Abstract:

Objective  To investigate the possible cerebral metabolic changes in the infarcted side and contralateral side in patients with type 2 diabetes mellitus and acute cerebral infarction using proton magnetic resonance spectroscopy (1H-MRS). Methods  24 patients with type 2 diabetes mellitus and acute cerebral infarction (DMCI group), 23 patients with acute cerebral infarction (CI group) and 26 healthy controls (HC group) were scanned with a 1.5-T MRI/MRS imager. The levels of N-acetylaspartate (NAA), Choline (Cho) and lactate (Lac) were detected and the ratios of NAA/Cr, Cho/Cr and Lac/Cr were calculated. Results  Cerebral NAA/Cr ratio in the infarcted side of CI group and DMCI group was lower than that in the HC group. There was a significant decrease in NAA/Cr ratio in the infarcted side of the DMCI group as compared to CI group. Cerebral NAA/Cr ratio in the infarcted side was lower than that in the contralateral side of the DMCI group, and NAA/Cr ratio in the contralateral side of the DMCI group tended to be lower than that in the HC group. Lac/Cr ratio in the DMCI group and CI group increased in the infarcted side compared to that in the HC group, and the Lac/Cr rataio in the infarcted side of DMCI group was higher than that in the CI group. HbA1c and FBG levels were negatively correlated with NAA/Cr ratio in the DMCI group. Conclusion  Type 2 diabetes may be associated with serious neuron damage in cerebral infarction, and it may cause cerebral damage in the white matter before the occurrence of infarction. 1H-MRS is useful in exploring the pathophysiologic mechanism of diabetes mellitus complicated with acute cerebral infarction.

Key words: Type 2 diabetes mellitus;  Acute cerebral infarction; Magnetic resonance spectroscopy; N-acetylaspartate; Lactate