Department of Clinical Neurophysiology, Karolinska University Hospital (Solna), SE-17176 Stockholm, Sweden.
Psychoneuroendocrinology. 2011 Jan;36(1):77-86. doi: 10.1016/j.psyneuen.2010.06.009. Epub 2010 Jul 24.
The mild cognitive decline associated with type 2 diabetes (T2DM) has been suggested to be reversible with improved glycemic control. In order to characterise this cognitive decline and study the effects of improved glycemic control we have studied patients with T2DM (N=28) and healthy control subjects (N=21). One group of patients with diabetes (N=15) were given a 2-month treatment of intensified glycemic control, whereas the other group (N=13) maintained their regular treatment. Cognitive function in four different domains, auditory event-related potentials (ERPs) and resting EEG power spectrum were studied in the two groups of patients and in healthy control subjects before and after the 2-month trial period. There were significant differences at baseline (p<0.02) between patients with T2DM and controls. Patients had lower scores in two cognitive domains: verbal fluency (p<0.01) and visuospatial ability (p<0.03). T2DM also affected ERP with a decrease in N100 amplitude (p<0.04) and an increase in P300 latency (p<0.03). Furthermore, resting EEG activity in the beta band (13-30Hz) was reduced (p<0.04). The change between 1st and 2nd investigation was significantly different in the three groups of patients/subjects (p<0.03). Patients receiving intensified treatment for glycemic control had an improvement of cognitive ability in visuospatial ability (p<0.02) and semantic memory performance (p<0.04) together with increased resting EEG activity in the alpha band (8-13Hz, p<0.02) and connectivity in the theta (4-8Hz, p<0.03) and alpha bands (p<0.03) over central and lateral regions. Furthermore, there was an increase in the connectivity in the beta band (p<0.04) over the central regions of the scalp. In conclusion, subjects with T2DM had a similar type of cognitive function impairment and EEG/ERP abnormality as previously demonstrated for subjects with type 1 diabetes (T1DM). Intensified therapy showed cognitive improvement not shown for regular treatment, suggesting that the negative effect of T2DM on cognition is reversible by means of improved glycemic control. Furthermore, there was an improvement in electro-physiological measures, suggesting increased availability of compensatory mechanisms in subjects with intensified treatment.
与 2 型糖尿病（T2DM）相关的轻度认知衰退据称可以通过改善血糖控制来逆转。为了描述这种认知衰退并研究改善血糖控制的效果，我们研究了 28 例 T2DM 患者（N=28）和 21 例健康对照受试者（N=21）。一组糖尿病患者（N=15）接受了为期 2 个月的强化血糖控制治疗，而另一组（N=13）则维持常规治疗。在为期 2 个月的试验期前后，我们研究了两组患者和健康对照受试者在四个不同认知领域的认知功能、听觉事件相关电位（ERPs）和静息 EEG 功率谱。T2DM 患者与对照组在基线时存在显著差异（p<0.02）。患者在两个认知领域的得分较低：语言流畅性（p<0.01）和视空间能力（p<0.03）。T2DM 还影响 ERP，导致 N100 振幅降低（p<0.04）和 P300 潜伏期延长（p<0.03）。此外，β频段（13-30Hz）的静息 EEG 活动减少（p<0.04）。三组患者/受试者之间的第 1 次和第 2 次调查的变化存在显著差异（p<0.03）。接受强化血糖控制治疗的患者在视空间能力（p<0.02）和语义记忆表现（p<0.04）方面的认知能力有所改善，同时α频段（8-13Hz，p<0.02）和θ频段（4-8Hz，p<0.03）的静息 EEG 活动增加以及中央和外侧区域的α频段（p<0.03）的连通性增加。此外，头皮中央区域的β频段连通性增加（p<0.04）。总之，与先前 1 型糖尿病（T1DM）患者所表现出的认知功能障碍和 EEG/ERP 异常相似，T2DM 患者表现出认知功能障碍和 EEG/ERP 异常。强化治疗显示出常规治疗未显示出的认知改善，这表明通过改善血糖控制，T2DM 对认知的负面影响是可以逆转的。此外，电生理测量指标有所改善，这表明强化治疗组的代偿机制有所增加。
