DETECTION OF CEREBRAL ATROPHY IN TYPE- II DIABETES MELLITUS BY MAGNETIC RESONANCE IMAGING OF BRAIN

Authors

  • Ghayyur Khan
  • Nasir Khan
  • Abdul Aziz

Abstract

Background: Diabetes is a metabolic disorder that affects many systems in the body. Cerebralatrophy is one of the complications of diabetes and research is on going to find out itsaetiopathological factors. The main aim of the study was to determine the frequency of cerebralatrophy in type-II diabetes mellitus using magnetic resonance imaging of the brain. Methods: Onehundred diabetic patients (Random blood sugar >126 mg/dl) were recruited in this study after theinformed consent from every patient. Duration of diabetes was five years and more in all the patientsas determined by their glycosylated haemoglobin which was >6 in all the patients. All the patientswere undergone MRI of brain using 1.5 Tesla power magnetic resonance imaging machine of PickerCompany. Evan’s index, a specific parameter for measurement of cerebral atrophy was calculated onMR images and was used in this study. Results: In male group the frequency of cerebral atrophy was22 (47%) and in female group it was found to be 23 (43%). When we study the overall populationthe frequency was found to be 45 (45%). The results are well in concordance with the previous datapublished on this issue. Conclusions: Cerebral atrophy, a complication of long standing diabetes isquite frequent in our population and is well diagnosed by MRI.Keywords: Diabetes Mellitus, cerebral atrophy, MRI, frequency, complications of diabetes

References

Brant-Zawadzki M, Heiserman JE. The roles of MR

angiography, CT angiography, and sonography in vascular

imaging of the head and neck. AJNR Am J Neuroradiol

;18:1820–5.

Hoeffner EG, Case I, Jain R, Gujar SK, Shah GV, Deveikis JP,

et al. Cerebral perfusion CT: technique and clinical

applications. Radiology 2004;231:632–44.

Provenzale JM, Shah K, Patel U, McCrory DC. Systematic

review of CT and MR perfusion imaging for assessment of

acute cerebrovascular disease. AJNR Am J Neuroradiol

;29:1476–82.

Pretorius PM, Quaghebeur G. The role of MRI in the

diagnosis of MS. Clin Radiol 2003;58:434–48.

Araki Y, Nomura M, Tanaka H, Yamamoto H, Tsukaguchi I,

Nakamura H. MRI of the brain in diabetes mellitus.

Neuroradiology 1994;36:101–3.

Inoue T, Fushimi H, Yamada Y, Udaka F, Kameyama M:

Asymptomatic multiple lacunae in diabetics and non-diabetics

detected by brain magnetic resonance imaging. Diabetes Res

Clin Pract 1996;31:81–6.

Kameyama M, Fushimi H, Udaka F. Diabetes mellitus and

cerebral vascular disease. Diabetes Res Clin Pract

;24(Suppl):S205–8.

Shintani S, Shiigai T, Arinami T: Subclinical cerebral lesion

accumulation on serial magnetic resonance imaging (MRI) in

patients with hypertension: risk factors. Acta Neurol Scand

;97:251–6.

Lunetta M, Damanti AR, Fabbri G, Lombardo M, DiMauro M,

Mughini L. Evidence by magnetic resonance imaging of

cerebral alterations of atrophy type in young insulin-dependent

diabetic patients. J Endocrinol Inves 1994;17:241–5.

Fushimi H, Inoue T, Yamada Y, Udaka F, Kameyama M.

Asymptomatic cerebral infarcts (lacunae), their risk factors and

intellectual disturbances. Diabetes 1996;45(Suppl 3):S98–100.

Fukuda H, Kitani M. Differences between treated and untreated

hypertensive subjects in the extent of periventricular

hyperintensities observed on brain MRI. Stroke 1995;26:1593–7.

Perros P, Deary IJ, Sellar RJ, Best JJ, Frier BM. Brain

abnormalities demonstrated by magnetic resonance imaging in

adult patients with and without a history of severe

hypoglycemia. Diabetes Care 1997;20:1013–8.

Moulin T, Tatu L, Vuillier F, Berger E, Chavot D, Rumbach L.

Role of a stroke data bank in evaluating cerebral infarction

subtypes: patterns and outcome of 1,776 consecutive patients

from the Besancon stroke registry. Cerebrovasc Dis

;10:261–71.

Bradley WG Jr, Waluch V, Brant-Zawadzki M, Yadley RA,

Wycoff RR. Patchy periventricular white matter lesions in the

elderly: a common observation during NMR imaging.

Noninvasive Med Imaging 1984;1:35–41.

Awad IA, Spetzler RF, Hodak JA, Awad CA, Carey R.

Incidental subcortical lesions identified on magnetic resonance

imaging in the elderly. I. Correlation with age and

cerebrovascular risk factors. Stroke 1986;17:1084–9.

Sarpel G, Chaudry F, Hindo W. Magnetic resonance imaging

periventricular hyperintensity in a veterans administration

hospital population. Arch Neurol 1987;44:725–728.

Kertesz A, Black SE, Tokar G, Benke T, Carr T, Nicholson L.

Periventricular and subcortical hyperintensities on magnetic

resonance imaging: rims, caps and unidentified bright objects.

Arch Neurol 1988;45:404–8.

Schmidt R, Fazekas F, Kleinert G, Offenbacher H, Gindl K,

Payer F, et al. Magnetic resonance imaging signal

hyperintensities in the deep and subcortical white matter: a

comparative study between stroke patients and normal

volunteers. Arch Neurol 1992;49:825–7.

Hendrie HC, Farlow MR, Austrom MG, Edwards MK,

Williams MA. Foci of increased T2 signal intensity on brain

MRI scans of healthy elderly subjects. AJNR Am J

Neuroradiol 1989;10:703–7.

Bots ML, vanSwieten JC, Breteler MMB, de Jong PT, van Gijn

J, Hofman A, Grobbee DE: Cerebral white matter lesions and

atherosclerosis in the Rotterdam study. Lancet 1993;341:1232–7.

Longstreth WT, Bernick C, Manolio TA, Bryan N, Jungreis

CA, Price TR. Lacunar infarcts defined by magnetic resonance

imaging of 3660 elderly people: the Cardiovascular Health

Study. Arch Neurol 1998;55:1217–25.

Longstreth WT, Manolio TA, Arnold A, Burke GL, Bryan N,

Jungreis CA, et al. Clinical correlates of white matter findings

on cranial magnetic resonance imaging of 3301 elderly people:

the Cardiovascular Health Study. Stroke 1996;23:1274–82.

Longstreth WT, Arnold A, Manolio TA, Burke GL, Bryan N,

Jungreis CA, et al. Clinical correlates of ventricular and sulcal

size on cranial magnetic resonance imaging of 3,301 elderly

people: the Cardiovascular Health Study Collaborative

Research Group. Neuroepidemiology 2000;19:30–42.

Schmidt R, Fazekas F, Kapeller P, Schmidt H, Hartung HP.

MRI white matter hyperintensities-three-year follow-up of the

Austrian Stroke Prevention Study. Neurology 1999;53:132–9.

UK Prospective Diabetes Study Group. Tight blood pressure

control and risk of macrovascular and microvascular

complications in type 2 diabetes: UKDPS 38. Br Med J

;317:703–13.

Finn R. MRI reveals cerebral atrophy in type 1 diabetic

patients. Clinical Psychiatry News, July 2003. Available from:

http://findarticles.com/p/articles/mi_hb4345/is_7_31/ai_n2901

/

Schmidt R, Launer LJ, Nilsson LG, Pajak A, Sans S, Berger K,

Breteler MM, et al. Magnetic Resonance Imaging of the Brain

in Diabetes The Cardiovascular Determinants of Dementia

(CASCADE) Study. Diabetes 2004;53:687–92.

Published

2010-06-01

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