Investigation Of Metabolite Changes In Prefrontal Lobe In Patients With Type2Diabetes Mellitus Using Proton Magnetic Resonance Spectroscopy

Background and Objective:Type2diabetes mellitus is an extremely prevalent metabolic disease,which is associated with a variety of acute and chronic complications. DM is associated with cognitive deficits and an increased risk of dementia, particularly in the elderly. A recent study reported that patients with type-2DM show impairments in several cognitive domains, mostly in the area of verbal memory and processing speed. Moreover, some recent evidences have shown that the brain is a target for diabetic end-organ damage, though the pathophysiology of diabetic encephalopathy is still not well understood. Proton magnetic resonance spectroscopy (1H MRS) is a unique neuroimaging method, which can be used non-invasively to obtain information about the neurochemical changes in T2DM. Previous works have shown that DM causes metabolic changes in the brain,but produced inconsistent results. In the present study, a systematic investigation was carried out to understand the effect of diabetes on four regions of the brain of patients with type-2DM using1H-MRS.Methods:Twenty-two subjects with T2DM (mean age=54.5±8.3yrs), and twenty-one age-matched healthy controls (HC; mean age=53.5±7.0yrs) subjects participated in the study. MRS signals were sequentially acquired within four voxels of the same size, respectively placed in the bilateral frontal white matter, bilateral frontal cortex. Data post-processing and analysis were performed using functool software packages.Results:1.Compared to HC subjects, decreased NAA (N-acetylaspartate) and NAA/MI in right frontal cortex; Meanwhile, increased Cho (choline-containing compounds)in right frontal whiter, increased MI in bilateral frontal cortex and the left thalamus.2. HbAlc were negatively correlated with NAA in the right frontal cortex of patients in the T2DM.Conclusion: 1.1H-MRS analysis indicates that type-2diabetes mellitus may cause subtle changes in the metabolic profile of the brain.2.Decreased concentrations of NAA and increased concentrations of Cho might be indicative of decreased neuronal viability in diabetics.3. HbAlc were negatively correlated with NAA in the right frontal cortex of patients in the T2DM.These findings suggested that neuronal damage was more serious in patients with diabetes with poor glycemic control than in well-controlled patients.