MR spectroscopy of cerebral white matter in type 2 diabetes; no association with clinical variables and cognitive performance.
BACKGROUND
Type 2 diabetes (DM2) is associated with cognitive decline, but the pathogenesis of this important complication remains unclear. We investigated whether abnormalities in neuronal metabolism or membrane integrity in normal appearing cerebral white matter are associated with cognitive impairment in patients with DM2.


METHODS
Single voxel proton magnetic resonance spectroscopy (1.5 T), aimed at N-acetyl-aspartate (NAA), total choline (Cho), and total creatine (Cr), was performed in the cerebral white matter (centrum semiovale) of 72 patients with DM2 and 40 control subjects. All participants underwent extensive neuropsychological evaluation.


RESULTS
Patients with DM2 performed worse with respect to global neuropsychological functioning than controls (p < 0.05), in particular on memory and information processing speed. We observed no differences in NAA/Cr, Cho/Cr, or NAA/Cho ratio's between patients with DM2 and controls. Cognitive performance in patients with DM2 was not correlated with any of these brain metabolites, neither were the clinical variables.


CONCLUSIONS
We conclude that disturbances in neuronal viability and cellular membrane status assessed by NAA/Cr, Cho/Cr, NAA/Cho ratios cannot explain cognitive decline in patients with DM2.
Department of Radiology (Hp E01.332), University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands. a.m.tiehuis@umcutrecht.nl
Audrey
A
Tiehuis
Femke
F
van der Meer
Willem
W
Mali
Marc
M
Pleizier
Geert Jan
GJ
Biessels
Jaap
J
Kappelle
Peter
P
Luijten
D000368:Aged; D000369:Aged, 80 and over; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001921:Brain / Q000378:metabolism*; D002794:Choline / Q000378:metabolism; D003071:Cognition; D003072:Cognition Disorders / Q000209:etiology / Q000378:metabolism*; D003401:Creatine / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism*; D005260:Female; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008568:Memory; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000378:metabolism*; D009483:Neuropsychological Tests; D017785:Photons; D013997:Time Factors
D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline