration of DM were significantly associated with cognitive dysfunction.
糖尿病（DM）认知功能障碍的确切机制仍不清楚。脑部影像学研究有助于识别认知功能障碍潜在的脑结构病变。
描述2型糖尿病独立生活患者详细的神经心理学特征。其次，研究认知障碍与磁共振成像（MRI）脑病变之间的相关性，即脑室周围高信号（PVH）、深部白质病变（DWML）、内侧颞叶萎缩（MTA）、脑萎缩和腔隙性梗死。此外，研究DM相关疾病变量的影响。
纳入92例2型糖尿病患者（平均年龄73.2±5.7岁，平均病程13.8±10.8年）和44例对照者（平均年龄72.9±5.3岁），进行广泛的神经心理测试组套和脑部MRI检查。
在一组老年2型糖尿病患者中，经高血压校正后，除记忆功能外，各认知领域的神经心理评分均比健康对照者差。仅PVH与运动速度独立相关，而所有其他MRI测量指标均与认知障碍无独立相关性。不同MRI测量指标之间不存在相互作用。糖化血红蛋白（HbA1c）和DM病程与认知功能障碍显著相关。
这项横断面研究的数据表明，2型糖尿病与不同认知领域的认知功能减退有关，而经高血压校正后记忆受影响较小。认知障碍与MRI测量指标的相关性不明确，而HbA1c和DM病程与认知功能障碍显著相关。
