| Background:Type 2 diabetes is a clinically common systemic metabolic disease,and it has become one of the prominent public health problems in China and even in the world.Type 2 diabetes can affect multiple organs throughout the body.Mild cognitive impairment is one of the most common complications in the central nervous system.Mild cognitive impairment is considered to be the transitional stage from normal to dementia.The condition is often irreversible when clinical symptoms appear,so early diagnosis and intervention treatment are important for the prognosis of patients.The early evaluation of type 2 diabetes with mild cognitive impairment is mainly assessed by the cognitive function check scale,but it is subjective and not highly accurate.At present,there is no clinically accurate inspection method.Functional magnetic resonance imaging,especially 3D-ASL,DTI and 1H-MRS technologies,can objectively reflect the microscopic changes in the brain of type 2 diabetic patients from many aspects.It is expected that the posterior cingulate gyrus area closely related to cognitive function will be used as the entry point.Become an early warning inspection method for type 2 diabetes with mild cognitive impairment in the future.Objective:To study the brain microstructure damage and metabolite changes in posterior cingulate cortex(PCC)area of patients with type 2 diabetes mellitus(T2DM),through the combined use of 3D-ASL,DTI and 1H-MRS technology to study the cerebral blood perfusion status,thereby providing diabetes with cognition Early diagnosis of dysfunction provides objective evidence and explores its related mechanisms.Methods: Based on the scores of the Mini Mental State Mental Scale(MMSE)and the Montreal Cognitive Assessment Scale(MoCA),37 T2 DM patients and 17 healthy volunteers,a total of 54 research subjects,were divided into three groups,namely 19T2 DM patients Patients with mild cognitive impairment(MCI group),18 patients with T2 DM without mild cognitive impairment(NMCI group)and 17 normal controls(NC group).All the cases were checked with 3D-ASL,DTI and multi-voxel MRS examinations respectively,and we calculated the PCC area of cerebral blood flow(CBF),anisotropy score(FA),average diffusion rate(MD)and the ratio of each metabolite peak,and analysed clinical relevant Correlation between laboratory indicators and cognitive function scores.Results: The CBF values of the left posterior cingulate gyrus of the MCI group and the NMCI group were lower than those of the NC group,but there was no significant difference(P>0.05);the FA value of the left posterior cingulate gyrus of the MCI group was significantly lower than that of the NC group,And the difference was statistically significant(P<0.05),the FA value of the MCI group was lower than that of the NMCI group,but there was no significant difference(P>0.05);the MD value of the left posterior cingulate gyrus of the MCI group was significantly higher than that of the NMCI group The m I/Cr ratio in the left posterior cingulate gyrus of the MCI group was significantly higher than that of the NMCI group and the NC group,and the difference was statistically significant(P<0.05);The NAA/Cr ratio of the left posterior cingulate gyrus of the MCI group was lower than that of the NMCI group and NC group,but the difference was not significant(P>0.05).The FA value in the left posterior cingulate gyrus of the MCI group was moderately positively correlated with the MoCA score(r=0.580,P<0.05),and the MD value and m I/Cr ratio were respectively moderately negatively correlated with the MoCA score(r1=-0.616),P<0.05;r2=-0.663,P<0.05).Conclusion:The combined use of 3D-ASL,DTI and multi-voxel 1H-MRS technology can respectively detect abnormal changes in blood flow,diffusion and metabolism in the PCC area of patients with T2 DM and MCI,which can provide objective basis of early clinical diagnosis for patients with type 2 diabetes and mild cognitive impairment,and can reflect the pathological basis of diabetic brain injury in a certain extent degree. |
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