Structural and Volumetric Characteristics of Cerebral Damage in Patients with Metabolic Syndrome

Abstract

The objective of the research was to identify volumetric brain indicators (hippocampal volume) in patients with chronic cerebral ischemia secondary to metabolic syndrome (MS) in comparison with patients suffering from chronic cerebral ischemia without MS; to identify hippocampal index as well as medial, lateral and upper perihippocampal indices in patients with MS in comparison with those in patients without MS.Materials and methods. Hippocampal volume of 47 patients (29 patients with MS - the main group and 18 patients without MS – the control group) was evaluated by means of volumetric method. During 49 studies (28 - the main group and 21 - the control group) the size of the hippocampus and perihippocampal cerebrospinal fluid space was measured.Results and discussion. We determined a significant increase (*P<0.05 in comparison with the control group) in the lateral perihippocampal cerebrospinal fluid space (cm) in the main group in comparison with the control group (Me [Q1, Q3]): on the right it was 2.90 [2.75 ; 2.96]  vs. 2.21 [1.82; 2.05] in the control group (р<0.05); on the left it was 2.97 [2.75; 2.96] vs. 2.275 [2.15; 2.76] in the control group (р>0.05). A significant decrease in the index of the right and left hippocampus was determined in patients with MS in comparison to the patients of the control group (Me [Q1,Q3]): on the right it was 0.50 [0.41; 0.54] vs. 0.594 [0.58; 0.61]; on the left it was 0.56 [0.52; 0.60] vs. 0.61 [0.58; 0.63] in the control group (р<0.05). A significant difference in the increase of the medial and upper perihippocampal indices on either side was defined in the main group in comparison with the control one. Lateral perihippocampal index did not significantly differ from the control group (р>0.05). Determination of the hippocampal volume (right and left) showed that it was significantly lower in patients with MS than in patients without MS (Me [Q1,Q3]): on the right it was 3.293058* [2.92616; 3.04016] in the main group, and 3.93 [3.72750; 4.29722] in the control group; on the left it was 2.84 [2.65; 3.02] * in the main group, and 3.55 [3.22, 3.7] in the control group. Components of MS cluster in patients with chronic cerebrovascular pathology are likely to contribute to the development of atrophic processes. The combination of hypertension, insulin resistance, dyslipidemia, etc. accelerate the processes of hippocampal atrophy more than each of these separate components determined in patients with chronic cerebral ischemia without MS.Conclusions. Thus, the degree of hippocampal atrophy in patients with chronic cerebrovascular diseases secondary to MS was defined to be significantly higher in comparison with patients without MS. To improve diagnosis of cerebrovascular diseases in patients with MS, it is possible to apply the identification of hippocampal index and perihippocampal indices if it is not possible to determine the volume of brain structures. 
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