Neurovascular uncoupling as a possible mechanism of cognitive impairment in patients with type 2 diabetes mellitus
10.19845/j.cnki.zfysjjbzz.2023.0191
- VernacularTitle:神经血管耦联受损是2型糖尿病合并认知功能障碍的可能机制
- Author:
Jinwei ZHANG
1
;
Yong YOU
1
Author Information
1. Department of Neurology, The Second Affiliated Hospital of Hainan Medical University, Haikou 570100, China
- Publication Type:Journal Article
- Keywords:
Type 2 diabetes mellitus;
Neurovascular coupling;
Cognitive decline
- From:
Journal of Apoplexy and Nervous Diseases
2023;40(10):871-876
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the relationship between neurovascular coupling and cognitive impairment in patients with type 2 diabetes mellitus （T2DM）. Methods We consecutively enrolled 192 patients with T2DM admitted to the Department of Endocrinology in The Second Affiliated Hospital of Hainan Medical University as well as 30 healthy controls matched for sex, age, and years of education from February 1, 2022 to February 28, 2023. General clinical data were collected. All the participants were tested with the Montreal Cognitive Assessment （MoCA）. Neurovascular coupling function was assessed through the dynamic changes in cerebral blood flow velocity （CBFV） induced by active elbow flexion monitored using functional transcranial Doppler sonography （fTCD）. Patients with T2DM were divided into normal cognition （T2DM-NC） group and impaired cognition （T2DM-IC） group according to the MoCA score. The fTCD parameters were compared between the HC group, T2DM-NC group, and T2DM-IC group. The correlation between fTCD parameters and MoCA score was analyzed. Results A total of 81 patients with T2DM （52 with T2DM-NC and 29 with T2DM-IC） and 21 healthy volunteers were enrolled in this study. The glycated hemoglobin level was significantly higher in the T2DM-IC group than in the T2DM-NC and HC groups. Compared with the HC group, the T2DM group showed a significantly smaller percentage change from baseline in mean CBFV （Vm） during motor （ΔVm）, a significantly smaller normalized area under the curve of Vm during motor （nAUC）, and a significantly lower Vm slope （all P < 0.05）. After normalization, the nAUC was significantly lower in the T2DM-IC group than in the T2DM-NC and HC groups, and the upward slope of Vm was significantly higher in the HC group than in the T2DM-NC and T2DM-IC groups （all P < 0.01）. The ΔVm （r = 0.343, P = 0.001） and nAUC （r = 0.356, P = 0.001） were positively correlated with MoCA score. Baseline pulsatility index （PI, r = -0.496, P < 0.001）, baseline resistance index （RI, r = -0.475, P < 0.001）, PI during motor （r = -0.542, P < 0.001）, and RI during motor （r = -0.523, P < 0.001） were negatively correlated with MoCA score. Conclusion Neurovascular uncoupling is a possible cause of cognitive impairment in patients with T2DM.
- Full text:2024061321230478143Neurovascular uncoupling as a possible mechanism of cognitive impairment in patients with type 2 diabetes mellitus.pdf
