title: Right Dorsolateral Frontal Lobe N-Acetyl Aspartate and Myoinositol Concentration Estimation in Type 2 Diabetes with Magnetic Resonance Spectroscopy.
abstract: BACKGROUND
  Chronic hyperglycaemia in type 2 diabetes, effects the central nervous system by altering the concentrations of brain metabolites like N-acetyl aspartate (NAA) and myoinositol (mI), which are indicators of neuronal integrity and glial cell damage respectively. Dorsolateral frontal lobe is associated with aspects of cognition especially right frontal lobe is involved in episodic memory retrieval, ninety percent of the diabetic cases are type 2 in nature globally and yoga is very effective in stabilizing the brain metabolites by bringing the blood glucose levels to near or within the physiological range in type 2 diabetes.
  
  
  OBJECTIVE
  The aim of the study was to observe the effects of yogasana and pranayama on glycosilated haemoglobin (HbA1c) levels and right dorsolateral frontal cortical NAA and mI concentration in type 2 diabetic subjects.
  
  
  METHODS
  It's a case control study. Sixty eight type 2 diabetic subjects of both the sex, aged between 35-65 years are included in the study, subjects are divided in to test and control group 34 each. Test group subjects did the yogasana and pranayama for a period of 6 months, 6 days in a week, 45-60 minutes daily under the supervision of a qualified yoga teacher. Control group subjects are not on any specific exercise regimen. Both the group subjects are taking oral hypoglycaemic agents. HbA1c levels are measured using the Bio-Rad D-10™ haemoglobin A1c program and Magnetic Resonance Spectroscopy (MRS) is used in assessing the metabolite concentrations.
  
  
  METHODS
  Analysis of data was done by using unpaired t-test. P-value for HbA1c level is <0.001, which is highly significant statistically. P-value for NAA was < 0.02 and for myoinositol was < 0.01, which are statistically significant.
  
  
  RESULTS
  HbA1c levels in control and test group subjects are 7.7 ± 1.84 and 6.02 ± 0.46 respectively. NAA concentrations in the right dorsolateral frontal lobe of control and test group are 1.44 ± 0.15 and 1.54 ± 0.19 respectively. The mI concentrations in the right dorsolateral frontal lobe of control and test group are 0.61 ± 0.22 and 0.47 ± 0.24 respectively.
  
  
  CONCLUSIONS
  Yogasana and pranayama minimized the neuronal and glial cellular damage in test group, which is evident by minimal changes in right dorsolateral frontal lobe NAA and mI levels in type 2 diabetic subjects.
authors.affiliation: Assistant Professor, Department of Physiology, MediCiti Institute of Medical Sciences , Hyderabad, India .
authors.forename: Rajani Santhakumari
authors.initials: RS
authors.lastname: Nagothu
authors.affiliation: Associate Professor, Department of Physiology, MediCiti Institute of Medical Sciences , Hyderabad, India .
authors.forename: Yogananda Indla
authors.initials: YI
authors.lastname: Reddy
authors.affiliation: Professor, Department of Physiology, Saveetha Medical college , Chennai, India .
authors.forename: Archana
authors.initials: A
authors.lastname: Rajagopalan
authors.affiliation: Professor, Department of Radiology, MediCiti Institute of Medical Sciences , Hyderabad, India .
authors.forename: Ravi
authors.initials: R
authors.lastname: Varma
keywords: Frontal lobe; Glycosilated haemoglobin; Yogasana and pranayama