| Title | Enhancement of Vasoreactivity and Cognition by Intranasal Insulin in Type 2 Diabetes |
| Authors | Novak, Vera Milberg, William Hao, Ying Munshi, Medha Novak, Peter Galica, Andrew Manor, Bradley Roberson, Paula Craft, Suzanne Abduljalil, Amir |
| Affiliation | Harvard Univ, Sch Med, Dept Neurol, Beth Israel Deaconess Med Ctr, Boston, MA 02115 USA. VA Boston Healthcare, Boston Div, New England Geriatr Res Educ & Clin Ctr, Boston, MA USA. Harvard Univ, Sch Med, Dept Psychiat, Boston, MA 02115 USA. Peking Univ, Acad Adv Interdisciplinary Studies, Beijing 100871, Peoples R China. Joslin Diabet Ctr, Boston, MA 02215 USA. Univ Massachusetts, Sch Med, Dept Neurol, Worcester, MA USA. Univ Arkansas Med Sci, Dept Biostat, Little Rock, AR 72205 USA. Wake Forest Univ, Bowman Gray Sch Med, Div Gerontol & Geriatr Med, Winston Salem, NC USA. Ohio State Univ, Dept Radiol, Columbus, OH 43210 USA. |
| Keywords | CEREBRAL-BLOOD-FLOW IMPAIRED OLDER-ADULTS BRAIN MEMORY HYPERINTENSITIES PRESSURE MELLITUS DELIVERY DISEASE ATROPHY |
| Issue Date | 2014 |
| Publisher | diabetes care |
| Citation | DIABETES CARE.2014,37,(3),751-759. |
| Abstract | OBJECTIVETo determine acute effects of intranasal insulin on regional cerebral perfusion and cognition in older adults with type 2 diabetes mellitus (DM).RESEARCH DESIGN AND METHODSThis was a proof-of-concept, randomized, double-blind, placebo-controlled intervention evaluating the effects of a single 40-IU dose of insulin or saline on vasoreactivity and cognition in 15 DM and 14 control subjects. Measurements included regional perfusion, vasodilatation to hypercapnia with 3-Tesla MRI, and neuropsychological evaluation.RESULTSIntranasal insulin administration was well tolerated and did not affect systemic glucose levels. No serious adverse events were reported. Across all subjects, intranasal insulin improved visuospatial memory (P 0.05). In the DM group, an increase of perfusion after insulin administration was greater in the insular cortex compared with the control group (P = 0.0003). Cognitive performance after insulin administration was related to regional vasoreactivity. Improvements of visuospatial memory after insulin administration in the DM group (R-adjusted(2) = 0.44, P = 0.0098) and in the verbal fluency test in the control group (R-adjusted(2) = 0.64, P = 0.0087) were correlated with vasodilatation in the middle cerebral artery territory.CONCLUSIONSIntranasal insulin administration appears safe, does not affect systemic glucose control, and may provide acute improvements of cognitive function in patients with type 2 DM, potentially through vasoreactivity mechanisms. Intranasal insulin-induced changes in cognitive function may be related to vasodilatation in the anterior brain regions, such as insular cortex that regulates attention-related task performance. Larger studies are warranted to identify long-term effects and predictors of positive cognitive response to intranasal insulin therapy. |
| URI | http://hdl.handle.net/20.500.11897/389735 |
| ISSN | 0149-5992 |
| DOI | 10.2337/dc13-1672 |
| Indexed | SCI(E) |
| Appears in Collections: | 前沿交叉学科研究院 |
