Cerebral blood flow based on 3D-ASL technology in the early detection of mild cognitive impairment in type 2 diabetic patients: a pilot study.

Abstract

Context: Type 2 diabetes mellitus (T2DM) significantly increases the risk of mild cognitive impairment (MCI), and earlier recognition is crucial for timely intervention and improving patients' quality of life.

Objective: The aim of this study was to characterize changes in cerebral white matter hyperintensities (WMH) and cerebral blood flow (CBF) based on 3D-arterial spin labeling (3D-ASL) measurements in T2DM with MCI, and to assess their potential as markers for early prediction of MCI.

Methods: This study included 30 T2DM patients stratified into T2DM-MCI and T2DM-nMCI groups using MMSE/MoCA. MRI assessed cerebral WMH volume (T2-FLAIR) and regional CBF (3D-ASL) in temporal, parietal, occipital, and hippocampal areas. Group differences in WMH/CBF were analyzed, ROC evaluated CBF's diagnostic efficacy for MCI, and CBF-cognition correlations were assessed via Spearman's analysis.

Results: Cranial MRI analysis shows that there were no significant differences between the two groups in terms of total cerebral WMH volume and regional volume (P>0.05). CBF in the temporal, parietal, occipital, and hippocampal regions was significantly lower in the T2DM-MCI group than in the T2DM-nMCI group (P<0.05). ROC analysis revealed that CBF in the hippocampus had the highest diagnostic efficacy (AUC = 0.813, optimal cutoff value of 41.165 ml/(100 g·min), sensitivity 73.3%, specificity 80.0%). Spearman's correlation analysis showed that CBF in the temporal, parietal, occipital, and hippocampal regions was significantly and positively correlated with MoCA scores (P < 0.05), with temporal and parietal CBF also significantly and positively correlated with MMSE scores (P < 0.05).

Conclusions: CBF, based on 3D-ASL measurements, especially in the hippocampus, is a promising functional marker for identifying MCI in patients with T2DM.