Diabetes tipo 2 y cognición: estudio cognitivo-conductual y de neuroimagen estructuro-funcional con resonancia magnética nuclear de alto campo (rnm 3t) y tomografía por emisión de positrones (18-fdg-pet)
- Autores: Natalia García Casares
- Directores de la Tesis: Pedro González Santos (dir. tes.), Juan Antonio García Arnés (codir. tes.), Marcelo L. Berthier Torres (codir. tes.)
- Lectura: En la Universidad de Málaga ( España ) en 2011
- Idioma: español
- Tribunal Calificador de la Tesis: Pedro Valdivielso Felices (presid.), Antonio Luis Gutiérrez Cardo (secret.), Niels Daniël Prins (voc.), Pablo Martínez-Lage Alvarez (voc.), Miguel Ángel Sánchez Chaparro (voc.)
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- Resumen
Type 2 Diabetes and Cognition: neuropsychological, structural and functlonal neuroimaging study with high field nuclear magnetic resonance (RNM3T) and F-18 Fluorodeoxyglucose positrón emlsslon tomography (18-FDG-PET)" "Aims": Effects of type 2 diabetes mellrtus (T2DM) on brain and cognition are not well known. Cagnitive failures and neuroimaging alteralions related to T2DM metabolic disturbances such hyperglycemia or insulin resistance is difficult to establish. We present a comprehensive and extensive analysis of neuropsychology, structural and functional brain testing in T2DM patients.
"Research Design and Meihods": We compared 25 type 2 diabetes patients aged 45-65 years with 25 age- and gender-matched healthy control participants. Neuropsychological and neuropsychiatry assessments, structural cerebral magnetic resonance ¡maging (MRI) ¡ncluding voxel-based morphometry (VBM), and F-18 fluorodeoxyglucose positrón emission tomography (18FDG-PET) were performed in both groups. The gray matter densities and metabollsm changes camparing between groups were analyzed uslng statlstical parametríc mapping (SPM5). We also ¡nvestigated the effects on neuroimaging of HbAlc levéis, duration of diabetes (DD), body mass índex (BMI), waist circumference (WC), Insulin resistance measurement (HOMA-IR), inflammatory markers and adipocytokínes on the diabetic group. Finally, we analyzed Ihe correlations between neuropsychological tests and the different Brodmann áreas that showed reduced gray matter and hypometabolism on the group of diabetic.
"Resulte": T2DM presents a cognitive performance worse than controls in executive function, memory and language (p< 0,001). Volumetric analysis revealed that. patients with T2DM in comparison with control subjects, presented reduced gray matter densities and reduced cerebral glucose metabolism in several fronto-temporal brain regions responsible for executive function, memory and language compared with controls [p < 0,001, adjusted for age, gender, education, Framingham score and the presence of at least one epsilon 4 alíele for the apolipoprotein. E (APOEE4 genotype) and depression]. In diabetic patients, longer DD, hlgher HbAlc levéis, WC, BMI, and HOMA-IR were associated with lower density of gray matter and reduced cerebral glucose metabollsm in predominantly fronto-temporal regions (p<0,001).
"Conclusions": There are clinical changes ¡n cognitive-behavloral and neuroimaging measures (gray matter volumen and cerebral glucose metabolism) with a predominance in frontotemporal regions in T2DM middle age population, despite no subjective complaints or clinically evident cognitive impairment and / or dementia.
