tailieunhanh - DIABETIC NEUROPATHY: CLINICAL MANAGEMENT - PART 5

Sâu màu trắng vấn đề tổn thương (DWML) ở bệnh nhân tiểu đường loại 2 (n = 115) và tuổi tác và quan hệ tình dục kết hợp điều khiển nondiabetic. Mức độ nghiêm trọng của DWML được đánh giá bán định lượng bằng cách sử dụng "Scheltens quy mô" | Diabetic Encephalopathy 197 Fig. 3. Deep white matter lesions DWML in type 2 diabetic patients n 115 and age and sex-matched nondiabetic controls. The severity of DWML was assessed semi-quantitatively using the Scheltens scale 116 a scale that takes both the number and the size of the lesions into account. Boxes represent quartiles and median scores. The DWML score is significantly p higher in the diabetic patients. After adjustment for the presence of hypertension HT defined as a systolic blood pressure 160 mmHg and or diastolic blood pressure 95 mmHg and or self reported use of antihypertensive medication the difference between the diabetic and nondiabetic group remains statistically significant. Data are derived from the Utrecht Diabetic Encephalopathy Study 54 . positively with the duration of diabetes and HbA1 levels 86 and can be improved by intensive insulin treatment 87 . Studies on somatosensory evoked potentials in diabetic patients have provided more variable results. Increased latencies of the central components of the somatosensory evoked potential have been reported 89 although other studies have only found significant conduction delays in peripheral components of the somatosensory pathways 90 91 . Event-Related Potentials The latency of the so-called P300 wave is also increased in type 1 as well as in type 2 diabetic patients 92 93 . This P300 wave is a positive deflection in the human event-related potential that is considered to reflect the speed of neuronal events underlying information processing 94 . It is most commonly elicited with an oddball paradigm in which a subject is instructed to detect an occasional target stimulus in a regular train of standard stimuli 94 . The increased latency of the P300 wave in diabetes may thus be a neurophysiological manifestation of impairment of higher brain functions. STUDIES IN MAN THERAPIES To date the only published studies that have evaluated the effects of different treatment modalities on cognition