Magnetic Resonance Spectroscopic Imaging in Leukoaraiosis patients with associated risk factor of Type II diabetes mellitus

Abstract

Purpose:

We aim to investigate the association of Type II diabetes with Leukoaraiosis, measure metabolite changes in the brain using Magnetic resonance spectroscopy (¹H-MRS), and determine neurocognitive impairment in this study.

Materials and Methods:

We recruited 64 patients with LA and 64 healthy controls all patients, regardless of gender, were enrolled in the study, with an age range of (50 to 90 years). It was a prospective study conducted in the period of (2022-2023).¹H-MRS was performed with the selected region of interest in the periventricular white matter. Three main ratios are considered NAA/Cho, NAA/Cr and Cho/Cr and are obtained.

Results:

We found the metabolite ratios of NAA/Cho, NAA/Cr in the white matter lesions is lower in the T2 DM group than the healthy control group (1.56 ± 0.45 vs 1.93 ± 0.24 and 1.42 ± 0.58 vs 1.98 ± 0.35, p<0.001) respectively. Whereas when comparing Cho/Cr with HbA1c values it shows that there is no significance between Cho/Cr and T2 DM (1.22 ± 0.31 vs 1.09 ± 0.15 and 8.49 ± 1.90 vs 5.55 ± 0.38, p> 0.05 respectively).There was a positive correlation between NAA/Cho with ACEIII (r=0.495, p=0.0001) and NAA/Cr with ACEIII (r=0.434, p=0.0001) and when Correlating Cho/Cr with ACEIII it shows a negative correlation (r=-0.206, p=0.020). The p-value and regression coefficient of HbA1c with NAA/Cho, which showed a positive significance (r=0.446, p=0.0001 and r=0.425, p=0.0001). The regression coefficient of HbA1cwith Cho/Cr ratio did not show any significance.

Conclusion:

In light of our findings, we conclude that the results estimate that Type II diabetes mellitus has a strong association with the increased risk of leukoaraiosis, and Magnetic Resonance Spectroscopy (¹H-MRS) is a potential biochemical marker compared to structural MRI for monitoring cognitive impairment in patients with leukoaraiosis.