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Microstructural white matter changes in metabolic syndrome

A diffusion tensor imaging study

From the Department of Psychiatry and Clinical Psychobiology (B.S., M.A.J., C.J.), University of Barcelona; Diabetes, Endocrinology and Nutrition Service (N.F.), Hospital de Sabadell, Corporació Sanitària Parc Taulí, Sabadell; Institute of Biomedical Research August Pi i Sunyer (C.F., C.J.), Barcelona; CIBER-BBN (C.F.), Barcelona; and Cerebrovascular Division (A.A.), Department of Neurology, Hospital Universitari del Sagrat Cor, University of Barcelona, Spain.

Address correspondence and reprint requests to Dr. Maria Angeles Jurado, Department of Psychiatry and Clinical Psychobiology, Faculty of Psychology, University of Barcelona, Passeig de la Vall d’Hebron 171, 08035, Barcelona, Spain majurado{at}ub.edu

Background: Although metabolic syndrome is associated with cardiovascular disease and stroke, limited information is available on specific brain damage in patients with this syndrome. We investigated the relationship of the syndrome with white matter (WM) alteration using a voxel-based approach with diffusion tensor imaging (DTI).

Methods: We compared fractional anisotropy (FA) and apparent diffusion coefficient (ADC) measurements of DTI in 19 patients with metabolic syndrome aged between 50 and 80 years and 19 age-matched controls without any vascular risk factors for the syndrome.

Results: Patients with metabolic syndrome showed an anterior–posterior pattern of deterioration in WM with reduced FA and increased ADC values compared with controls. WM changes were not related to any isolated vascular risk factor.

Conclusion: Although the mechanism of this damage is not clear, the results indicate microstructural white matter alterations in patients with metabolic syndrome, mainly involving the frontal lobe.

Abbreviations: ADC = apparent diffusion coefficient; ADC Cont = ADC mean values in the control group; ADC SdMet = ADC mean values in the patient group; ant = anterior; c = corpus; corr = corrected; DICOM = Digital Imaging and Communications in Medicine; DTI = diffusion tensor imaging; F = frontal lobe; FA = fractional anisotropy; FA Cont = FA mean values in the control group; FA SdMet = FA mean values in the patient group; fas = fasciculus; FOV = field of view; FWHM = full-width at half-maximum; HDL = high-density lipoprotein; inf = inferior; Lb = limbic lobe; MNI = Montreal Neurological Institute; NCEP = National Cholesterol Education Program; SPM = Statistical Parametric Mapping; Sub = sublobar; sup = superior; T = temporal lobe; TE = echo time; TI = inversion time; TR = repetition time; WM = white matter.

Supplemental data at www.neurology.org

Supported by grant 2005 SGR00855 from the Generalitat of Catalunya and the grant Ajuts per la formació en la recerca i la docència to Bàrbara Segura Fàbregas from the University of Barcelona.

Disclosure: The authors report no disclosures.

References e1–e11 may be found on the Neurology® Web site at www.neurology.org.

Received December 18, 2008. Accepted in final form May 1, 2009.