Brain changes in diabetes mellitus patients with gastrointestinal symptoms

Table 3 Imaging findings in patients with diabetes

Ref.	Method	Results
Jongen et al[72]	MR images of 99 DM patients and 46 controls	Larger lateral ventricular volume with white matter lesion and smaller great matter volume was seen in the diabetes patients. The effect of diabetes on brain atrophy where only significant in women
Kodl et al[83]	25 type-1 diabetes patients and controls were scanned with a diffusion tensor imaging protocol	White matter microstructural deficits in patients with longstanding diabetes type-1 were found. The deficits correlated with the neurocognitive tests
Last et al[71]	Cerebral blood flow was examined in 26 diabetes patients and 25 controls using continuous arterial spin labeling imaging during baseline, CO2 rebreathing and hyperventilation	Type-2 diabetes was associated with cortical and subcortical atrophy involving frontal and temporal brain regions and with diminished vasoreactivity and regional cerebral perfusion. Uncontrolled diabetes may further contribute to hypoperfusion and atrophy
Kamiyama et al[74]	Voxel-based morphometric analysis was performed on 28 diabetes patients and 28 controls	Diabetes patients had hippocampal region atrophy and whole-brain atrophy
Northham et al[84]	MRI and IQ test were performed on 106 type-1 diabetes patients and 75 control subjects at baseline and then a 12-yr follow-up	DM subjects had lower verbal and full scale IQs, a decreased gray matter in bilateral thalami and right parahippocampal gyrus and insular cortex. White matter was decreased in bilateral parahippocampus, left temporal lobe, and middle frontal area
van Elderen et al[32]	Cognitive function test and MRI was conducted on 438 control subjects and 89 DM patients aged 70-82 yr	Elderly DM patients have accelerated progression of brain atrophy with significant consequences in cognition compared to the control subjects
Frøkjær et al[68]	MR scanning was performed in 23 controls and 26 patients with DM and GI symptoms and diffusion tensor imaging was performed	Diabetes patients had microstructural changes in brain areas involved in visceral sensory processing. This could be related to generalized DM-induced brain changes
Rosebud et al[73]	MRI on 51437 subjects including 214 with diabetes was performed	Midlife diabetes was associated with subcortical infarctions. Reduced hippocampal volume, whole brain volume and mild cognitive impairment were registered in diabetes patients
Frøkjær et al[75]	20 healthy controls and 15 patients with longstanding type 1 diabetes mellitus were scanned and cortical thickness was assessed based on a cortical segmentation method	Reduced cortical thickness of superior parietal and postcentral gyrus. No overall macrostructural brain alterations were detected, but the authors concluded that cortical thinning involving sensory related areas might be important in diabetes

MR: Magnetic resonance; MRI: Magnetic resonance imaging; GI: Gastrointestinal; IQ: Intelligence quotient; DM: Diabetes mellitus.