title: Impaired cerebrovascular responsiveness and cognitive performance in adults with type 2 diabetes.
abstract: OBJECTIVE
  Cognitive deficits in type 2 diabetes mellitus (T2DM) may be partly attributable to stiffness in cerebral arteries and impaired vasodilator function, limiting the ability to increase blood flow in brain regions to meet cognitive demands. We undertook a comparison of cerebrovascular responsiveness (CVR) and cognitive performance in adults with and without T2DM.
  
  
  METHODS
  Older adults with (50) and without (Herath, Cherbuin, Eramudugolla, & Anstey, 2016) T2DM underwent transcranial Doppler ultrasound measurements of basal cerebral mean blood flow velocity (MBFV) and pulsatility index (PI), a measure of arterial stiffness, in the middle cerebral arteries (MCA). A battery of tasks assessing domains of working memory, executive function and information processing/motor speed was then administered while MBFV was recorded. CVR to cognitive tasks was calculated as a percentage increase in MBFV from the basal level.
  
  
  RESULTS
  There was no difference in basal MBFV between groups. However, PI was 14% higher in the T2DM group (P<0.05), who performed poorer across all cognitive domains assessed and displayed poorer CVR in three tasks. Cognitive performance was inversely related to the PI/MBFV ratio, an indicator of intracranial stenosis.
  
  
  CONCLUSIONS
  Impaired cerebral perfusion during mental tasks is accompanied by poor cognitive performance and stiffness in the cerebral vessels.
authors.affiliation: Clinical Nutrition Research Centre, School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, Newcastle, New South Wales 2308, Australia. Electronic address: Rhenan.nealon@uon.edu.au.
authors.forename: Rhenan Scott
authors.initials: RS
authors.lastname: Nealon
authors.affiliation: Clinical Nutrition Research Centre, School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, Newcastle, New South Wales 2308, Australia. Electronic address: Peter.howe@newcastle.edu.au.
authors.forename: Peter Ranald Charles
authors.initials: PR
authors.lastname: Howe
authors.affiliation: Clinical Nutrition Research Centre, School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, Newcastle, New South Wales 2308, Australia. Electronic address: Lyanne.jansen@hotmail.com.
authors.forename: Lyanne
authors.initials: L
authors.lastname: Jansen
authors.affiliation: Clinical Nutrition Research Centre, School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, Newcastle, New South Wales 2308, Australia. Electronic address: Manohar.garg@newcastle.edu.au.
authors.forename: Manohar
authors.initials: M
authors.lastname: Garg
authors.affiliation: Clinical Nutrition Research Centre, School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, Newcastle, New South Wales 2308, Australia. Electronic address: rachel.wong@newcastle.edu.au.
authors.forename: Rachel Heloise Xiwen
authors.initials: RH
authors.lastname: Wong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D060825:Cognitive Dysfunction / Q000209:etiology*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D018450:Disease Progression; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D008570:Memory, Short-Term; D008606:Mental Processes; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D009517:New South Wales / Q000453:epidemiology; D063177:Pulse Wave Analysis; D012306:Risk; D012720:Severity of Illness Index; D017585:Ultrasonography, Doppler, Transcranial; D014655:Vascular Resistance; D059289:Vascular Stiffness
keywords: Arterial stiffness; Cerebral perfusion; Cognitive decline; Diabetes mellitus; Transcranial Doppler