title: Microstructural white matter abnormalities and cognitive functioning in type 2 diabetes: a diffusion tensor imaging study.
abstract: OBJECTIVE
  To examine whether type 2 diabetes is associated with microstructural abnormalities in specific cerebral white matter tracts and to relate these microstructural abnormalities to cognitive functioning.
  
  
  METHODS
  Thirty-five nondemented older individuals with type 2 diabetes (mean age 71 ± 5 years) and 35 age-, sex-, and education-matched control subjects underwent a 3 Tesla diffusion-weighted MRI scan and a detailed cognitive assessment. Tractography was performed to reconstruct several white matter tracts. Diffusion tensor imaging measures, including fractional anisotropy (FA) and mean diffusivity (MD), were compared between groups and related to cognitive performance.
  
  
  RESULTS
  MD was significantly increased in all tracts in both hemispheres in patients compared with control subjects (P < 0.05), reflecting microstructural white matter abnormalities in the diabetes group. Increased MD was associated with slowing of information-processing speed and worse memory performance in the diabetes but not in the control group after adjustment for age, sex, and estimated IQ (group × MD interaction, all P < 0.05). These associations were independent of total white matter hyperintensity load and presence of cerebral infarcts.
  
  
  CONCLUSIONS
  Individuals with type 2 diabetes showed microstructural abnormalities in various white matter pathways. These abnormalities were related to worse cognitive functioning.
authors.affiliation: Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands. y.d.reijmer@umcutrecht.nl
authors.forename: Yael D
authors.initials: YD
authors.lastname: Reijmer
authors.forename: Manon
authors.initials: M
authors.lastname: Brundel
authors.forename: Jeroen
authors.initials: J
authors.lastname: de Bresser
authors.forename: L Jaap
authors.initials: LJ
authors.lastname: Kappelle
authors.forename: Alexander
authors.initials: A
authors.lastname: Leemans
authors.forename: Geert Jan
authors.initials: GJ
authors.lastname: Biessels
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D001921:Brain; D002648:Child; D003071:Cognition / Q000502:physiology*; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D005234:Fatty Liver / Q000503:physiopathology*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D008099:Liver / Q000378:metabolism / Q000473:pathology; D008297:Male; D009765:Obesity / Q000503:physiopathology