%0 Journal Article %A Y. Xie %A Y. Zhang %A W. Qin %A S. Lu %A C. Ni %A Q. Zhang %T White Matter Microstructural Abnormalities in Type 2 Diabetes Mellitus: A Diffusional Kurtosis Imaging Analysis %D 2017 %R 10.3174/ajnr.A5042 %J American Journal of Neuroradiology %P 617-625 %V 38 %N 3 %X 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.ADaxial diffusivityAKaxial kurtosisCCcorpus callosumDKIdiffusional kurtosis imagingFAfractional anisotropyHbA1cglycosylated hemoglobinlECleft external capsuleMDmean diffusivityMKmean kurtosisRDradial diffusivityrPF_WMright prefrontal white matterRKradial kurtosisRT of ANTreaction time of Attention Network TestT2DMtype 2 diabetes mellitus %U https://www.ajnr.org/content/ajnr/38/3/617.full.pdf