title: Brain expansion in patients with type II diabetes following insulin therapy: a preliminary study with longitudinal voxel-based morphometry.
abstract: OBJECTIVE
  We performed a longitudinal analysis based on magnetic resonance (MR) imaging to investigate the brain structural and perfusion changes caused by insulin therapy in patients with type II diabetes.
  
  
  METHODS
  High resolution three-dimensional T1-weighted fast spoiled gradient recalled echo images and flow-sensitive alternating inversion recovery (FAIR) images were obtained from 11 patients with type II diabetes before and 1 year after initiation of insulin therapy and 11 normal controls. Brain volume changes were investigated by a longitudinal voxel-based morphometry (VBM), and perfusion changes were evaluated by FAIR imaging between baseline and follow-up data.
  
  
  RESULTS
  Significant regional gray matter (GM) expansion located in bilateral frontal, parietal, and left occipital lobes, and regional white matter (WM) expansion was shown in left precentral subcortical WM and right angular subcortical WM after insulin therapy (P < .05 with FDR correction). Brain hyperperfusion was detected in bilateral frontal cortex, left occipital cortex, and right temporal cortex after insulin therapy (P < .05).
  
  
  CONCLUSIONS
  In patients with type II diabetes, brain expansion and hyperperfusion were demonstrated 1 year after initiation of insulin therapy, and insulin therapy could contribute to the brain volume gainment in the patients with type II diabetes.
authors.affiliation: Department of Radiology, PLA General Hospital, Beijing, China.
authors.forename: Zhiye
authors.initials: Z
authors.lastname: Chen
authors.forename: Jinfeng
authors.initials: J
authors.lastname: Li
authors.forename: Jie
authors.initials: J
authors.lastname: Sun
authors.forename: Lin
authors.initials: L
authors.lastname: Ma
mesh_terms: D000368:Aged; D001921:Brain / Q000187:drug effects / Q000473:pathology*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000473:pathology*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007328:Insulin / Q000627:therapeutic use*; D008137:Longitudinal Studies; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009929:Organ Size / Q000187:drug effects; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin
keywords: MRI; Type II diabetes; brain; insulin; voxel-based morphometry