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White matter impairment in type 2 diabetes mellitus with and without microvascular disease.
Neuroimage Clin 2019; 24:101945NC

Abstract

BACKGROUND AND OBJECTIVE

Type 2 diabetes mellitus (T2DM) is a serious public health problem, and the phenomenon of T2DM occurring in younger people has directed more attention to functional changes in the brain. In this study, the microstructural integrity of white matter (WM) was evaluated in three groups of middle-aged subjects: healthy controls (HCs) and T2DM patients with and without peripheral microvascular complications (T2DM-C and T2DM-NC patients, respectively).

METHODS

Diffusion tensor imaging (DTI) and related clinical examinations were performed in 66 subjects, including 20 T2DM-C patients, 20 T2DM-NC patients, 26 age- and sex-matched HCs. Magnetic resonance imaging (MRI) at 3 T was used to perform DTI; then, FSL and tract-based spatial statistics (TBSS) software were used to assess differences in the fractional anisotropy (FA) and mean diffusivity (MD) among the groups. The use of the FA and MD as parameters was evaluated by receiver operating characteristic (ROC) curve analysis.

RESULTS

There were no significant differences in sex or age among the groups, and the clinical data of the groups met the experimental requirements. There was no significant difference in the FA values between the HCs and T2DM-NC groups. Compared with the HCs, the T2DM-C patients showed decreased FA values and increased MD values in the corpus callosum, bilateral anterior limb of the internal capsule, right retrolenticular part of the internal capsule, bilateral posterior thalamic radiation, right superior longitudinal fasciculus, bilateral superior corona radiata and left middle frontal gyrus (P < .01). Compared with the T2DM-NC patients, the T2DM-C patients showed decreased FA values and increased MD values in the corpus callosum, bilateral fornix, right retrolenticular part of the internal capsule, middle cerebral peduncle, right superior longitudinal fasciculus, right posterior thalamic radiation, and left middle frontal gyrus (P < .01).

CONCLUSIONS

This study indicates that WM impairment is present in T2DM patients and may be related to microvascular complications. More importantly, this study also shows that such impairment may be diagnosed using the DTI mode of functional MRI before it can be diagnosed clinically.

Authors+Show Affiliations

Department of Radiology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200080, PR China; Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 200000, PR China.Department of Endocrinology and Metabolic Diseases, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200020, PR China.Department of Radiology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200080, PR China.Department of Radiology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200080, PR China.Department of Radiology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200080, PR China.School of Computer Science and Technology, Fudan University, Shanghai Key Laboratory of Data Science, Shanghai, PR China.School of Mathematical Sciences, Zhejiang University, Zhejiang 310027, PR China.Department of Radiology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200080, PR China. Electronic address: Kangan.li@shsmu.edu.cn.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31374399

Citation

Zhuo, Yaoyao, et al. "White Matter Impairment in Type 2 Diabetes Mellitus With and Without Microvascular Disease." NeuroImage. Clinical, vol. 24, 2019, p. 101945.
Zhuo Y, Fang F, Lu L, et al. White matter impairment in type 2 diabetes mellitus with and without microvascular disease. Neuroimage Clin. 2019;24:101945.
Zhuo, Y., Fang, F., Lu, L., Li, T., Lian, J., Xiong, Y., ... Li, K. (2019). White matter impairment in type 2 diabetes mellitus with and without microvascular disease. NeuroImage. Clinical, 24, p. 101945. doi:10.1016/j.nicl.2019.101945.
Zhuo Y, et al. White Matter Impairment in Type 2 Diabetes Mellitus With and Without Microvascular Disease. Neuroimage Clin. 2019 Jul 18;24:101945. PubMed PMID: 31374399.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - White matter impairment in type 2 diabetes mellitus with and without microvascular disease. AU - Zhuo,Yaoyao, AU - Fang,Fang, AU - Lu,Lunbo, AU - Li,Ting, AU - Lian,Jingge, AU - Xiong,Yun, AU - Kong,Dexing, AU - Li,Kangan, Y1 - 2019/07/18/ PY - 2018/10/08/received PY - 2019/05/09/revised PY - 2019/07/17/accepted PY - 2019/8/3/pubmed PY - 2019/8/3/medline PY - 2019/8/3/entrez KW - Diffusion tensor imaging KW - Functional magnetic resonance imaging KW - Middle age KW - Type 2 diabetes mellitus KW - White matter impairment SP - 101945 EP - 101945 JF - NeuroImage. Clinical JO - Neuroimage Clin VL - 24 N2 - BACKGROUND AND OBJECTIVE: Type 2 diabetes mellitus (T2DM) is a serious public health problem, and the phenomenon of T2DM occurring in younger people has directed more attention to functional changes in the brain. In this study, the microstructural integrity of white matter (WM) was evaluated in three groups of middle-aged subjects: healthy controls (HCs) and T2DM patients with and without peripheral microvascular complications (T2DM-C and T2DM-NC patients, respectively). METHODS: Diffusion tensor imaging (DTI) and related clinical examinations were performed in 66 subjects, including 20 T2DM-C patients, 20 T2DM-NC patients, 26 age- and sex-matched HCs. Magnetic resonance imaging (MRI) at 3 T was used to perform DTI; then, FSL and tract-based spatial statistics (TBSS) software were used to assess differences in the fractional anisotropy (FA) and mean diffusivity (MD) among the groups. The use of the FA and MD as parameters was evaluated by receiver operating characteristic (ROC) curve analysis. RESULTS: There were no significant differences in sex or age among the groups, and the clinical data of the groups met the experimental requirements. There was no significant difference in the FA values between the HCs and T2DM-NC groups. Compared with the HCs, the T2DM-C patients showed decreased FA values and increased MD values in the corpus callosum, bilateral anterior limb of the internal capsule, right retrolenticular part of the internal capsule, bilateral posterior thalamic radiation, right superior longitudinal fasciculus, bilateral superior corona radiata and left middle frontal gyrus (P < .01). Compared with the T2DM-NC patients, the T2DM-C patients showed decreased FA values and increased MD values in the corpus callosum, bilateral fornix, right retrolenticular part of the internal capsule, middle cerebral peduncle, right superior longitudinal fasciculus, right posterior thalamic radiation, and left middle frontal gyrus (P < .01). CONCLUSIONS: This study indicates that WM impairment is present in T2DM patients and may be related to microvascular complications. More importantly, this study also shows that such impairment may be diagnosed using the DTI mode of functional MRI before it can be diagnosed clinically. SN - 2213-1582 UR - https://www.unboundmedicine.com/medline/citation/31374399/White_matter_impairment_in_type_2_diabetes_mellitus_with_and_without_microvascular_disease L2 - https://linkinghub.elsevier.com/retrieve/pii/S2213-1582(19)30295-5 DB - PRIME DP - Unbound Medicine ER -