Human cerebral neuropathology of Type 2 diabetes mellitus.
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.
Nelson
Peter T
PT
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
Smith
Charles D
CD
Abner
Erin A
EA
Schmitt
Frederick A
FA
Scheff
Stephen W
SW
Davis
Gregory J
GJ
Keller
Jeffrey N
JN
Jicha
Gregory A
GA
Davis
Daron
D
Wang-Xia
Wang
W
Hartman
Adria
A
Katz
Douglas G
DG
Markesbery
William R
WR
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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