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Hippocampal atrophy, asymmetry, and cognition in type 2 diabetes mellitus.

ABSTRACT: Introduction:Type 2 diabetes mellitus is associated with global and hippocampal atrophy and cognitive deficits, and some studies suggest that the right hippocampus may display greater vulnerability than the left. Methods:Hippocampal volumes, the hippocampal asymmetry index, and cognitive functioning were assessed in 120 nondemented adults with long duration type 2 diabetes. Results:The majority of the sample displayed left greater than right hippocampal asymmetry (which is the reverse of the expected direction seen with normal aging). After adjustment for age, sex, and IQ, right (but not left) hippocampal volumes were negatively associated with memory, executive function, and semantic fluency. These associations were stronger with the hippocampal asymmetry index and remained significant for memory and executive function after additional adjustment for global brain atrophy. Conclusions:We conclude that asymmetric hippocampal atrophy may occur in type 2 diabetes, with greater atrophy occurring in the right than the left hippocampus, and that this may contribute to cognitive impairment in this disorder. These cross-sectional associations require further verification but may provide clues into the pathogenesis of cognitive disorders in type 2 diabetes.

SUBMITTER: Milne NT

PROVIDER: S-EPMC5853633 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature

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Hippocampal atrophy, asymmetry, and cognition in type 2 diabetes mellitus.

Milne Nicole T NT Bucks Romola S RS Davis Wendy A WA Davis Timothy M E TME Pierson Ronald R Starkstein Sergio E SE Bruce David G DG

Brain and behavior 20171222 1

<h4>Introduction</h4>Type 2 diabetes mellitus is associated with global and hippocampal atrophy and cognitive deficits, and some studies suggest that the right hippocampus may display greater vulnerability than the left.<h4>Methods</h4>Hippocampal volumes, the hippocampal asymmetry index, and cognitive functioning were assessed in 120 nondemented adults with long duration type 2 diabetes.<h4>Results</h4>The majority of the sample displayed left greater than right hippocampal asymmetry (which is ...[more]

PMID: 29568674

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Project description:OBJECTIVES:To study the interactive effect of white matter hyperintensities (WMH) and hippocampal atrophy on cognition in the oldest old. DESIGN:Ongoing longitudinal study. SETTING:In Southern California, brain magnetic resonance imaging (MRI) scans were conducted between May 2014 and December 2017. PARTICIPANTS:Individuals from The 90+ Study with a valid brain MRI scan (N = 141; 94 cognitively normal and 47 with cognitive impairment). MEASUREMENTS:Cognitive testing was performed every 6 months with a mean follow-up of 2 years and included these tests: Mini-Mental State Examination (MMSE), modified MMSE (3MS), California Verbal Learning Test (CVLT) immediate recall over four trials and delayed recall, Digit Span Backward, Animal Fluency, and Trail Making Test (TMT) A, B, and C. We used one linear mixed model for each cognitive test to study the baseline and longitudinal association of WMH and hippocampal volume (HV) with cognition. Models were adjusted for age, sex, and education. RESULTS:Mean age was 94.3 years (standard deviation [SD] = 3.2 y). At baseline, higher WMH volumes were associated with worse scores on the 3MS, CVLT immediate and delayed recall, and TMT B. Lower HVs were associated with worse baseline scores on all cognitive tests, except for the Digit Span Backward. Longitudinally, higher WMH and lower HVs were associated with faster decline in the 3MS and MMSE, and lower HV was also associated with faster decline in the CVLT immediate recall. No association was observed between WMH and HV and no interaction between WMH and HV in their association with baseline cognition or cognitive decline. CONCLUSION:We show that WMH and hippocampal atrophy have an independent, negative effect on cognition that make these biomarkers relevant to evaluate in the diagnostic work-up of the oldest-old individuals with cognitive complaints. However, the predictive value of WMH for cognitive decline seems to be less evident in the oldest-old compared with a younger group of older adults. J Am Geriatr Soc 67:1827-1834, 2019.

Dataset Information

Hippocampal atrophy, asymmetry, and cognition in type 2 diabetes mellitus.

Publications

Hippocampal atrophy, asymmetry, and cognition in type 2 diabetes mellitus.

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