Cerebral perfusion in relation to cognitive function and type 2 diabetes.
OBJECTIVE
Underlying mechanisms for decreased cognitive functioning in patients with type 2 diabetes are unclear. In the general population, cerebral hypoperfusion is a risk factor for cognitive dysfunction and dementia. Reduced cerebral perfusion may account for cognitive impairments in diabetic patients relative to controls.


METHODS
A total of 98 patients with type 2 diabetes and 47 control participants underwent neuropsychological evaluation. Total cerebral blood flow (CBF) was assessed non-invasively by measuring the volume flow in the internal carotid arteries and basilar artery with two-dimensional phase-contrast magnetic resonance angiography. Relative total CBF, a measure of mean total cerebral perfusion, was obtained by expressing total CBF per 100 ml brain parenchyma volume.


RESULTS
Patients with type 2 diabetes performed worse on neuropsychological tests (p < 0.05). Total CBF per 100 ml brain parenchyma volume did not differ between participants with and without diabetes (difference -2.3 ml min(-1) 100 ml(-1); 95% CI -6.0, 1.3). In the entire group, total CBF per 100 ml brain parenchyma volume was positively associated with cognitive functioning (0.09 SD increase in composite z score per 10 ml min(-1) 100 ml(-1) increase in relative total CBF). This association was not affected by type 2 diabetes.


CONCLUSIONS
Although total CBF per 100 ml brain parenchyma volume was associated with cognitive functioning, it did not explain cognitive impairments in patients with type 2 diabetes relative to controls.
Tiehuis
A M
AM
Department of Radiology and Image Sciences Institute, University Medical Center Utrecht, Utrecht, the Netherlands. a.m.tiehuis@umcutrecht.nl
Vincken
K L
KL
van den Berg
E
E
Hendrikse
J
J
Manschot
S M
SM
Mali
W P T M
WP
Kappelle
L J
LJ
Biessels
G J
GJ
D000368:Aged; D001921:Brain / Q000098:blood supply / Q000473:pathology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000473:pathology / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests