**2.3. Characteristics of magnetic resonance imaging of the brain in patients with type 1 diabetes mellitus and in control group**

Analysis of magnetic resonance imaging of the brain revealed indirect signs of atrophy of the gray matter of the frontal and partly parietal lobes. Thus, in patients with type 1 diabetes mellitus, arachnoid changes (93.1%) and expansion of the convective liquor spaces (72.4%) were significantly more frequent. In the control group, changes in thearachnoid changes were detected in 67% (**Table 3**). **Figure 2** in the coronal projection (mode T2) shows the expansion of the convective fluidic spaces.

number series and serial subtraction). That is, the higher the levels of carbohydrate metabolism, the worse the memory and attention are (**Table 4**). On the part of other indicators of the

Note: The significance of the differences between the control group and patients with type 1 diabetes mellitus at the

**Table 3.** Characterization of the magnetic resonance pattern of the brain of patients with type 1 diabetes mellitus in

**(n = 98)**

Expansion of convective fluidic spaces 71 (72.4%) 0 (0%) χ<sup>2</sup> = 63.84; p = 0.01 Expansion of Virchow-Robin spaces 79 (80.6%) 2 (6.7%) χ<sup>2</sup> = 43.4; p = 0.01 Gliosis 15 (15.3%) 0 (0%) χ<sup>2</sup> = 4.32;

Arachnoidal changes in the cerebrospinal fluid 108 (93.1%) 2 (6.7%) χ2; p

Leukoareosis 18 (18.3%) 0 (0%) χ<sup>2</sup> = 5.19;

**Control group (n = 29)**

**χ2**

Cognitive Impairment in Patients with Diabetes Mellitus http://dx.doi.org/10.5772/intechopen.74388 21

p = 0.01

p = 0.02

In assignments for attention, a negative correlation was found only with the protein S100 (r = −0.3, p = 0.02, r = −0.3, p = 0.004). We revealed relationship between the decrease in memory functions and the increase in the level was the decrease in memory functions with a simultaneous increase in the level of the studied neurospecific proteins, that is, the presence of a negative correlation with the S100 (r = −0.4, p = 0.001), GFAP (r = −0.4, p = 0.02), and MBP (r = −0.5,

To assess the significance for the diagnosis of proteins, sensitivity and specificity were assessed. It was shown that they are highly specific and have a moderate sensitivity (**Table 5**). Thus, in patients with type 1 diabetes mellitus and identified cognitive dysfunction, an increase in the content of all neurospecific proteins against hyperglycemia is characteristic. Based on the assessment of specificity and sensitivity, a high level of diagnostic significance of neurospecific proteins is shown, which makes it possible to use them in general medical

When evaluating the effect of carbohydrate metabolism parameters on the change in the results of magnetic resonance imaging of the brain in patients with type 1 diabetes mellitus, positive correlation relationships were recorded. Thus, moderate strengths between the expansion of the cerebrospinal fluid and the level of HbA1c (r = 0.6, p = 0.001) and fasting glycemia (r = 0.5, p = 0.001) were revealed. In addition, connections have also been found with extensions of the Virchow-Robin spaces (r = 0.6, p = 0.001, r = 0.5, p = 0.001) and convective spaces (r = 0.5, p = 0.004, r = 0.3, p = 0.003) with the indices of carbohydrate metabolism. Analysis of the effect of cognitive dysfunction on the results of magnetic resonance imaging of the brain showed the presence of a bond. A correlation was found between memory loss in patients with type 1 diabetes mellitus and the expansion of arachnoid (r = −0.3, p = 0.02) and Virchow-Robin spaces (r = −0.3, p = 0.007). A link was also found between the decrease in attention and atrophy of gray matter in the brain in patients with type 1 diabetes mellitus. Patients with an expansion of arachnoid (r = −0.3, p = 0.007), convective spaces

MoCA, the connection was not found.

**Indicators Type 1 DM**

p = 0.001) proteins.

practice.

level: \*

p < 0.001.

comparison with the control group.

MRI of the brain showed the presence of gliosis sites in 15.5% of cases and lesions of leukoareosis in 18.3% of cases in patients with type 1 diabetes mellitus, whereas in the control group no changes were revealed (**Table 3**). In **Figure 3**, in the axial projection (FLAIR mode) in the white matter of the frontal and parietal lobes, small foci of a dystrophic character are defined.

In **Figure 4**, coronal lesions are identified in the coronal projection. According to the classification proposed by Lui, the severity of leukoareosis is two points.

Perivascular spaces of Virchow-Robin are a morphological and functional structure of the central nervous system; therefore, various versions of their dilatation can be an indirect reflection of changes in the brain substance and indicate atrophy. In the study, expansion of Virchow-Robin spaces occurred in 80.6% of cases in patients with type 1 diabetes mellitus, which was significantly higher than in the control group, 6.7%, respectively (**Table 3**).

These changes are shown in **Figure 5**, where in the coronal projection in the thalamus region, nonuniformly expanded Virchow-Robin spaces are determined from both sides. Given the classification of MacLullich, they are estimated at 2 points.

Thus, according to MRI, the morphological changes in the brain in patients with type 1 diabetes mellitus are represented by arachnoid changes in the liquor cystic, the expansion of the convective spaces, and the Virchow-Robin spaces of the brain.
