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White matter microstructure alterations in type 2 diabetes mellitus and its correlation with cerebral small vessel
Yangyingqiu Liu1,2, Yuhan Jiang1, Wei Du1
1Department of Radiology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang, Dalian, China.
Abstract:
Microstructural abnormalities of white matter fiber tracts are considered as one of the etiology of diabetes-induced neurological disorders. We explored the cerebral white matter microstructure alteration accurately, and to analyze its correlation between cerebral small vessel disease (CSVD) burden and cognitive performance in type 2 diabetes mellitus (T2DM). The clinical-laboratory data, cognitive scores [including mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA), California verbal learning test (CVLT), and symbol digit modalities test (SDMT)], CSVD burden scores of the T2DM group (n = 34) and healthy control (HC) group (n = 21) were collected prospectively. Automatic fiber quantification (AFQ) was applied to generate bundle profiles along primary white matter fiber tracts. Diffusion tensor images (DTI) metrics and 100 nodes of white matter fiber tracts between groups were compared. Multiple regression analysis was used to analyze the relationship between DTI metrics and cognitive scores and CSVD burden scores. For fiber-wise and node-wise, DTI metrics in some commissural and association fibers were increased in T2DM. Some white matter fiber tracts DTI metrics were independent predictors of cognitive scores and CSVD burden scores. White matter fiber tracts damage in patients with T2DM may be characterized in specific location, especially commissural and association fibers. Aberrational specific white matter fiber tracts are associated with visuospatial function and CSVD burden.
Insights
Type 2 diabetes mellitus (T2DM) is linked to neurological issues due to white matter damage. Specific fiber tracts show abnormalities, impacting cognitive function and cerebral small vessel disease (CSVD) burden.
Area of Science:
- Neuroscience
- Radiology
- Endocrinology
Background:
- Diabetes-induced neurological disorders are often linked to white matter abnormalities.
- Understanding these microstructural changes is crucial for managing T2DM complications.
Purpose of the Study:
- To accurately explore cerebral white matter microstructure alterations in type 2 diabetes mellitus (T2DM).
- To analyze the correlation between these alterations, cerebral small vessel disease (CSVD) burden, and cognitive performance.
Main Methods:
- Prospective data collection of clinical-laboratory data and cognitive scores (MMSE, MoCA, CVLT, SDMT) from T2DM patients (n=34) and healthy controls (HC, n=21).
- Application of Automatic Fiber Quantification (AFQ) for white matter tract analysis using Diffusion Tensor Imaging (DTI) metrics.
- Multiple regression analysis to assess relationships between DTI metrics, cognitive scores, and CSVD burden.
Main Results:
- Increased DTI metrics were observed in specific commissural and association fibers in the T2DM group compared to HC.
- Certain white matter fiber tracts' DTI metrics independently predicted cognitive scores and CSVD burden.
- White matter fiber tract damage in T2DM is localized, particularly affecting commissural and association fibers.
Conclusions:
- White matter microstructural abnormalities, especially in commissural and association fibers, are characteristic of T2DM.
- These specific aberrant white matter tracts correlate with impaired visuospatial function and increased CSVD burden in T2DM patients.
