Arterial Pulsatility as an Index of Cerebral Microangiopathy in Diabetes

Abstract

Background and Purpose-This study was designed to evaluate cerebral hemodynamic changes related to diabetes mellitus (DM) with transcranial Doppler ultrasonography (TCD). Methods-We measured the flow velocities and the Gosling pulsatility index (PI) of the middle cerebral artery (MCA), extracranial internal carotid artery (ICA), and basilar artery (BA) in 56 stroke-free, normotensive patients with type 2 DM and 70 age-and gender-matched healthy volunteers. Patients were divided into 2 groups according to the presence of microvascular complications such as retinopathy, nephropathy, and neuropathy. Results-Patients showed slightly lower hematocrit and higher serum fibrinogen levels than control subjects, but other clinical profiles, including stroke risk factors except for diabetes, were comparable between patients and controls. The flow velocity of the ICA but not the MCA and BA in patients regardless of the complication was significantly higher than that in controls. The PIs of the MCA and ICA were significantly higher in patients with complication than those without complication, as well as in controls. The PI of the BA was also significantly higher, even in patients without complication, than in controls. The PIs of the MCA and ICA but not the BA were closely correlated with the duration of DM (r 2 ϭ0.46 and 0.34, respectively). Conclusions-This study defines TCD findings of diabetes-related cerebral hemodynamic changes and suggests that the PI reflects microangiopathic changes of cerebral vessels.

The effect of levodopa treatment on cerebral hemodynamics in patients with Parkinson's disease: Serial transcranial Doppler studies

“…All TCD studies were performed by a single operator with a three-dimensional mapping instrument (Trans-scan, EME) using examination techniques similar to those previously described [8]. Doppler signals from the left main stem of the middle cerebral artery (MCA) were obtained with a 2-MHz probe attached to a stereotactic headpiece through a transtemporal window at a depth of 62-66 mm, and follow-up TCD in each patient was performed at the same depth to initial examination.…”

Methadone Treatment Induces Attenuation of Cerebrovascular Deficits Associated with the Prolonged Abuse of Cocaine and Heroin

“…Our findings suggest that the vasculature of 30 to 40-yearold polysubstance abusers might be compromised, thus putting them at risk for cerebrovascular accidents (Strandgaard, 1993;Jamrozik et al, 2000), small vessel diseases (Lee et al, 2000;Kidwell et al, 2001), and/or cognitive impairments (Anstey and Smith, 1999;Rabbitt and Lowe, 2000). Our study reveals that treatment with methadone can reduce these abnormalities, although this therapeutic approach did not normalize these measures.…”

“…Patients with multi-infarct dementia have reported mean MCA PI values of 1.27+0.15 (Biedert et al, 1995) and of 1.20 (standard deviation not given) (Sattel et al, 1996). Chronic hypertensives (Cho et al, 1997) and diabetic patients (Lee et al, 2000) have been reported to have PI increases, which correspond to means of 0.89 (standard deviation not given) and 0.87+0.22, respectively. Middle cerebral artery PI values were found to be correlated with MRI measures of small vessel diseases characterized by periventricular hyperintensity (PI cutoff point for detection: 1.17), deep white matter hyperintensity (PI cutoff point for detection: 0.96), and lacunar disease (PI cutoff point for detection: 0.96) (Kidwell et al, 2001).…”

P2‐107: Intracranial Atherosclerosis as a contributing factor to Alzheimer's disease Dementia

“…Failure to cushion systolic pulsation due to arterial wall stiffening, results in larger amplitude of intracranial blood beating and microvasculature damage [43;44], and consequent endothelial cell shedding, myocyte damage, BBB failure and vessel rupture [45]. In general, accumulating diffuse microangiopathic disease promotes increased vascular resistance [46][47][48] escalating hypertension and impaired venous outflow [43;49].…”