title: Cerebral blood flow, blood supply, and cognition in Type 2 Diabetes Mellitus.
abstract: We investigated whether type 2 diabetes (T2DM) and the presence of cognitive impairment are associated with altered cerebral blood flow (CBF). Forty-one participants with and thirty-nine without T2DM underwent 3-Tesla MRI, including a quantitative technique measuring (macrovascular) blood flow in the internal carotid artery and an arterial spin labeling technique measuring (microvascular) perfusion in the grey matter (GM). Three analysis methods were used to quantify the CBF: a region of interest analysis, a voxel-based statistical parametric mapping technique, and a 'distributed deviating voxels' method. Participants with T2DM exhibited significantly more tissue with low CBF values in the cerebral cortex and the subcortical GM (3.8-fold increase). The latter was the only region where the hypoperfusion remained after correcting for atrophy, indicating that the effect of T2DM on CBF, independent of atrophy, is small. Subcortical CBF was associated with depression. No associations were observed for CBF in other regions with diabetes status, for carotid blood flow with diabetes status, or for CBF or flow in relation with cognitive function. To conclude, a novel method that tallies total 'distributed deviating voxels' demonstrates T2DM-associated hypoperfusion in the subcortical GM, not associated with cognitive performance. Whether a vascular mechanism underlies cognitive decrements remains inconclusive.
authors.affiliation: Departments of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands. jacobus.jansen@mumc.nl.|School for Mental Health and Neuroscience (MHeNS), Maastricht, the Netherlands. jacobus.jansen@mumc.nl.
authors.forename: Jacobus F A
authors.identifier: 0000-0002-5271-8060
authors.initials: JF
authors.lastname: Jansen
authors.affiliation: Departments of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands.|School for Mental Health and Neuroscience (MHeNS), Maastricht, the Netherlands.
authors.forename: Frank C G
authors.initials: FC
authors.lastname: van Bussel
authors.affiliation: Departments of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands.|School for Mental Health and Neuroscience (MHeNS), Maastricht, the Netherlands.|Departments of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Harm J
authors.initials: HJ
authors.lastname: van de Haar
authors.affiliation: Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Matthias J P
authors.initials: MJ
authors.lastname: van Osch
authors.affiliation: Departments of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Paul A M
authors.initials: PA
authors.lastname: Hofman
authors.affiliation: School for Mental Health and Neuroscience (MHeNS), Maastricht, the Netherlands.|Departments of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Martin P J
authors.initials: MP
authors.lastname: van Boxtel
authors.affiliation: School for Mental Health and Neuroscience (MHeNS), Maastricht, the Netherlands.|Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands.|Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: van Oostenbrugge
authors.affiliation: Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands.
authors.forename: Miranda T
authors.initials: MT
authors.lastname: Schram
authors.affiliation: Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands.|Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Coen D A
authors.initials: CD
authors.lastname: Stehouwer
authors.affiliation: Departments of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands.|Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands.
authors.forename: Joachim E
authors.initials: JE
authors.lastname: Wildberger
authors.affiliation: Departments of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands.|School for Mental Health and Neuroscience (MHeNS), Maastricht, the Netherlands.
authors.forename: Walter H
authors.initials: WH
authors.lastname: Backes
mesh_terms: D000368:Aged; D000886:Anthropometry; D002560:Cerebrovascular Circulation; D003071:Cognition; D003924:Diabetes Mellitus, Type 2 / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged