Brundel Manon, Reijmer Yael D, van Veluw Susanne J, Kuijf Hugo J, Luijten Peter R, Kappelle L Jaap, Biessels Geert Jan
Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands.
Diabetes. 2014 Oct;63(10):3523-9. doi: 10.2337/db14-0122. Epub 2014 Apr 23.
Cerebral small vessel disease, including microvascular lesions, is considered to play an important role in the development of type 2 diabetes mellitus (T2DM)-associated cognitive deficits. With ultra-high field MRI, microvascular lesions (e.g., microinfarcts and microbleeds) can now be visualized in vivo. For the current study, 48 nondemented older individuals with T2DM (mean age 70.3 ± 4.1 years) and 49 age-, sex-, and education-matched control subjects underwent a 7-Tesla brain MRI scan and a detailed cognitive assessment. The occurrence of cortical microinfarcts and cerebral microbleeds was assessed on fluid-attenuated inversion recovery and T1-weighted and T2*-weighted images, respectively, compared between the groups, and related to cognitive performance. Microinfarcts were found in 38% of control subjects and 48% of patients with T2DM. Microbleeds were present in 41% of control subjects and 33% of patients (all P > 0.05). The presence and number of microinfarcts or microbleeds were unrelated to cognitive performance. This study showed that microvascular brain lesions on ultra-high field MRI are not significantly more common in well-controlled patients with T2DM than in control subjects.
脑小血管疾病，包括微血管病变，被认为在2型糖尿病（T2DM）相关认知缺陷的发生发展中起重要作用。借助超高场磁共振成像（MRI），现在可以在体内观察到微血管病变（如微梗死和微出血）。在本研究中，48名无痴呆的老年T2DM患者（平均年龄70.3±4.1岁）和49名年龄、性别及教育程度相匹配的对照受试者接受了7特斯拉脑部MRI扫描和详细的认知评估。分别在液体衰减反转恢复序列、T1加权像和T2*加权像上评估皮质微梗死和脑微出血的发生情况，比较两组之间的差异，并将其与认知表现相关联。在38%的对照受试者和48%的T2DM患者中发现了微梗死。41%的对照受试者和33%的患者存在微出血（所有P>0.05）。微梗死或微出血的存在及数量与认知表现无关。这项研究表明，在血糖控制良好的T2DM患者中，超高场MRI上的微血管脑病变并不比对照受试者更常见。
