Abstract
BACKGROUND AND PURPOSE: Increasing DTI studies have demonstrated that white matter microstructural abnormalities play an important role in type 2 diabetes mellitus–related cognitive impairment. In this study, the diffusional kurtosis imaging method was used to investigate WM microstructural alterations in patients with type 2 diabetes mellitus and to detect associations between diffusional kurtosis imaging metrics and clinical/cognitive measurements.
MATERIALS AND METHODS: Diffusional kurtosis imaging and cognitive assessments were performed on 58 patients with type 2 diabetes mellitus and 58 controls. Voxel-based intergroup comparisons of diffusional kurtosis imaging metrics were conducted, and ROI-based intergroup comparisons were further performed. Correlations between the diffusional kurtosis imaging metrics and cognitive/clinical measurements were assessed after controlling for age, sex, and education in both patients and controls.
RESULTS: Altered diffusion metrics were observed in the corpus callosum, the bilateral frontal WM, the right superior temporal WM, the left external capsule, and the pons in patients with type 2 diabetes mellitus compared with controls. The splenium of the corpus callosum and the pons had abnormal kurtosis metrics in patients with type 2 diabetes mellitus. Additionally, altered diffusion metrics in the right prefrontal WM were significantly correlated with disease duration and attention task performance in patients with type 2 diabetes mellitus.
CONCLUSIONS: With both conventional diffusion and additional kurtosis metrics, diffusional kurtosis imaging can provide additional information on WM microstructural abnormalities in patients with type 2 diabetes mellitus. Our results indicate that WM microstructural abnormalities occur before cognitive decline and may be used as neuroimaging markers for predicting the early cognitive impairment in patients with type 2 diabetes mellitus.
Abbreviations
- AD
- axial diffusivity
- AK
- axial kurtosis
- CC
- corpus callosum
- DKI
- diffusional kurtosis imaging
- FA
- fractional anisotropy
- HbA1c
- glycosylated hemoglobin
- lEC
- left external capsule
- MD
- mean diffusivity
- MK
- mean kurtosis
- RD
- radial diffusivity
- rPF_WM
- right prefrontal white matter
- RK
- radial kurtosis
- RT of ANT
- reaction time of Attention Network Test
- T2DM
- type 2 diabetes mellitus
Footnotes
Y. Xie and Y. Zhang contributed equally to this work.
- © 2017 American Society of Neuroradiology