Evaluation of Cerebral Vasoreactivity in Type2 Diabetic Patients by using Transcranial Doppler Ultrasonography (TCD)

Abstract

Background Type 2 diabetes mellitus (T2DM) is associated with an increased risk of cardiovascular and cerebrovascular diseases with high mortality and disability. Cerebral vasomotor reactivity (VMR), one of the most accurate markers of cerebral hemodynamics, has been shown to be impaired in subjects with carotid artery steno-occlusive disease and associated with an increased risk of ischemic events. Transcranial Doppler ultrasonography )TCD( study have been used to investigate cerebral vasoreactivity to identify patients with increased risk and to better plan the treatment. Objective: The aim of study was to assess cerebral vasoreactivity among type2 diabetes mellitus patients by using transcranial Doppler ultrasonography. Patients and method: sixty five persons (45 type 2 diabetic patients and 20 normal control) (32 male,33 female) with mean age (46.95 ± 7.459) enrolled in this study. The study groups are collected randomly from Al Najaf center for Diabetic and endocrine in Al Sader teaching hospital during the time between January 2016 to June 2016. TCD examination was performed in Middle Euphrates Neuroscience Center for all stuied group to assess cerebral vasoreactivity in middle cerebral artery by breath holing test,hyperventilation test (HV), Transient hyperemic test (THRR). (Statistical Package of Social Sciences) SPSS version 23 was used for the statistical analysis. Results : There was highly significant change of breath holding index BHI{ between control group and diabetic group} (p.value<0.05) and significant change of HV between control group and diabetic group . Also statistical significant change in THRR in relation to glycemic control(p.value< 0.05). Conclusion : There was significant changes in TCD indices that assessed cerebral vasoreactivity in breath holding index, ,hyperventilation in type2 diabetic patients compared with control subjects. Effect of glycemic control on cerebral vasoreactivity in diabetic patients shows evaluation of CVR in diabetic goup in relation to glycemic control. There is no significant statistical association in BHI,HV between two groups of glycemic control but show statistical significant change in THRR (p.value< 0.05).