Department of Radiology (Hp E01.332), University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands.
Neuroradiology. 2010 Feb;52(2):155-61. doi: 10.1007/s00234-009-0598-4. Epub 2009 Sep 30.
Type 2 diabetes (DM2) is associated with cognitive decline, but the pathogenesis of this important complication remains unclear. We investigated whether abnormalities in neuronal metabolism or membrane integrity in normal appearing cerebral white matter are associated with cognitive impairment in patients with DM2.
Single voxel proton magnetic resonance spectroscopy (1.5 T), aimed at N-acetyl-aspartate (NAA), total choline (Cho), and total creatine (Cr), was performed in the cerebral white matter (centrum semiovale) of 72 patients with DM2 and 40 control subjects. All participants underwent extensive neuropsychological evaluation.
Patients with DM2 performed worse with respect to global neuropsychological functioning than controls (p < 0.05), in particular on memory and information processing speed. We observed no differences in NAA/Cr, Cho/Cr, or NAA/Cho ratio's between patients with DM2 and controls. Cognitive performance in patients with DM2 was not correlated with any of these brain metabolites, neither were the clinical variables.
We conclude that disturbances in neuronal viability and cellular membrane status assessed by NAA/Cr, Cho/Cr, NAA/Cho ratios cannot explain cognitive decline in patients with DM2.
2 型糖尿病（DM2）与认知能力下降有关，但这种重要并发症的发病机制仍不清楚。我们研究了正常外观的脑白质中神经元代谢或膜完整性的异常是否与 DM2 患者的认知障碍有关。
在 72 例 DM2 患者和 40 例对照者的脑白质（半卵圆中心）中进行了单体质子磁共振波谱（1.5T），目的是检测 N-乙酰天冬氨酸（NAA）、总胆碱（Cho）和总肌酸（Cr）。所有参与者都接受了广泛的神经心理学评估。
DM2 患者的整体神经心理学功能较对照组差（p<0.05），尤其是在记忆和信息处理速度方面。我们没有观察到 DM2 患者和对照组之间 NAA/Cr、Cho/Cr 或 NAA/Cho 比值的差异。DM2 患者的认知表现与这些脑代谢物均无相关性，与临床变量也无相关性。
我们得出结论，NAA/Cr、Cho/Cr、NAA/Cho 比值评估的神经元活力和细胞膜状态的紊乱不能解释 DM2 患者的认知下降。
