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Published on: July 28, 2013
White Matter Microstructural Abnormalities in Type 2 Diabetes Mellitus: A Diffusional Kurtosis Imaging Analysis
1From the Department of Radiology and Tianjin Key Laboratory of Functional Imaging (Y.X., Y.Z., W.Q., Q.Z.), Tianjin Medical University General Hospital, Tianjin, China.
Background And Purpose:
Increasing DTI studies have demonstrated that white matter microstructural abnormalities play an important role in type 2 diabetes mellitus-related cognitive impairment. In this study, the diffusional kurtosis imaging method was used to investigate WM microstructural alterations in patients with type 2 diabetes mellitus and to detect associations between diffusional kurtosis imaging metrics and clinical/cognitive measurements.
Materials And Methods:
Diffusional kurtosis imaging and cognitive assessments were performed on 58 patients with type 2 diabetes mellitus and 58 controls. Voxel-based intergroup comparisons of diffusional kurtosis imaging metrics were conducted, and ROI-based intergroup comparisons were further performed. Correlations between the diffusional kurtosis imaging metrics and cognitive/clinical measurements were assessed after controlling for age, sex, and education in both patients and controls.
Results:
Altered diffusion metrics were observed in the corpus callosum, the bilateral frontal WM, the right superior temporal WM, the left external capsule, and the pons in patients with type 2 diabetes mellitus compared with controls. The splenium of the corpus callosum and the pons had abnormal kurtosis metrics in patients with type 2 diabetes mellitus. Additionally, altered diffusion metrics in the right prefrontal WM were significantly correlated with disease duration and attention task performance in patients with type 2 diabetes mellitus.
Conclusions:
With both conventional diffusion and additional kurtosis metrics, diffusional kurtosis imaging can provide additional information on WM microstructural abnormalities in patients with type 2 diabetes mellitus. Our results indicate that WM microstructural abnormalities occur before cognitive decline and may be used as neuroimaging markers for predicting the early cognitive impairment in patients with type 2 diabetes mellitus.
Insights
Type 2 diabetes mellitus is linked to white matter changes affecting cognition. Diffusional kurtosis imaging reveals these abnormalities, potentially serving as early markers for cognitive decline.
Area of Science:
- Neuroimaging
- Diabetology
- Neurology
Background:
- Type 2 diabetes mellitus (T2DM) is associated with cognitive impairment.
- White matter (WM) microstructural abnormalities are implicated in T2DM-related cognitive decline.
- Diffusion Tensor Imaging (DTI) studies highlight the role of WM changes.
Purpose of the Study:
- Investigate WM microstructural alterations in T2DM patients using diffusional kurtosis imaging (DKI).
- Assess associations between DKI metrics and clinical/cognitive measures in T2DM.
- Explore DKI's potential for early detection of cognitive impairment.
Main Methods:
- DKI and cognitive assessments performed on 58 T2DM patients and 58 controls.
- Voxel-based and ROI-based intergroup comparisons of DKI metrics.
- Correlation analyses between DKI metrics and clinical/cognitive data, controlling for covariates.
Main Results:
- Significant differences in diffusion metrics observed in corpus callosum, frontal WM, temporal WM, external capsule, and pons.
- Abnormal kurtosis metrics found in the splenium of the corpus callosum and pons.
- Altered diffusion in right prefrontal WM correlated with disease duration and attention performance.
Conclusions:
- DKI provides additional insights into WM microstructural abnormalities in T2DM beyond conventional diffusion.
- WM microstructural abnormalities may precede cognitive decline in T2DM.
- DKI metrics show promise as neuroimaging markers for predicting early cognitive impairment in T2DM.
