Impaired cerebral blood flow in type 2 diabetes mellitus – A comparative study with subjective cognitive decline, vascular dementia and Alzheimer’s disease subjects

摘要

The link between non-demented type 2 diabetes mellitus (T2DM) and different types of cognitive impairment is controversial. By controlling for co-morbidities such as cerebral macrovascular and microvascular changes, cerebral atrophy, amyloid burden, hypertension or hyperlipidemia, the current study investigated the cerebral blood flow of T2DM individuals as compared to cognitively impaired subjects recruited from a memory clinic.15 healthy control (71.8?±?6.1?years), 18 T2DM (62.5?±?3.7?years), as well as 8 Subjective Cognitive Decline (69.5?±?7.5?years), 12 Vascular Dementia (79.3?±?4.2?years) and 17 Alzheimer’s Disease (75.1?±?8.2?years) underwent multi-parametric MRI brain scanning. Subjects with T2DM and from the memory clinic also had 18-F Flutametamol PET-CT scanning to look for any amyloid burden. Pseudocontinuous Arterial Spin Labeling (PCASL), MR Angiography Head, 3D FLAIR and 3D T1-weighted sequences were used to quantify cerebral blood flow, cerebrovascular changes, white matter hyperintensities and brain atrophy respectively. Vascular risk factors were retrieved from the medical records. The 37 subjects from memory clinic were classified into subjective cognitive decline (SCD), vascular dementia (VD) and Alzheimer’s disease (AD) subgroups by a multi-disciplinary panel consisting of a neuroradiologist, and 2 geriatricians.Absolute cortical CBF in our cohort of T2DM, SCD, VD and AD was significantly decreased (p?