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Updated: Sep 26, 2025
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Tractography in Type 2 Diabetes Mellitus With Subjective Memory Complaints: A Diffusion Tensor Imaging Study
Jun Wang1, Laiyang Ma1, Guangyao Liu1
1Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China.
Abstract:
The brain white matter (WM) structural injury caused by type 2 diabetes mellitus (T2DM) has been linked to cognitive impairment. However, the focus was mainly on the mild cognitive impairment (MCI) stage in most previous studies, with little attention made to subjective memory complaints (SMC). The main purpose of the current study was to investigate the characteristics of WM injury in T2DM patients and its correlation with SMC symptoms. In a group of 66 participants (33 HC and 33 T2DM-S), pointwise differences along WM tracts were identified using the automated fiber quantification (AFQ) approach. Then we investigated the utility of DTI properties along major WM tracts as features to distinguish patients with T2DM-S from HC via the support vector machine (SVM). Based on AFQ analysis, 10 primary fiber tracts that represent the subtle alterations of WM in T2DM-S were identified. Lower fractional anisotropy (FA) in the right SLF tract (r = -0.538, p = 0.0013), higher radial diffusivity (RD) in the thalamic radiation (TR) tract (r = 0.433, p = 0.012), and higher mean diffusivity (MD) in the right inferior fronto-occipital fasciculus (IFOF) tract (r = 0.385, p = 0.0029) were significantly associated with a long period of disease. Decreased axial diffusivity (AD) in the left arcuate was associated with HbA1c (r = -0.368, p = 0.049). In addition, we found a significant negative correlation between delayed recall and abnormal MD in the left corticospinal tract (r = -0.546, p = 0.001). The FA of the right SLF tracts and bilateral arcuate can be used to differentiate the T2DM-S and the HC at a high accuracy up to 88.45 and 87.8%, respectively. In conclusion, WM microstructure injury in T2DM may be associated with SMC, and these abnormalities identified by DTI can be used as an effective biomarker.
Insights
Type 2 diabetes mellitus (T2DM) can cause brain white matter (WM) injury, potentially leading to subjective memory complaints (SMC). Diffusion tensor imaging (DTI) reveals WM abnormalities in T2DM patients, serving as potential biomarkers for SMC.
Area of Science:
- Neuroimaging
- Endocrinology
- Neurology
Background:
- Type 2 diabetes mellitus (T2DM) is associated with cognitive impairment, often linked to white matter (WM) structural injury.
- Previous research primarily focused on mild cognitive impairment (MCI), with limited investigation into subjective memory complaints (SMC) in T2DM patients.
- Understanding WM alterations in T2DM is crucial for identifying early signs of cognitive decline.
Purpose of the Study:
- To investigate the characteristics of white matter (WM) injury in type 2 diabetes mellitus (T2DM) patients experiencing subjective memory complaints (SMC).
- To explore the correlation between specific diffusion tensor imaging (DTI) properties of WM tracts and SMC symptoms in T2DM.
- To assess the utility of DTI-derived WM features in differentiating T2DM patients with SMC from healthy controls (HC).
Main Methods:
- Sixty-six participants (33 T2DM with SMC, 33 HC) underwent diffusion tensor imaging (DTI).
- Automated fiber quantification (AFQ) was employed to identify pointwise differences along white matter (WM) tracts.
- Support vector machine (SVM) analysis was used to evaluate the discriminative power of DTI properties for distinguishing between groups.
Main Results:
- Significant associations were found between WM microstructure alterations and disease duration or glycemic control (HbA1c).
- Lower fractional anisotropy (FA) in the right SLF and higher mean diffusivity (MD) in the right IFOF were linked to longer disease duration.
- Abnormal MD in the left corticospinal tract correlated negatively with delayed recall, and FA in the right SLF and bilateral arcuate showed high accuracy (88.45% and 87.8%) in differentiating T2DM-SMC from HC.
Conclusions:
- White matter (WM) microstructure injury in type 2 diabetes mellitus (T2DM) is associated with subjective memory complaints (SMC).
- Diffusion tensor imaging (DTI) can detect subtle WM abnormalities in T2DM patients with SMC.
- Identified DTI metrics, particularly FA in the SLF and arcuate tracts, show potential as effective biomarkers for SMC in T2DM.
