A Study Of Proton Magnetic Resonance Spectroscopy And The Correlated With Cognitive Function On Bilateral Hippocampus In Patients With Diabetic Brain Damage

Objective:Compare the differences of hippocampus by proton magnetic resonance spectroscopy(1H-MRS)among patients with type 2 diabetic encephalopathy(T2DE), type 2diabetes mellitus(T2DM) and healthy control(HC).To analysis the hippocampus MR volume changes, and the relationship with cognitive function of metabolins on bilateral hippocampus.Materials and Methods:16 patients with T2 DE, 26 patients with T2 DM and 27 HC were collect during July 2013- February 2015 from Dalian University Affiliated Zhongshan Hospital, all participants accepted proton magnetic resonance spectroscopy(1H-MRS), Region of interest(ROI) which were placed on bilateral hippocampus. Three groups of participants were acquired complete clinical data and no left-handed, had no causes which affected the cognitive function. There were no statistically differents among the three groups in years of education,age and gender. All the participants were received proton magnetic resonance spectroscopy(1H-MRS) testing on bilateral hippocampus,volume measurement and Simple Intelligence Scale(MoCA) score. Observations of NAA,Cho,Cr, MI, and their ratios were assessed by statistical analysis. Differences between the three groups by single factor analysis of variance, between two groups significantly compared with LSD-T Test.Between T2 DE patients metabolite ratios,volume and the MoCA score used partial correlation analysis.Differences were statistically significant while P<0.05.Results:1.There were significant differences of NAA on bilateral hippocampus in T2 DE patients,T2 DM patients and healthy controls(P<0.05).2.The NAA/Cr is significant positive correlated with the score of MoCA in T2 DE patients’ left hippocampus(r=0.774, P<0.01).3. There were significant differences of NAA/(Cr+Cho) on bilateral hippocampus increased in T2 DE patients and T2 DM patients(P<0.05). But there was no difference between T2 DE and T2DM(P>0.05).4.No significant difference existed in bilateral hippocampus of NAA、Cho、Cr、mI、NAA/Cr、mI/Cr、 Cho/Cr and NAA/(Cr+Cho) among these three groups(P>0.05).5. There were significant differences of bilateral hippocampus volume among three groups, T2 DE less than HC(P<0.05),T2 DM less than HC(P<0.05),T2 DE less than T2DM(P<0.05).And the left hippocampus VBM is positive correlated with the score of MoCA in T2 DE patients(r=0.687, P<0.05).Conclusion:1.NAA、NAA/(Cr+Cho) on bilateral hippocampus can reflect brain injury in T2 DE patients, especially for the change of NAA. NAA/Cr ratio can be used as a biochemical index of cognitive function assessment. On the left hippocampus,NAA/Cr ratio decrease may be the biological marker of cognitive impairment in T2 DE patients.2.This is a feasible way to use MRI in measuring hippocampus volume;there exists obvious atrophy in T2 DE and T2 DM volume; Meanwhile, left hippocampus volume changes are significant positively correlated with the score of MoCA in T2 DE patients. All these results provided the evidence of morphological in cognitive function assessment and diagnosis in these patients. Therefore, combination MR volume and 1H-MRS may provide effective imaging strategies and methods to early diagnosis brain damage and quantitative assessment cognitive function in DM patients.