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Disrupted white matter microstructural integrity of type 2 diabetes mellitus with mild cognitive impairments

Xianxian Zhou1, Jiehuan Wang2, Xueyong Yang1

  • 1Department of Medical Imaging, Zoucheng People's Hospital, Zoucheng 273500, Shandong Province, China.

Neuroscience
|June 14, 2026
PubMed

Insights

Type 2 diabetes mellitus (T2DM) is linked to brain changes affecting cognition. This study reveals white matter alterations in T2DM patients with mild cognitive impairment, correlating with cognitive decline.

Area of Science:

  • Neuroscience
  • Medical Imaging
  • Endocrinology

Background:

  • Type 2 diabetes mellitus (T2DM) is a common condition often associated with cognitive impairments.
  • Understanding the underlying neural mechanisms of cognitive decline in T2DM is crucial for early intervention.

Purpose of the Study:

  • To investigate white matter microstructural changes in individuals with T2DM and mild cognitive impairment (T2DM-MCI).
  • To correlate these microstructural changes with cognitive performance and blood glucose levels.

Main Methods:

  • Employed Neurite Orientation Dispersion and Density Imaging (NODDI) to assess white matter microstructure.
  • Included three groups: T2DM-MCI (n=16), T2DM with normal cognition (T2DM-NC, n=36), and healthy controls (HC, n=29).
  • Utilized cognitive assessments and correlational analysis.

Main Results:

  • Both T2DM-MCI and T2DM-NC groups exhibited reduced neurite density index (NDI) and increased orientation dispersion index (ODI) and free water fraction (FWF) compared to HC in key white matter tracts.
  • The T2DM-MCI group showed significantly higher ODI and FWF than the T2DM-NC group.
  • White matter alterations in T2DM-MCI significantly correlated with cognitive scores and blood glucose levels.

Conclusions:

  • T2DM is associated with widespread white matter microstructural abnormalities, even in individuals with normal cognition.
  • T2DM-MCI is characterized by more pronounced white matter changes, contributing to cognitive impairments.
  • These findings enhance the understanding of the neural basis of early cognitive dysfunction in T2DM.
Keywords:
Cognitive impairmentsNeuriteorientationdispersion anddensityimagingType 2 diabetes mellitusWhite matter microstructure

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