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Brain atrophy in type 2 diabetes: Regional distribution and influence on cognition

Citation

Moran, C and Phan, TG and Chen, J and Blizzard, L and Beare, R and Venn, A and Munch, G and Wood, AG and Forbes, J and Greenaway, TM and Pearson, S and Srikanth, V, Brain atrophy in type 2 diabetes: Regional distribution and influence on cognition, Diabetes Care, 36, (12) pp. 4036-4042. ISSN 0149-5992 (2013) [Refereed Article]


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Copyright Statement

Copyright 2013 by the American Diabetes Association

DOI: doi:10.2337/dc13-0143

Abstract

Objective-Type 2 diabetes (T2DM) is associated with brain atrophy and cerebrovascular disease. We aimed to define the regional distribution of brain atrophy in T2DM and to examine whether atrophy or cerebrovascular lesions are feasible links between T2DMand cognitive function. Research design and methods-This cross-sectional study used magnetic resonance imaging (MRI) scans and cognitive tests in 350 participants with T2DM and 363 participants without T2DM. With voxel-basedmorphometry, we studied the regional distribution of atrophy in T2DM. We measured cerebrovascular lesions (infarcts, microbleeds, and white matter hyperintensity [WMH] volume) and atrophy (gray matter, white matter, and hippocampal volumes) while blinded to T2DM status. With use of multivariable regression, we examined for mediation or effect modification of the association between T2DM and cognitive measures by MRI measures. Results-T2DM was associated with more cerebral infarcts and lower total gray, white, and hippocampal volumes (all P < 0.05) but not with microbleeds or WMH. T2DM-related gray matter loss was distributed mainly in medial temporal, anterior cingulate, and medial frontal lobes, and white matter loss was distributed in frontal and temporal regions. T2DM was associated with poorer visuospatial construction, planning, visual memory, and speed (P ≤ 0.05) independent of age, sex, education, and vascular risk factors. The strength of these associations was attenuated by almost one-half when adjusted for hippocampal and total gray volumes but was unchanged by adjustment for cerebrovascular lesions or white matter volume. Conclusions-Cortical atrophy in T2DM resembles patterns seen in preclinical Alzheimer disease. Neurodegeneration rather than cerebrovascular lesions may play a key role in T2DM-related cognitive impairment. © 2013 by the American Diabetes Association.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Neurosciences
Research Field:Neurology and Neuromuscular Diseases
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Diabetes
Author:Blizzard, L (Associate Professor Leigh Blizzard)
Author:Venn, A (Professor Alison Venn)
Author:Pearson, S (Dr Sue Pearson)
Author:Srikanth, V (Dr Velandai Srikanth)
ID Code:88926
Year Published:2013
Web of Science® Times Cited:124
Deposited By:Menzies Institute for Medical Research
Deposited On:2014-02-20
Last Modified:2014-06-25
Downloads:0

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