Published online Apr 15, 2021. doi: 10.4239/wjd.v12.i4.499
Peer-review started: December 11, 2020
First decision: January 11, 2021
Revised: January 12, 2021
Accepted: March 7, 2021
Article in press: March 7, 2021
Published online: April 15, 2021
Type 2 diabetes mellitus (T2DM) has been strongly associated with an increased risk of developing cognitive dysfunction and dementia. The mechanisms of diabetes-associated cognitive dysfunction (DACD) have not been fully elucidated to date. Some studies proved lower cerebral blood flow (CBF) in the hippocampus was associated with poor executive function and memory in T2DM. Increasing evidence showed that diabetes leads to abnormal vascular endothelial growth factor (VEGF) expression and CBF changes in humans and animal models. In this study, we hypothesized that DACD was correlated with CBF alteration as measured by three-dimensional (3D) arterial spin labeling (3D-ASL) and VEGF expression in the hippocampus.
To assess the correlation between CBF (measured by 3D-ASL and VEGF expression) and DACD in a rat model of T2DM.
Forty Sprague-Dawley male rats were divided into control and T2DM groups. The T2DM group was established by feeding rats a high-fat diet and glucose to induce impaired glucose tolerance and then injecting them with streptozotocin to induce T2DM. Cognitive function was assessed using the Morris water maze experiment. The CBF changes were measured by 3D-ASL magnetic resonance imaging. VEGF expression was determined using immunofluorescence.
The escape latency time significantly reduced 15 wk after streptozotocin injection in the T2DM group. The total distance traveled was longer in the T2DM group; also, the platform was crossed fewer times. The percentage of distance in the target zone significantly decreased. CBF decreased in the bilateral hippocampus in the T2DM group. No difference was found between the right CBF value and the left CBF value in the T2DM group. The VEGF expression level in the hippocampus was lower in the T2DM group and correlated with the CBF value. The escape latency negatively correlated with the CBF value. The number of rats crossing the platform positively correlated with the CBF value.
Low CBF in the hippocampus and decreased VEGF expression might be crucial in DACD. CBF measured by 3D-ASL might serve as a noninvasive imaging biomarker for cognitive impairment associated with T2DM.
Core Tip: This study aimed to assess the correlation between cerebral blood flow measured by three-dimensional arterial spin labeling, vascular endothelial growth factor expression, and diabetes-associated cognitive dysfunction in a rat model of type 2 diabetes (T2D). Our results showed low cerebral blood flow in the hippocampus and decreased vascular endothelial growth factor expression might be crucial in diabetes-associated cognitive dysfunction. Cerebral blood flow measured by three-dimensional arterial spin labeling might serve as a noninvasive imaging biomarker for cognitive impairment associated with T2D. This study would help in the early detection of diabetes-associated cognitive dysfunction and guide treatment.