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氢质子磁共振技术联合脑神经元代谢物分析在 2 型糖尿病认知功能障碍治疗中的应用。

Application of Hydrogen Proton Magnetic Resonance Technology Combined with Brain Neurometabolite Analysis in the Treatment of Cognitive Impairment Caused by Type 2 Diabetes Mellitus.

机构信息

Department of Endocrinology, Harbin Deren Hospital, Heilongjiang, 150001, China.

Department of Neurology, Harbin Deren Hospital, Heilongjiang, 150001, China.

出版信息

World Neurosurg. 2020 Jun;138:654-662. doi: 10.1016/j.wneu.2019.12.162. Epub 2020 Jan 7.

Abstract

This study used hydrogen proton magnetic resonance imaging to detect the changes of white matter and the medial cortex in the prefrontal cortex of patients with type 2 diabetes, analyzed its relationship with cognitive function and blood glucose level, and discussed the recognition of patients with type 2 diabetes from the perspective of brain metabolism. We discuss the neural mechanisms affected by the disorder. The experiment recruited 65 volunteers, including 32 control subjects and 33 patients with type 2 diabetes. All volunteers underwent clinical cognitive function and psychological evaluation, including a simple intelligent mental state examination scale, digital breadth test, Raven intelligence test, Flanker paradigm experiment, connection test, auditory word learning test, depression self-evaluation scale, and anxiety self-rating scale. All subjects underwent multivoxel proton magnetic resonance scanning, and the spectral data were processed and metabolite concentration analysis was completed by Functool software. The detected regions of interest included the bilateral prefrontal white matter and bilateral prefrontal cortex. This study found that the N-acetylaspartate (NAA) and NAA/myo-inositol (MI) of the right prefrontal cortex were reduced, the right prefrontal white matter choline-containing compounds increased, and the MI of the bilateral prefrontal cortex increased in the type 2 diabetes group compared with the control group. The NAA value of the right prefrontal cortex in the type 2 diabetes group was negatively correlated with the glycated hemoglobin concentration. The study found that the right prefrontal cortex NAA value of patients with type 2 diabetes was negatively correlated with the glycated hemoglobin concentration, reflecting that recent blood glucose levels can affect the changes of brain metabolites, and reasonable control of blood glucose can effectively delay brain neurons caused by diabetes.

摘要

本研究采用氢质子磁共振成像技术检测 2 型糖尿病患者前额叶白质和内侧皮质的变化,分析其与认知功能和血糖水平的关系,并从脑代谢角度探讨对 2 型糖尿病患者的识别。我们讨论了受紊乱影响的神经机制。该实验招募了 65 名志愿者,包括 32 名对照组和 33 名 2 型糖尿病患者。所有志愿者均接受了临床认知功能和心理评估,包括简易智能精神状态检查量表、数字广度测试、瑞文智力测验、Flanker 范式实验、连线测验、听觉词语学习测验、抑郁自评量表和焦虑自评量表。所有受试者均接受多体素质子磁共振扫描,通过 Functool 软件处理谱数据并完成代谢物浓度分析。检测的感兴趣区域包括双侧前额叶白质和双侧前额叶皮质。本研究发现,与对照组相比,2 型糖尿病组右侧前额叶皮质的 N-乙酰天冬氨酸(NAA)和 NAA/肌醇(MI)降低,右侧前额叶白质胆碱含量增加,双侧前额叶皮质 MI 增加。2 型糖尿病组右侧前额叶皮质的 NAA 值与糖化血红蛋白浓度呈负相关。研究发现,2 型糖尿病患者右侧前额叶皮质 NAA 值与糖化血红蛋白浓度呈负相关,反映了近期血糖水平会影响脑代谢物的变化,合理控制血糖可以有效延缓糖尿病引起的脑神经元变化。

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