Analysis of the role of neurospecific proteins in the diagnosis of cognitive dysfunction in patients with type 1 diabetes mellitus

Abstract

Background: Impairment of the central nervous system manifested as cognitive dysfunction caused by metabolic or structural changes is a severe progressive vascular complication of type 1 diabetes mellitus (T1DM). Significant difficulties in the diagnosis of cognitive dysfunction are associated with subjective diagnostic techniques. Objective: To identify the role of neurospecific markers in the diagnosis of cognitive dysfunction in patients with T1DM. Materials and Methods: A total of 58 patients with T1DM aged 16-30 years were included in this study. The control group included 29 healthy young adults matched by gender and age. The survey included clinical and laboratory examinations, psychological testing and magnetic resonance imaging (MRI) of the brain. The Montreal Cognitive Assessment (MoCA) was used to screen for cognitive impairment. The levels of neurospecific proteins (S100, glial fibrillary acidic protein and myelin basic protein) were determined to identify early markers of cognitive impairment. MRI of the brain was performed using a Siemens Magnetom 1.0 T system to assess structural changes in the central nervous system. Results: The study revealed increased levels of all neurospecific proteins, which correlated with parameters of hyperglycaemia and cognitive deficit (MoCA scores of <26 points). MRI of the brain revealed signs of grey matter atrophy and involvement of white matter, which correlated with the presence of chronic hyperglycaemia, cognitive impairment and microvascular complications. Conclusion: Chronic hyperglycemia can be involved in the pathogenesis of cognitive dysfunction in T1DM patients. More studies (prospective controlled and observational trials) are needed to clarify the relationship of diabetes and central nervous system impairment.