Alterations in blink and masseter reflex latencies in older adults with neurocognitive disorder and/or diabetes mellitus

doi:10.12998/wjcc.v10.i1.177

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World Journal of Clinical Cases

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World J Clin Cases. Jan 7, 2022; 10(1): 177-188
Published online Jan 7, 2022. doi: 10.12998/wjcc.v10.i1.177

Alterations in blink and masseter reflex latencies in older adults with neurocognitive disorder and/or diabetes mellitus

Jaime Alberto Bricio-Barrios, Eder Ríos-Bracamontes, Mónica Ríos-Silva, Miguel Huerta, Walter Serrano-Moreno, José Enrique Barrios-Navarro, Genaro Gabriel Ortiz, Miguel Huerta-Trujillo, José Guzmán-Esquivel, Xóchitl Trujillo

Jaime Alberto Bricio-Barrios, José Enrique Barrios-Navarro, Miguel Huerta-Trujillo, Faculty of Medicine, University of Colima, Colima 28040, Colima, Mexico

Eder Ríos-Bracamontes, José Guzmán-Esquivel, General Hospital Zone #1, Mexican Social Security Institute, Villa de Alvarez 28983, Colima, Mexico

Mónica Ríos-Silva, Miguel Huerta, Walter Serrano-Moreno, Xóchitl Trujillo, University Biomedical Research Center, University of Colima, Colima 28045, Colima, Mexico

Mónica Ríos-Silva, University Biomedical Research Center, CONACYT, Colima 28045, Colima, Mexico

Genaro Gabriel Ortiz, Department of Philosophical and Methodological Disciplines, University Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico

Author contributions: Bricio-Barrios JA and Guzmán-Esquivel J contributed to the conceptualization, methodology, and software; Ríos-Bracamontes E, Serrano-Moreno W, Ortiz GG, and Huerta-Trujillo M contributed to the data curation, and methodology; Ríos-Silva M and Huerta M contributed to the conceptualization, methodology, review, and editing; Barrios-Navarro JE contributed to the methodology and the validation; Trujillo X contributed to the conceptualization, review, and editing.

Institutional review board statement: The study was reviewed and approved by the Bioethics Committee of the State Institute of Cancerology (CEICANCL131216-BIOALZR-11).

Informed consent statement: All study participants, or their legal guardians, provided informed written consent prior to study enrollment.

Conflict-of-interest statement: The authors report no potential conflicts of interest relevant to this article.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Corresponding author: Xóchitl Trujillo, PhD, Research Scientist, University Biomedical Research Center, University of Colima, Av. 25 de Julio #965, Col. Villas San Sebastian, Colima 28045, Colima, Mexico. rosio@ucol.mx

Received: March 12, 2021
Peer-review started: March 12, 2021
First decision: July 28, 2021
Revised: July 30, 2021
Accepted: November 25, 2021
Article in press: November 25, 2021
Published online: January 7, 2022
Processing time: 293 Days and 7.2 Hours

Abstract

BACKGROUND

Blink and masseter reflexes provide reliable, quantifiable data on the function of the central nervous system: Delayed latencies have been found in patients with neurocognitive disorder (ND) and type 2 diabetes mellitus (T2DM), but this has not been studied in patients with both pathologies.

AIM

To investigate if older adults with ND plus T2DM have prolonged latencies of blink and masseter-reflex and if they were associated with disease progression.

METHODS

This cross-sectional study included 227 older adults (> 60 years) from Colima, Mexico. Neurocognitive disorder was identified by a neuropsychological battery test, and T2DM identified by medical history, fasting glucose, and glycosylated hemoglobin. Latencies in the early reflex (R1), ipsilateral late (R2), and contralateral late (R2c) components of the blink reflex were analyzed for all subjects, and 183 subjects were analyzed for latency of the masseter reflex.

RESULTS

In 20.7% of participants, ND was detected. In 37%, T2DM was detected. Latencies in R1, R2, and R2c were significantly prolonged for groups with ND plus T2DM, ND, and T2DM, compared with the control group (P < 0.0001). The masseter reflex was only prolonged in older adults (regardless of T2DM status) with ND vs controls (P = 0.030). In older adults with ND and without T2DM, the more the cognitive impairment progressed, the more prolonged latencies in R2 and R2c presented (P < 0.01).

CONCLUSION

These findings suggest that blink and masseter reflexes could be used to evaluate possible changes in brainstem circuits in older adults with ND and T2DM.

Keywords: Blink reflex; Masseter reflex; Brainstem reflexes; Neurocognitive disorder; Type 2 diabetes mellitus; Older adults

Core Tip: Delayed latencies were found in patients with neurocognitive disorder (ND) and type 2 diabetes mellitus (T2DM), but they have not been reported before for patients with both pathologies. We report, through blink and masseter reflex techniques, reliable and quantifiable data of the central nervous system function at the level of brainstem. The clinical implication is that brainstem reflexes could be linked with ND progression in the presence of T2DM in older adults. Older adults with ND and T2DM had longer latencies of the blink reflex components compared with healthy controls. In older adults with ND vs controls, the masseter reflex latency was prolonged. Age, sex, education, and dependence altered blink reflex latency in ND patients, while T2DM control, depression, and renal damage did not alter blink reflex latency.