25Apr 2017

ELECTROENCEPHALOGRAPHIC CHANGES IN TYPE 2 DIABETES MELLITUS DURING HYPERVENTILATION AND POST-HYPERVENTILATION

  • Department of Physiology, Trinity School of Medicine, St. Vincent and the Grenadines.
  • Department of Basic & Clinical Physiology, B.P. Koirala Institute of Health Sciences, Nepal.
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Diabetes mellitus is the most common metabolic disorder that results in various complications including the brain abnormalities. Hyperventilation (HV) is a classic activation procedure during routine electroencephalography (EEG) recording that increases the yield of electrical activity generated in the cerebral cortex. Objectives: To investigate the electroencephalographic (EEG) changes in type 2 diabetes mellitus (T2DM) patients during hyperventilation (HV) and post-HV. Methods: The 16-channel EEG recording of 35 male patients with T2DM on oral hypoglycemic medication and 35 age- and sex-matched healthy subjects (controls) were done during and after hyperventilation for 3 minutes each. The quantitative EEG analysis was done using Fast Fourier Transformation (FFT). The EEG power spectra were subjected to log-transformation and compared using student?s t-test. Results: The T2DM patients had diffuse increase in low-frequency slow waves at delta range (p <0.05) and high-frequency fast waves at beta range (p <0.05) as compared to the controls in EEG during HV. There was a prolonged existence of delta activity at few brain regions (p <0.05) and beta activity in some brain regions (p <0.05) in the EEG after cessation of HV during post-HV. Conclusion: The increased yield of EEG activity at delta and beta ranges in T2DM patients during HV and the prolonged existence of these responses after cessation of HV are suggestive of central nervous system (CNS) abnormalities in T2DM patients.

  1. International Diabetes Federation: IDF Diabetes Atlas, 7th Brussels, Belgium. www.diabetesatlas.org (updated 2015).
  2. Powers AC. Harrison?s principles of internal medicine. 19th New York: The McGraw-Hill Companies, Inc; 2015. Chapter 419, Diabetes Mellitus: Complications; p2422-30.
  3. Biessels GJ, Kappelle AC, Bravenboer B, Erkelens DW, Gispen WH. Cerebral function in diabetes mellitus. Diabetologia 1994;37:643-50.
  4. Pan A, Lucas M, Sun Q, van Dam RM, Franco OH, Manson JE, Willet WC, Ascherio A, Hu FB. Bidirectional association between depres?sion and type 2 diabetes mellitus in women. Arch Intern Med 2010;170(21):1884-91.
  5. Balhara YPS. Diabetes and psychiatric disorders. Indian J Endocrinol Metab 2011;15(4):274-83.
  6. Paudel BH, Limbu N, Panta R, Ghimire N, Shrestha B, Deo S. Neurophysiology Application Notes. Dharan: Physiological Society of Nepal; 2012. Chapter 1, Electroencephalography; p7-18.
  7. Duffy FH, Iyer VG, Surwillo WW. Clinical electroencephalography?and?topographic brain mapping.?New York: Springer-Verlag Inc; 1989. Chapter 1, Brain Electrical Activity: An Introduction to EEG Recording; p1-10.
  8. Panta R, Khadka R, Thakur D, Limbu N, Paudel BH. Which occurs first in patients with type 2 diabetes mellitus? Central or peripheral neuropathy. Int Arch BioMed Clin Res 2016;2(2):73-8.
  9. Baskaran A, Milev R, McIntyre RS. A review of electroencephalographic changes in diabetes mellitus in relation to major depressive disorder. Neuropsychiatr Dis 2013;9:143-50.
  10. Aminoff MJ. Electrodiagnosis in clinical neurology. Philadelphia: Elsevier Inc; 2005. Chapter 3, Electroencephalography: General Principles and Clinical Applications; p37-84.
  11. Naquet R, Vigouroux RA. EEG Handbook of electroencephalography and clinical neurophysiology. Vol 14(A). Amsterdam: Elsevier Inc; 1972. p38-84.
  12. Lustman P, Anderson RJ, Freedland KE, de Groot M, Carney RM, Clouse RE. Depression and poor glycemic control: a meta-analytic review of the literature. Diabetes Care 2000;23:934-42.
  13. Demakakos P, Pierce MB, Hardy R. Depressive symptoms and risk of type 2 diabetes in a national sample of middle-aged and older adults: the English longitudinal study of aging. Diabetes Care 2010;33(4):792-97.
  14. McIntyre RS, Soczynska JK, Konarski JZ, Woldeyohannes HO, Law CW, Miranda A, Fulgosi D, Kennedy SH. Should depressive syndromes be reclassified as ?metabolic syndrome type II?? Ann Clin Psychiatry 2007;19(4):257-64.
  15. McIntyre RS, Kenna HA, Nguyen HT, Law CW, Sultan F, Woldeyohannes HO, Adams AK, ChengJS, Lourenco M, Kennedy SH, Rasgon NL. Brain volume abnormalities and neurocognitive deficits in diabetes mellitus: points of pathophysi?ological commonality with mood disorders? Adv Ther 2010;27(2):63?80.
  16. Collins MM, Corcoran P, and Perry IJ. Anxiety and depression symptoms in patients with diabetes. Diabet Med 2009;26:153-61.
  17. Kwon JS, Youn T, Jung HY. Right hemisphere abnormalities in major depression: quantitative electroencephalographic findings before and after treatment. J Affect Disord 1996;40(3):169-73.
  18. Maccario M, Messis CP, Vastola EF. Focal seizures as a manifestation of hyperglycemia without ketoacidosis. A report of seven cases with review of the literature.Neurology?1965;15:195?206.
  19. Gibbs FA, Williams D, Gibbs EL. Modification of the cortical frequency spectrum by changes in CO2, blood sugar, and O2.?J Neurophysiol?1940;3:49-58.
  20. Maccario M. Neurological dysfunction associated with nonketotic hyperglycemia.Arch Neurol?1968;19:525?34.
  21. Khan KA, Lalani S, Dhanani R, Iqbal SA, Rafique G, White F. Anxiety and depression among outpatients with type 2 diabetes: A multi-centre study of prevalence and associated factors. Diabetol Metab Syndr 2010;2:72
  22. Grigsby AB, Anderson RJ, Freedland KF, Couse FE, Lustman PJ. Prevalence of anxiety in adults with diabetes: a systematic review. J Psychosom Res 2002;53(6):1053-60.
  23. Maier W, Falkai P. The epidemiology of comorbidity between depression, anxiety disorders, and somatic diseases. Int Clin Psychopharmacol 1999;14(Suppl 2):S1-6.
  24. Lustman PJ, Griffith LS, Clouse RE, Cryer PE. Psychiatric illness in diabetes mellitus. Relationship to symptoms and glucose control. J Nerv Ment Dis 1986;174(12):736-42.
  25. John R. Hughes. EEG in clinical practice. 2nd Boston: Butterworth-Heinemann; 1994; Chapter 2, Names of rhythms or patterns; p15-18.
  26. Cohn R. The influence of emotions on the human electroencephalogram. J Nerv Ment Dis 1946;104:351-57.
  27. Takahashi T. Electroencephalography: basic principles, clinical applications, and related field. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2005: Chapter 14, Activation methods; p241-62.

[Raju Panta, Bishnu Hari Paudel, and Nirmala Limbu (2017); ELECTROENCEPHALOGRAPHIC CHANGES IN TYPE 2 DIABETES MELLITUS DURING HYPERVENTILATION AND POST-HYPERVENTILATION Int. J. of Adv. Res. 5 (Apr). 809-815] (ISSN 2320-5407). www.journalijar.com

Dr. Raju Panta
Department of Physiology, Trinity School of Medicine, St. Vincent and the Grenadines

DOI:

Article DOI: 10.21474/IJAR01/3879      
DOI URL: https://dx.doi.org/10.21474/IJAR01/3879

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