Region-specific susceptibility change in cognitively impaired patients with diabetes mellitus

PLoS One. 2018 Oct 11;13(10):e0205797. doi: 10.1371/journal.pone.0205797. eCollection 2018.

Abstract

Emerging evidence suggests that diabetes mellitus (DM) is associated with iron and calcium metabolism. However, few studies have investigated the presence of DM in cognitively impaired patients and its effect on brain iron and calcium accumulation. Therefore, we assessed the effects of DM on cognitively impaired patients using quantitative susceptibility mapping (QSM). From June 2012 to Feb 2014, 92 eligible cognitively impaired patients underwent 3T magnetic resonance imaging (MRI). There were 46 patients with DM (DM+) and 46 aged matched patients without DM (DM-). QSM was obtained from gradient echo data and analyzed by drawing regions of interest around relevant anatomical structures. Clinical factors and vascular pathology were also evaluated. Measurement differences between DM+ and DM- patients were assessed by t tests. A multiple regression analysis was performed to identify independent predictors of magnetic susceptibility. DM+ patients showed lower susceptibility values, indicative of lower brain iron content, than DM- patients, which was significant in the hippocampus (4.80 ± 8.31 ppb versus 0.22 ± 10.60 ppb, p = 0.024) and pulvinar of the thalamus (36.30 ± 19.88 ppb versus 45.90 ± 20.02 ppb, p = 0.023). On multiple regression analysis, microbleed number was a predictor of susceptibility change in the hippocampus (F = 4.291, beta = 0.236, p = 0.042) and DM was a predictor of susceptibility change in the pulvinar of the thalamus (F = 4.900, beta = - 0.251, p = 0.030). In cognitively impaired patients, presence of DM was associated with lower susceptibility change in the pulvinar of the thalamus and hippocampus. This suggests that there may be region-specific alterations of calcium deposition in cognitively impaired subjects with DM.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Brain / diagnostic imaging
  • Brain / metabolism
  • Brain Chemistry
  • Calcium / analysis
  • Calcium / metabolism
  • Case-Control Studies
  • Cognitive Dysfunction / complications*
  • Cognitive Dysfunction / etiology
  • Diabetic Neuropathies / complications*
  • Female
  • Hippocampus / chemistry
  • Hippocampus / diagnostic imaging
  • Humans
  • Iron / analysis
  • Iron / metabolism
  • Magnetic Resonance Imaging
  • Male
  • Neuroimaging
  • Risk Factors
  • Thalamus / chemistry
  • Thalamus / diagnostic imaging

Substances

  • Iron
  • Calcium

Grants and funding

This work was supported by the National Research Foundation of Korea(NRF) grant funded by the Korea government (MSIP) (No. 2017R1A2B4010634). This research was also supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI18C1038). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.