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Diabetes Status Affects Brain Damage in Dementia

Autopsy study reveals two patterns of cerebral damage in patients with and without diabetes

MONDAY, Jan. 12 (HealthDay News) -- Elderly dementia patients with or without diabetes appear to have distinct patterns of cerebral damage, according to study findings published online Jan. 12 in the Archives of Neurology.

Joshua A. Sonnen, M.D., of the University of Washington in Seattle, and colleagues conducted a comprehensive neuropathologic assessment of 259 participants in a community-based study of incident dementia (Adult Changes in Thought Study) who underwent autopsies, including 196 with known diabetes status.

In the 125 subjects without dementia, the researchers found that neuropathologic and biochemical end points were similar in those with and without diabetes. But in the 71 subjects with dementia, they found that those with diabetes tended to have a greater number of microvascular infarcts and a higher concentration of cortical interleukin-6. Subjects with dementia whose diabetes was treated tended to have a higher number of microvascular infarcts in deep cerebral structures while those with untreated diabetes tended to have a greater amyloid plaque load, the investigators report. Dementia subjects without diabetes tended to have a greater amyloid-beta peptide load and increased levels of F2-isoprostanes in the cerebral cortex, the report indicates.

"These novel characterizations of two apparently different patterns of injury in dementia depending on diabetes mellitus status may have important etiologic and therapeutic implications," the authors conclude.

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