title: Microstructural white matter abnormalities in type 2 diabetes mellitus: a diffusion tensor imaging study.
abstract: This study investigated whether diffusion tensor imaging (DTI) could identify potential abnormalities in type 2 diabetes mellitus (T2DM) patients without cognitive complaints compared to healthy controls. In addition, the existence of associations between diffusion measures and clinical parameters was examined. Forty T2DM patients and 97 non-diabetic controls completed a clinical and biochemistry examination. Structural MRI scans (DTI, T1, T2, FLAIR) were subsequently acquired with a 1.5 Tesla scanner. In addition to a global DTI analysis, voxel-based analysis was performed on the fractional anisotropy (FA), mean diffusivity (MD), and axial (AD) and transverse (TD) diffusivity maps to investigate regions that exhibit (i) WM differences between patients and controls; and (ii) associations between clinical measurements and these DTI indices. There were no significant differences in age, gender, and WM hyperintensity scores derived by the conventional MRI scans between controls and T2DM patients. For the T2DM patients, however, the MD of the brain parenchyma was significantly increased compared to controls and was positively correlated with disease duration. The voxel based analyses revealed (i) a significantly decreased FA in the bilateral frontal WM compared to controls which was mainly caused by an increased TD and not a decreased AD within these regions; (ii) a significant association between disease duration and microstructural properties in several brain regions including bilateral cerebellum, temporal lobe WM, right caudate, bilateral cingulate gyrus, pons, and parahippocampal gyrus. Our findings indicate that microstructural WM abnormalities and associations with clinical measurements can be detected with DTI in T2DM patients.
authors.affiliation: Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan.
authors.forename: Jung-Lung
authors.initials: JL
authors.lastname: Hsu
authors.forename: Yen-Ling
authors.initials: YL
authors.lastname: Chen
authors.forename: Jyu-Gang
authors.initials: JG
authors.lastname: Leu
authors.forename: Fu-Shan
authors.initials: FS
authors.lastname: Jaw
authors.forename: Cheng-Hui
authors.initials: CH
authors.lastname: Lee
authors.forename: Yuh-Feng
authors.initials: YF
authors.lastname: Tsai
authors.forename: Chien-Yeh
authors.initials: CY
authors.lastname: Hsu
authors.forename: Chyi-Huey
authors.initials: CH
authors.lastname: Bai
authors.forename: Alexander
authors.initials: A
authors.lastname: Leemans
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology*; D003924:Diabetes Mellitus, Type 2 / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity