title: Type-2 diabetes mellitus reduces cortical thickness and decreases oxidative metabolism in sensorimotor regions after stroke.
abstract: Individuals with type-2 diabetes mellitus experience poor motor outcomes after ischemic stroke. Recent research suggests that type-2 diabetes adversely impacts neuronal integrity and function, yet little work has considered how these neuronal changes affect sensorimotor outcomes after stroke. Here, we considered how type-2 diabetes impacted the structural and metabolic function of the sensorimotor cortex after stroke using volumetric magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS). We hypothesized that the combination of chronic stroke and type-2 diabetes would negatively impact the integrity of sensorimotor cortex as compared to individuals with chronic stroke alone. Compared to stroke alone, individuals with stroke and diabetes had lower cortical thickness bilaterally in the primary somatosensory cortex, and primary and secondary motor cortices. Individuals with stroke and diabetes also showed reduced creatine levels bilaterally in the sensorimotor cortex. Contralesional primary and secondary motor cortex thicknesses were negatively related to sensorimotor outcomes in the paretic upper-limb in the stroke and diabetes group such that those with thinner primary and secondary motor cortices had better motor function. These data suggest that type-2 diabetes alters cerebral energy metabolism, and is associated with thinning of sensorimotor cortex after stroke. These factors may influence motor outcomes after stroke.
authors.affiliation: 1 Faculty of Medicine, Graduate program of Rehabilitation Sciences, University of British Columbia, Vancouver, Canada.
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Ferris
authors.affiliation: 1 Faculty of Medicine, Graduate program of Rehabilitation Sciences, University of British Columbia, Vancouver, Canada.
authors.forename: Sue
authors.initials: S
authors.lastname: Peters
authors.affiliation: 1 Faculty of Medicine, Graduate program of Rehabilitation Sciences, University of British Columbia, Vancouver, Canada.
authors.forename: Katlyn E
authors.initials: KE
authors.lastname: Brown
authors.affiliation: 2 Department of Psychology, University of British Columbia, Vancouver, Canada.
authors.forename: Katherine
authors.initials: K
authors.lastname: Tourigny
authors.affiliation: 1 Faculty of Medicine, Graduate program of Rehabilitation Sciences, University of British Columbia, Vancouver, Canada.|3 Department of Physical Therapy, University of British Columbia, Vancouver, Canada.|4 Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada.
authors.forename: Lara A
authors.initials: LA
authors.lastname: Boyd
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D004734:Energy Metabolism / Q000502:physiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000502:physiology; D066191:Sensorimotor Cortex / Q000378:metabolism* / Q000473:pathology*; D020521:Stroke / Q000150:complications* / Q000378:metabolism / Q000473:pathology
keywords: Chronic stroke; creatine; magnetic resonance imaging; magnetic resonance spectroscopy; volumetrics