title: Metabolite differences in the lenticular nucleus in type 2 diabetes mellitus shown by proton MR spectroscopy.
abstract: OBJECTIVE
  Previous studies by using proton MR spectroscopy found metabolite abnormalities in the cerebral cortex and white matter of patients with type 2 diabetes mellitus. The present study was undertaken to detect metabolite differences in the lenticular nuclei and thalamus in patients with T2DM.
  
  
  METHODS
  Twenty subjects with T2DM and 22 age-matched control subjects underwent single-voxel MR spectroscopy in the left and right lenticular nuclei and left and right thalami. NAA/Cr and Cho/Cr ratios were calculated. Brain lactic acid, fasting blood glucose, and glycosylated hemoglobin levels were also monitored.
  
  
  RESULTS
  The NAA/Cr ratio was lower in the left lenticular nuclei of subjects with T2DM (P = .007), whereas the Cho/Cr ratio was increased in both the and right lenticular nuclei (P = .001). The NAA/Cr ratio was negatively correlated with FBG in the left (r = -0.573, P = .008) and right nuclei (r = -0.564, P = .010). It was also negatively correlated to HbA1c in the left (r = -0.560, P = .010) and right (r = -0.453, P = .045) nuclei. The Cho/Cr ratio was positively correlated with these variables (P < .05). No significant differences in NAA/Cr or Cho/Cr ratios were observed in the thalamus of patients with T2DM. Lactic acid was not detected in any of the patients in the study.
  
  
  CONCLUSIONS
  The different metabolic statuses of the lenticular nuclei and thalamus suggest different effects of T2DM in each of these brain nuclei, with the lenticular nuclei being more vulnerable than the thalamus. The abnormal metabolic status was observed before lesions had appeared in these brain areas.
authors.affiliation: Departments of Neurology.
authors.forename: Y
authors.initials: Y
authors.lastname: Lin
authors.forename: J
authors.initials: J
authors.lastname: Zhou
authors.forename: L
authors.initials: L
authors.lastname: Sha
authors.forename: Y
authors.initials: Y
authors.lastname: Li
authors.forename: X
authors.initials: X
authors.lastname: Qu
authors.forename: L
authors.initials: L
authors.lastname: Liu
authors.forename: H
authors.initials: H
authors.lastname: Chen
authors.forename: Z
authors.initials: Z
authors.lastname: An
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
authors.forename: C
authors.initials: C
authors.lastname: Sun
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D002794:Choline / Q000032:analysis / Q000378:metabolism*; D003342:Corpus Striatum / Q000378:metabolism*; D003401:Creatine / Q000032:analysis / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000378:metabolism*; D005260:Female; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011522:Protons; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013788:Thalamus / Q000378:metabolism*; D014018:Tissue Distribution
chemical_list: D015415:Biomarkers; D011522:Protons; D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline