Related Experiment Video
Updated: Feb 3, 2026
Advanced Diffusion Imaging in The Hippocampus of Rats with Mild Traumatic Brain Injury
Published on: August 14, 2019
Brain microstructural alterations in type 2 diabetes: diffusion kurtosis imaging provides added value to diffusion
Ying Xiong1, Yi Sui2,3, Shun Zhang1
1Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, People's Republic of China.
Objectives:
To investigate brain microstructural changes in white matter and gray matter of type 2 diabetes mellitus (T2DM) patients using diffusion kurtosis imaging.
Methods:
Diffusion kurtosis imaging (b values = 0, 1250, and 2500 s/mm2) was performed for 30 T2DM patients and 28 controls. FMRIB Software Library with tract-based spatial statistics was used to analyze intergroup differences in fractional anisotropy (FA), mean diffusivity (MD), mean kurtosis (MK), axial kurtosis (K∥), and radial kurtosis (K⊥) of multiple white matter regions. Atlas-based ROI analysis was conducted in gray matter structures and some fiber tracts. Correlations between MK changes and clinical measurements were determined.
Results:
In whole-brain tract-based spatial statistics analysis, T2DM patients exhibited abnormalities in 29.6%, 30.4%, 35.4%, 10.5%, and 26.0% of white matter regions as measured by FA, MD, MK, K∥, and K⊥, respectively, when compared to the controls. MK reduction was contributed more by the decreased K⊥. In atlas-based analysis, MK detected more ROIs (27/48) with white matter microstructural changes than FA (13/48) and MD (17/48). MK decreased in bilateral thalamus and caudate, while FA showed statistically significant difference only in the left caudate. MK values negatively correlated with disease duration in the genu of corpus callosum and anterior corona radiata (R = -0.512 and -0.459) and positively correlated with neuropsychological scores in the cingulum (hippocampus) (R = 0.466 and 0.440).
Conclusions:
Diffusion kurtosis imaging detects more brain regions with white matter and gray matter microstructural alterations of T2DM patients than DTI metrics. It provides valuable information for studying the pathology of diabetic encephalopathy and may lead to better imaging biomarkers for monitoring disease progression.
Key Points:
• Diffusion kurtosis imaging detects more brain regions with microstructural alterations in white matter and gray matter of T2DM patients than DTI. • Mean kurtosis changes are associated with disease severity and impaired neuropsychological function in T2DM. • Diffusion kurtosis imaging demonstrates potential to assess cognitive impairment in T2DM patients and predict disease progression.
Insights
Diffusion kurtosis imaging reveals more widespread brain microstructural changes in type 2 diabetes mellitus (T2DM) patients than traditional DTI. Mean kurtosis alterations correlate with disease severity and cognitive function, offering potential biomarkers for diabetic encephalopathy.
Area of Science:
- Neuroimaging
- Radiology
- Endocrinology
Background:
- Type 2 diabetes mellitus (T2DM) is associated with neurological complications.
- Diabetic encephalopathy involves microstructural brain changes.
- Diffusion tensor imaging (DTI) has limitations in detecting subtle alterations.
Purpose of the Study:
- To investigate brain microstructural changes in white and gray matter of T2DM patients.
- To compare the sensitivity of diffusion kurtosis imaging (DKI) with DTI metrics.
- To explore correlations between microstructural changes and clinical parameters.
Main Methods:
- Diffusion kurtosis imaging (DKI) with high b-values (0, 1250, 2500 s/mm²) was performed on 30 T2DM patients and 28 controls.
- Tract-based spatial statistics (TBSS) and atlas-based region of interest (ROI) analyses were used.
- Fractional anisotropy (FA), mean diffusivity (MD), mean kurtosis (MK), axial kurtosis (K∥), and radial kurtosis (K⊥) were quantified.
- Correlations between MK and clinical data (disease duration, neuropsychological scores) were assessed.
Main Results:
- DKI detected microstructural abnormalities in a higher percentage of white matter regions compared to DTI metrics (e.g., MK: 35.4% vs. FA: 29.6%, MD: 30.4%).
- Mean kurtosis (MK) reduction was primarily driven by decreased radial kurtosis (K⊥).
- MK identified more affected gray matter ROIs (27/48) than FA (13/48) and MD (17/48), with decreased MK in the thalamus and caudate.
- MK changes correlated negatively with disease duration and positively with neuropsychological scores.
Conclusions:
- Diffusion kurtosis imaging is more sensitive than DTI in detecting white and gray matter microstructural alterations in T2DM patients.
- Mean kurtosis alterations are linked to disease severity and cognitive impairment in T2DM.
- DKI shows promise as a biomarker for assessing cognitive deficits and monitoring disease progression in diabetic encephalopathy.
Related Concept Videos
01:12Diffusion
01:21Diffusion
01:22Diabetes Mellitus: Type 2 and Gestational
01:16Facilitated Diffusion
In this process, substrates such as organic compounds and ions interact with a transporter on one side, triggering conformational changes in proteins that enable...
03:48Behavior of Gas Molecules: Molecular Diffusion, Mean Free Path, and Effusion
01:24Protein Diffusion in the Membrane