Article

Structural brain imaging in diabetes: A methodological perspective

Department of Neurology/Image Sciences Institute, University Medical Center Utrecht, Q0S.459, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
European Journal of Pharmacology (Impact Factor: 2.68). 06/2008; 585(1):208-18. DOI: 10.1016/j.ejphar.2007.11.085
Source: PubMed

ABSTRACT Brain imaging provides information on brain anatomy and function and progression of cerebral abnormalities can be monitored. This may provide insight into the aetiology of diabetes related cerebral disorders. This paper focuses on the methods for the assessment of white matter hyperintensities and brain atrophy on structural brain images, mostly magnetic resonance imaging, in diabetes. These methods range from visual rating scales to advanced semi-automated and automated image processing techniques such as volumetry and voxel-based morphometry. The findings of previous imaging studies in diabetes are discussed from a methodological perspective and recommendations for future research are given.

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    • "Pulse pressure (the difference between systolic and diastolic blood pressure, which is associated with vessel stiffening and vascular aging) has also been cross-sectionally associated with white matter hyperintensities in older adults [80]. Glucose-related disturbances have also been associated with brain structural changes [81] [82] [83]. Among lifestyle factors, attention has recently focused on the role of diet and physical activity as well as to social and cognitive engagement in brain aging [84]. "
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    ABSTRACT: Maintaining brain health promotes successful aging. The main determinants of brain health are the preservation of cognitive function and remaining free from structural and metabolic abnormalities, including loss of neuronal synapses, atrophy, small vessel disease and focal amyloid deposits visible by neuroimaging. Promising studies indicate that these determinants are to some extent modifiable, even among adults seventy years and older. Converging animal and human evidence further suggests that inflammation is a shared mechanism, contributing to both cognitive decline and abnormalities in brain structure and metabolism. Thus, inflammation may provide a target for intervention. Specifically, circulating inflammatory markers have been associated with declines in cognitive function and worsening of brain structural and metabolic characteristics. Additionally, it has been proposed that older brains are characterized by a sensitization to neuroinflammatory responses, even in the absence of overt disease. This increased propensity to central inflammation may contribute to poor brain health and premature brain aging. Still unknown is whether and how peripheral inflammatory factors directly contribute to decline of brain health. Human research is limited by the challenges of directly measuring neuroinflammation in vivo. This review assesses the role that inflammation may play in the brain changes that often accompany aging, focusing on relationships between peripheral inflammatory markers and brain health among well-functioning, community-dwelling adults seventy years and older. We propose that monitoring and maintaining lower levels of systemic and central inflammation among older adults could help preserve brain health and support successful aging. Hence, we also identify plausible ways and novel experimental study designs of maintaining brain health late in age through interventions that target the immune system.
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    • "Magnetic resonance imaging (MRI) based brain volumetry is a valuable technique for identifying subcortical morphometric changes in vivo and determining the regional neurological impact of psychopathology, disease progression, and advancing therapeutic regimens. This approach has been useful for characterizing the effects of dementia (Carmichael et al. 2005, Teipel et al. 2008, Thompson et al. 2001), psychiatric disorders (Csernansky et al. 1998, Hickie et al. 2005, Konarski et al. 2008, Styner et al. 2004), and normal aging (Brickman et al. 2008, Elderkin-Thompson et al. 2008, Walhovd et al. 2005), as well as uncovering regional and global neurological consequences of systemic diseases such as the Human Immunodeficiency Virus (HIV) (Carmichael et al. 2007, Sporer et al. 2005, Stout et al. 1998, Thompson et al. 2005, Thompson et al. 2006), diabetes (Jongen and Biessels 2008, Perantie et al. 2007, Tiehuis et al. 2008, Wessels et al. 2007), and scoliosis (Liu et al. 2008). As techniques in MRI continue to advance, in vivo volumetric measurement will become increasingly valuable in the drive to understand the evolution and progression of injury for CNS disorders as well as typical aging. "
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    NeuroImage 03/2010; 51(4):1334-44. DOI:10.1016/j.neuroimage.2010.03.033 · 6.36 Impact Factor
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    • "Several large population-based studies did not observe a significant association between T2DM and WMHs (reviewed in [53]). However, case-control studies that applied more refined WMH rating scales or volumetric measurements did observe a modest increase in WMH severity in patients with T2DM [54] [58]. A recent study also identified T2DM is a risk factor for WMH progression [59]. "
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