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J Neural Transm (Vienna). 2017 Nov;124(11):1431-1454. doi: 10.1007/s00702-017-1763-2. Epub 2017 Aug 1.

The diabetic brain and cognition.

Author information

1
Center of Mental Health, Department Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, 97080, Würzburg, Germany. peter.riederer@mail.uni-wuerzburg.de.
2
Department of Neurology, Tel Aviv University, 69978, Ramat Aviv, Israel.
3
Center for Aging and Associated Diseases, Helmy Institute of Medical Science, Zewail City of Science and Technology, Giza, Egypt.
4
Department of Neurology, Neurosurgery and Psychiatry, University of Medicine and Pharmacy Carol Davila Bucharest, S Plaiul Independentei 169, Sector 5, 050098, Bucharest, Romania.
5
Department of Neurology, Hallym Hospital, 900-4 Jakjeon-dong, Gyeyang-gu, Incheon-si, 407-060, Korea.
6
Department of Neurology, Henry Ford Hospital, Detroit, MI, USA.
7
Clinical Hospital Merkur-University, Clinic Vuk Vrhovac, Zajčeva (Zajceva) 19, 10000, Zagreb, Croatia.
8
Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University Zurich, Zurich, Switzerland.
9
Neuroscience Center Zurich, University of Zurich and the ETH Zurich, Zurich, Switzerland.
10
Zurich Center for Integrative Human Physiology, University of Zurich, 5th Floor Room K118, Wagistrasse 12, 8952, Zurich, Switzerland.
11
Institute of Clinical Neurobiology, Alberichgasse 5/13, 1150, Vienna, Austria.
12
King Fahd Medical Research Center, King Abdulaziz University, P. O. Box 80216, Jeddah, 21589, Saudi Arabia.
13
Enzymoics, 7 Peterlee Place, Hebersham, NSW, 2770, Australia.
14
Novel Global Community Educational Foundation, Sydney, Australia.
15
Biomediotronics, Enzymoic, 7 Peterlee Pl, Hebersham, NSW, 2770, Australia.
16
Department of Psychiatry, Wroclaw Medical University, Pasteura 10, Str., 50-367, Wroclaw, Poland.
17
Chair of Psychiatry and Head of the Odense Brain, Research Center, Department of Psychiatry Odense, University of Southern Denmark, Winslowsvej 20, 5000, Odense C, Denmark.
18
Department of Biochemistry, College of Science, King Abdulaziz University, Jeddah, 21589, Saudi Arabia.
19
Department of Neurology, University Medical Center Ljubljana, Zaloska 7, 1525, Ljubljana, Slovenia.
20
The Center for Successful Aging with Diabetes, Endocrinology Institute, Gertner Institute, Sheba Medical Center, Epidemiology D., Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
21
Department of Neurology, University Ljubljana, Ljubljana, Slovenia.
22
Department of Neurology, University Medical Centre Maribor, Maribor, Slovenia.
23
Department of Pharmacology, University of Zagreb School of Medicine, Salata 11, 10 000, Zagreb, Croatia.
24
Department of Neurology, Med. Univ. Graz, Auenbruggerplatz 22, 8036, Graz, Austria.
25
Labor für translationale Neurowissenschaften, der Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Würzburg, Margarete Höppel-Platz 1, 97080, Würzburg, Germany.
26
Endocrine and Diabetes Centre, 15-12-15 Krishnanagar, Visakhapatnam, 530 002, India.
27
Department of Neurology and MTA-SZTE Neuroscience Research Group, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Semmelweis u. 6., 6725, Szeged, Hungary.
28
Department of Geriatrics, Medical University of Bialystok, Fabryczna Str.27, 15-741, Bialystok, Poland.
29
Department of Family Medicine, Faculty of Medicine, Akdeniz University, 07059, Antalya, Turkey.

Abstract

The prevalence of both Alzheimer's disease (AD) and vascular dementia (VaD) is increasing with the aging of the population. Studies from the last several years have shown that people with diabetes have an increased risk for dementia and cognitive impairment. Therefore, the authors of this consensus review tried to elaborate on the role of diabetes, especially diabetes type 2 (T2DM) in both AD and VaD. Based on the clinical and experimental work of scientists from 18 countries participating in the International Congress on Vascular Disorders and on literature search using PUBMED, it can be concluded that T2DM is a risk factor for both, AD and VaD, based on a pathology of glucose utilization. This pathology is the consequence of a disturbance of insulin-related mechanisms leading to brain insulin resistance. Although the underlying pathological mechanisms for AD and VaD are different in many aspects, the contribution of T2DM and insulin resistant brain state (IRBS) to cerebrovascular disturbances in both disorders cannot be neglected. Therefore, early diagnosis of metabolic parameters including those relevant for T2DM is required. Moreover, it is possible that therapeutic options utilized today for diabetes treatment may also have an effect on the risk for dementia. T2DM/IRBS contribute to pathological processes in AD and VaD.

KEYWORDS:

Alzheimer’s disease; Cognition; Diabetes mellitus; Diabetic brain; Epidemiology of dementive disorders; Experimental model of dementia; Imaging in dementia; Insulin resistance; Neurogenesis in dementia; Neurotransmitters in dementia; Pathology of dementia; Vascular dementia

PMID:
28766040
DOI:
10.1007/s00702-017-1763-2
[Indexed for MEDLINE]

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