University of Debrecen, Faculty of Medicine, Department of Medical Imaging, Division of Nuclear Medicine and Translational Imaging, Hungary.
Scanomed Ltd. Nuclear Medicine Centers, Hungary, Hungary.
Nucl Med Rev Cent East Eur. 2021;24(1):11-15. doi: 10.5603/NMR.2021.0002.
Cerebral blood flow abnormalities are supposed to be potential risk factors for developing cognitive dysfunction in the general population. Aging, obesity and type 2 diabetes mellitus are associated with perfusion abnormalities leading to cognitive impairment, neurodegeneration and future development of dementia. In our study, we aimed at identifying independent factors that contribute to the appearance of regional brain perfusion changes besides those that are already known.
Forty-three type 2 diabetic and twenty-six obese patients were enrolled. After the intravenous administration of 740 MBq 99mTc-hexamethylpropylene amine oxime (HMPAO), all subjects underwent brain perfusion SPECT imaging applying AnyScan S Flex dual-head gamma camera (Mediso, Hungary). Using Philips Achieva 3T scanner brain resting-state functional MRI was also performed. The SPECT and MRI images were co-registered and transformed to the MNI152 atlas space so that data of the following standard volumes of interest (VOIs) could be obtained: frontal lobe, parietal lobe, temporal lobe, occipital lobe, limbic region, cingulate, insula, basal ganglia, cerebrum, limbic system and brain stem. Using the SPSS 25 statistical software package, general linear regression analysis, Student's t-test, and Mann-Whitney U-test were applied for statistical analyses.
Multivariate linear analysis identified that BMI and age are significantly (p < 0.0001) associated with perfusion, and patient group was slightly above threshold (p = 0.0524). We also found that the presence of diabetes was an independent significant predictor of normalized regional brain perfusion only in the insula (p < 0.001). Other independent predictors of normalized regional brain perfusion were: age in the insula (p < 0.001) and in the limbic region (p < 0.01), and BMI in the brain stem (p < 0.01).
Age and BMI proved to be general, and diabetes regional predictor of brain hypoperfusion. BMI appeared to be a novel factor affecting brain perfusion. In one specific region, the insula, we detected a difference between the obese and the diabetic group. These findings may be significant in the understanding of the development of cognitive impairment in metabolic diseases.
脑血流异常被认为是普通人群发生认知功能障碍的潜在危险因素。衰老、肥胖和 2 型糖尿病与灌注异常有关，导致认知障碍、神经退行性变和未来痴呆的发展。在我们的研究中，我们的目的是确定除已知因素外，导致区域性脑灌注变化的独立因素。
纳入 43 例 2 型糖尿病患者和 26 例肥胖患者。静脉注射 740MBq 99mTc-六甲基丙烯酰胺肟（HMPAO）后，所有患者均接受 AnyScan S Flex 双头伽马相机（Mediso，匈牙利）进行脑灌注 SPECT 成像。使用飞利浦 Achieva 3T 扫描仪进行脑静息状态功能 MRI。将 SPECT 和 MRI 图像配准并转换到 MNI152 图谱空间，以便获得以下标准感兴趣区（VOI）的数据：额叶、顶叶、颞叶、枕叶、边缘区、扣带回、岛叶、基底节、大脑、边缘系统和脑干。使用 SPSS 25 统计软件包进行统计分析，采用一般线性回归分析、学生 t 检验和 Mann-Whitney U 检验。
多元线性分析表明，BMI 和年龄与灌注显著相关（p<0.0001），且患者组略高于阈值（p=0.0524）。我们还发现，糖尿病的存在是岛叶正常化区域脑灌注的独立显著预测因子（p<0.001）。正常化区域脑灌注的其他独立预测因子为：岛叶（p<0.001）和边缘区（p<0.01）的年龄，以及脑干（p<0.01）的 BMI。
年龄和 BMI 被证明是脑灌注普遍的、糖尿病区域性的预测因子。BMI 似乎是影响脑灌注的新因素。在一个特定的区域，即岛叶，我们发现肥胖组和糖尿病组之间存在差异。这些发现可能对理解代谢性疾病中认知障碍的发展具有重要意义。
