title: Human cerebral neuropathology of Type 2 diabetes mellitus.
abstract: The cerebral neuropathology of Type 2 diabetes (CNDM2) has not been positively defined. This review includes a description of CNDM2 research from before the 'Pubmed Era'. Recent neuroimaging studies have focused on cerebrovascular and white matter pathology. These and prior studies about cerebrovascular histopathology in diabetes are reviewed. Evidence is also described for and against the link between CNDM2 and Alzheimer's disease pathogenesis. To study this matter directly, we evaluated data from University of Kentucky Alzheimer's Disease Center (UK ADC) patients recruited while non-demented and followed longitudinally. Of patients who had come to autopsy (N = 234), 139 met inclusion criteria. These patients provided the basis for comparing the prevalence of pathological and clinical indices between well-characterized cases with (N = 50) or without (N = 89) the premortem diagnosis of diabetes. In diabetics, cerebrovascular pathology was more frequent and Alzheimer-type pathology was less frequent than in non-diabetics. Finally, a series of photomicrographs demonstrates histopathological features (including clinical-radiographical correlation) observed in brains of persons that died after a history of diabetes. These preliminary, correlative, and descriptive studies may help develop new hypotheses about CNDM2. We conclude that more work should be performed on human material in the context of CNDM2.
authors.affiliation: Department of Pathology, Division of Neuropathology, University of Kentucky Medical Center, Sanders-Brown Center on Aging and Alzheimer's Disease Center, University of Kentucky, Lexington, KY 40536-0230, USA. pnels2@email.uky.edu
authors.forename: Peter T
authors.initials: PT
authors.lastname: Nelson
authors.forename: Charles D
authors.initials: CD
authors.lastname: Smith
authors.forename: Erin A
authors.initials: EA
authors.lastname: Abner
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Schmitt
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Scheff
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Davis
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Keller
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Jicha
authors.forename: Daron
authors.initials: D
authors.lastname: Davis
authors.forename: Wang
authors.initials: W
authors.lastname: Wang-Xia
authors.forename: Adria
authors.initials: A
authors.lastname: Hartman
authors.forename: Douglas G
authors.initials: DG
authors.lastname: Katz
authors.forename: William R
authors.initials: WR
authors.lastname: Markesbery
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D000818:Animals; D001921:Brain / Q000098:blood supply / Q000378:metabolism / Q000473:pathology*; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D003704:Dementia / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000150:complications / Q000378:metabolism / Q000473:pathology; D008297:Male; D012189:Retrospective Studies
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