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Updated: May 11, 2026

Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Evaluation of the glymphatic system using the DTI-ALPS index in type 2 diabetes mellitus-induced cognitive impairment
Nan Wang1, Rendi Yin1, Yao Fang1
1The Graduate School, Xuzhou Medical University, Xuzhou, Jiangsu, China.
Objectives:
The objective of the study is to assess the utility of the perivascular space diffusion tensor imaging - along the perivascular space (DTI-ALPS) index in evaluating the activity of the brain glymphatic system in patients with type 2 diabetes mellitus (T2DM) and cognitive impairment.
Material And Methods:
This study included 40 T2DM patients with cognitive impairment and 40 healthy controls (HCs). All participants underwent DTI, and the DTI-ALPS index was calculated based on relevant DTI parameters. Statistical analyses were performed using the Statistical Package for the Social Sciences version 26.0, with significance set at P < 0.05.
Results:
The DTI-ALPS index in T2DM patients with cognitive impairment were significantly lower than that of the HCs. A significant negative correlation was observed between the DTI-ALPS index and glycated hemoglobin levels, while positive correlations were found with vitamin D, Montreal Cognitive Assessment scores, and high-density lipoprotein cholesterol levels.
Conclusion:
This study confirms glymphatic dysfunction in T2DM patients with cognitive impairment, as indicated by the reduced DTI-ALPS index. Furthermore, it demonstrates the feasibility of utilizing the DTI-ALPS method to assess glymphatic system activity in this patient population.

