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(Stroke. 2000;31:1111.)
© 2000 American Heart Association, Inc.

Original Contributions

Arterial Pulsatility as an Index of Cerebral Microangiopathy in Diabetes

Kyung Y. Lee, MD; Young H. Sohn, MD; Jong S. Baik, MD; Gyung W. Kim, MD Jin-Soo Kim, MD

From the Department of Neurology and Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea.

Correspondence to Young H. Sohn, MD, Department of Neurology, Yonsei University College of Medicine, CPO Box 8044, Seoul, Korea. E-mail yhsohn62{at}yumc.yonsei.ac.kr

Background and Purpose—This study was designed to evaluate cerebral hemodynamic changes related to diabetes mellitus (DM) with transcranial Doppler ultrasonography (TCD).

Methods—We measured the flow velocities and the Gosling pulsatility index (PI) of the middle cerebral artery (MCA), extracranial internal carotid artery (ICA), and basilar artery (BA) in 56 stroke-free, normotensive patients with type 2 DM and 70 age- and gender-matched healthy volunteers. Patients were divided into 2 groups according to the presence of microvascular complications such as retinopathy, nephropathy, and neuropathy.

Results—Patients showed slightly lower hematocrit and higher serum fibrinogen levels than control subjects, but other clinical profiles, including stroke risk factors except for diabetes, were comparable between patients and controls. The flow velocity of the ICA but not the MCA and BA in patients regardless of the complication was significantly higher than that in controls. The PIs of the MCA and ICA were significantly higher in patients with complication than those without complication, as well as in controls. The PI of the BA was also significantly higher, even in patients without complication, than in controls. The PIs of the MCA and ICA but not the BA were closely correlated with the duration of DM (r²=0.46 and 0.34, respectively).

Conclusions—This study defines TCD findings of diabetes-related cerebral hemodynamic changes and suggests that the PI reflects microangiopathic changes of cerebral vessels.

Key Words: cerebral blood flow • cerebrovascular disorders • diabetes mellitus • ultrasonography, Doppler, transcranial

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