DKI And MRS Correlation Research On Frontal Lobe In T2DM Patients With Cognitive Impairment

Objective:In the 20th century,the aging degree of the society is becoming more and more serious,and the incidence of T2DM is getting higher and higher,and the cognitive dysfunction caused by it is attracting more and more attention.This research adopts the DKI and ~1H-MRS technology,damage to the brain in patients with T2DM microstructure,metabolic disorder situation carries on the preliminary exploration,DKI,~1H-MRS parameter values and basic clinical index,the correlation between cognitive function score.To help explore the pathophysiology of cognitive dysfunction in patients with T2DM may,and provide imaging evaluation basis,also to DKI,~1H-MRS jointly applied in T2DM patients to evaluate the value of the associated with cognitive dysfunction.Materials and methods:Pick the first hospital of lanzhou university during March 2017 to January 2018,comply with the standard set of 42 people hospitalized patients with type 2 diabetes,mental state of patients according to the score of Mo CA scale,it can be divided into group A(T2DM-MCI group)and group B(T2DM-NMCI group),A group for T2DM with cognitive dysfunction(21 points?Mo CA score<26 points),including six male,and nine female;In group B,patients with T2DM were not associated with cognitive dysfunction(score>26points),male 11 and female 16;There were 20 healthy control groups(HC group),10 males and 10 females.Acquisition of the selected objects based on clinical and biochemical laboratory indicators,including age,gender,level of education,height,weight,BMI,course duration(diabetes),blood lipid(TG,TC,LDL,HDL),at the same time for the selected object routine MRI scan sequence and ~1H-MRS,DKI scanning.DKI and MRS parameters were measured by symmetry,and the lateral prefrontal cortex was the ROI,and the same anatomical level was selected as far as possible(the baseline was the largest level in the anterior horn of bilateral ventricle).Basis for clinical index,index test and MoCA score difference analysis,the gender for count data by chi-square analysis,the rest are measurement data using single factor analysis of variance,p<0.05,the difference is statistically significant.Between the three groups of bilateral frontal lobe DKI parameter values,~1H-MRS metabolites and ratio difference comparison using single factor analysis of variance,p<0.05,and then to multiple comparison between the two groups,with minimum difference(LSD)test.In addition,by spearman correlation analysis of bilateral frontal lobe DKI parameter values,and~1H-MRS metabolites content ratio based indicators,test indicators,MoCA score and clinical correlation analysis,and the correlation coefficient r and hypothesis testing and report as a result,when p<0.05,statistically significant difference between the groups.Results:1.From the ~1H-MRS metabolites content results showed that T2DM-MCI,T2DM-NMCI group compared with HC group,bilateral frontal lobes,Cho,NAA,Cr that Glx content is reduced,and m I content increase,the difference is statistically significant(p<0.05);From the results of the ratio of ~1H-MRS metabolites,it can be seen that compared with HC group in T2DM-MCI and T2DM-NMCI group,there was a decrease in the bilateral upper lobe Cho/Cr,Glx/Cr,and increased mI/Cr,and the difference was statistically significant(p<0.05).The correlation analysis found that the left frontal lobe NAA,Cho,Cr,Cho/Cr,Glx/Cr and the right frontal lobes NAA,NAA/Cr,Glx/Cr were negatively correlated with the course of the disease,and the left frontal lobe mI/Cr and the right frontal lobe mI,mI/Cr were positively correlated with the course of the disease.The left frontal lobe Cho,Glx,NAA/Cr and the right frontal lobe NAA,Cho,Glx,Cho/Cr were negatively correlated with BMI,and the left frontal lobe mI/Cr and the right frontal lobe mI,mI/Cr were positively correlated with BMI.Bilateral frontal lobes NAA,Cho,Glx,Cho/Cr,Glx/Cr and left frontal lobe Cr were negatively correlated with Hb A1c,and the bilateral frontal lobe mI,mI/Cr and HbA1c were positively correlated.Bilateral frontal lobe mI,mI/Cr and MoCA score were negatively correlated,and bilateral frontal lobe Cho,Cho/Cr,Glx/Cr and right frontal lobe Glx were positively correlated with Mo CA score.Bilateral frontal lobe Cho,Glx,Cho/Cr,Glx/Cr were negatively correlated with fasting blood glucose,and bilateral frontal lobe mI,mI/Cr and fasting blood glucose were positively correlated.The left frontal lobe Cho and the right frontal lobe Cho,Glx,Glx/Cr were negatively correlated with triglyceride,and the left frontal lobe m I,mI/Cr was positively correlated with triglyceride.2.Compared with HC group,T2DM-MCI and T2DM-MCI were gradually reduced in both lateral lobe MK and FA,and MD was gradually increased,and the difference was statistically significant(p<0.05).The correlation analysis found that the bilateral frontal lobe MK,FA and the course of disease were negatively correlated,and the bilateral frontal lobe MD was negatively correlated with the course of disease.The right frontal lobe MD was positively correlated with BMI.The left frontal lobe MK,FA and BMI were negatively correlated.Bilateral frontal lobe MD was positively correlated with HbA1c,and the left frontal lobe MK,FA and right frontal lobe MK were negatively correlated with HbA1c.The bilateral frontal lobe MK and FA were positively correlated with MoCA scores.The right frontal lobe was positively correlated with fasting blood glucose,and bilateral frontal FA was negatively correlated with fasting blood glucose.The right frontal lobe was positively correlated with triglyceride,and the right frontal lobe was negatively correlated with triglyceride.Conclusion:1.Selection of bilateral frontal lobe for ROI,the application of ~1H-MRS technology acquisition selected object data and calculate the ratio of metabolites,these parameters are just at the beginning of reaction T2DM patients with cognitive dysfunction with bilateral frontal metabolic disorder situation and its change rule;In patients with T2DM,the content of NAA,Cr and Glx decreased in bilateral frontal lobes,while Cho/Cr,Glx/Cr decreased,mI content increased,and mI/Cr increased,suggesting that T2DM had an energy metabolism disorder.These parameters are expected to be the biological indicators for the assessment of patients with T2DM-MCI.2.MK,FA,MD,confirmed that the change rule of T2DM patients with bilateral frontal micro-structure parenchymal damage and can response to the damage severity,infer micro-structure T2DM patients with brain injury may be the pathophysiological mechanism.3.The results showed that the DKI and 1h-mrs parameters of T2DM patients were correlated with the pathogenesis,BMI,fasting blood glucose,Hb A1c and MoCA scores of T2DM patients.This plays a very important role in predicting and diagnosing early cognitive impairment in T2DM patients,and also provides effective measures for intervention of cognitive dysfunction in T2DM patients.4.Joint MRS and DKI technology can accurately reflect T2DM brain microstructure damage,metabolic disorders,to make early diagnosis of T2DM brain injury and to assess the damage,for our early intervention,early treatment of T2DM brain damage,is important for prognosis and disease progression in patients with positive significance.