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Association of Glymphatic Dysfunction with Cognitive Performance in Type 2 Diabetes Mellitus and Prediabetes
Liya Gong1, Jing He1, Ziqi Wu1
1Department of Medical Imaging, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Prediabetes and type 2 diabetes show glymphatic system (GS) changes, including altered diffusion tensor imaging-anisotropic diffusion along the perivascular space (DTI-ALPS) index and cerebrospinal fluid (CSF) space, linked to cognitive decline.
Area of Science:
- Neuroscience
- Radiology
- Endocrinology
Background:
- The glymphatic system (GS) is crucial for brain waste clearance, and its dysfunction is linked to cognitive decline.
- Alterations in GS function are increasingly recognized in metabolic disorders.
- This study investigates GS changes in prediabetes (PDM) and type 2 diabetes mellitus (T2DM).
Purpose of the Study:
- To assess glymphatic system (GS) alterations in prediabetes (PDM) and type 2 diabetes mellitus (T2DM) using MRI-derived metrics.
- To examine the association between these GS alterations and cognitive performance.
Main Methods:
- Cross-sectional study of 147 participants (52 T2DM, 44 PDM, 51 healthy controls).
- Brain MRI was used to evaluate glymphatic system (GS) metrics: CSF-plaque (CP) volume, perivascular space (PVS) volume, glymphatic function (FW) index, and diffusion tensor imaging-anisotropic diffusion along the perivascular space (DTI-ALPS) index.
- Cognitive function and clinical variables were assessed and correlated with GS metrics.
Main Results:
- Prediabetes (PDM) showed increased CP volume and FW index compared to controls.
- Type 2 diabetes mellitus (T2DM) exhibited reduced DTI-ALPS index, increased CP volume, and higher FW index.
- In both PDM and T2DM groups, lower DTI-ALPS index and higher CP volume/FW index correlated with poorer cognitive performance.
Conclusions:
- Prediabetes (PDM) and type 2 diabetes mellitus (T2DM) demonstrate significant glymphatic system (GS) alterations.
- These GS changes, including reduced DTI-ALPS index and increased CP volume/FW index, are associated with cognitive impairment.
- Glymphatic system (GS) metrics show potential as neuroimaging biomarkers for cognitive deficits in diabetes and prediabetes.
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