title: Effects of Type 2 Diabetes on Brain Structure and Cognitive Function: African American-Diabetes Heart Study MIND.
abstract: OBJECTIVE
  Rates of type 2 diabetes are higher among African Americans compared with individuals of European ancestry. The purpose of this investigation was to determine the relationship between MR imaging measures of brain structure (volume of GM, WM, WM lesions) and cognitive function in a population of African Americans with type 2 diabetes. These MR imaging measures of brain structure are affected by type 2 diabetes-associated macrovascular and microvascular disease and may be associated with performance on tasks of cognitive function in the understudied African American population.
  
  
  METHODS
  African Americans with type 2 diabetes enrolled in the African American-Diabetes Heart Study MIND study (n = 263) were evaluated across a broad range of cognitive domains and imaged with brain MR imaging. Associations between cognitive parameters and MR imaging measures of whole-brain GM, WM, and WM lesion volumes were assessed by using adjusted multivariate models.
  
  
  RESULTS
  Lower GM volume was associated with poorer performance on measures of general cognitive function, working memory, and executive function. Higher WM lesion volume was associated with poorer performance on a smaller subset of cognitive domains compared with GM volume but included aspects of working memory and executive function. There were no statistically significant associations with WM volume.
  
  
  CONCLUSIONS
  Markers of cortical atrophy and WM lesion volume are associated with cognitive function in African Americans with type 2 diabetes. These associations are described in an African American cohort with disease control similar to that of individuals of European ancestry, rather than underserved African Americans with poor access to health care. Interventions to reduce cortical atrophy and WM disease may improve cognitive outcomes in this understudied population.
authors.affiliation: From the Department of Radiology, Section of Neuroradiology (C.T.W., J.A.M.) Advanced Neuroscience Imaging Research Laboratory (C.T.W., J.A.M.) Department of Biomedical Engineering (C.T.W., J.A.M.) cwhitlow@wakehealth.edu.
authors.forename: C T
authors.initials: CT
authors.lastname: Whitlow
authors.affiliation: Department of Internal Medicine, Section on Gerontology and Geriatric Medicine (K.M.S., C.E.H., J.D.W.).
authors.forename: K M
authors.initials: KM
authors.lastname: Sink
authors.affiliation: Division of Public Health Sciences, Department of Biostatistical Sciences (J.D.).
authors.forename: J
authors.initials: J
authors.lastname: Divers
authors.affiliation: Department of Biochemistry (S.C.S., J.X., N.D.P., D.W.B.).
authors.forename: S C
authors.initials: SC
authors.lastname: Smith
authors.affiliation: Department of Biochemistry (S.C.S., J.X., N.D.P., D.W.B.).
authors.forename: J
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Biochemistry (S.C.S., J.X., N.D.P., D.W.B.) Center for Diabetes Research, Center for Genomics and Personalized Medicine Research (N.D.P., D.W.B., B.I.F.).
authors.forename: N D
authors.initials: ND
authors.lastname: Palmer
authors.affiliation: Department of Internal Medicine, Section on Gerontology and Geriatric Medicine (K.M.S., C.E.H., J.D.W.).
authors.forename: C E
authors.initials: CE
authors.lastname: Hugenschmidt
authors.affiliation: Department of Internal Medicine, Section on Gerontology and Geriatric Medicine (K.M.S., C.E.H., J.D.W.).
authors.forename: J D
authors.initials: JD
authors.lastname: Williamson
authors.affiliation: Department of Biochemistry (S.C.S., J.X., N.D.P., D.W.B.) Center for Diabetes Research, Center for Genomics and Personalized Medicine Research (N.D.P., D.W.B., B.I.F.).
authors.forename: D W
authors.initials: DW
authors.lastname: Bowden
authors.affiliation: Center for Diabetes Research, Center for Genomics and Personalized Medicine Research (N.D.P., D.W.B., B.I.F.) Department of Internal Medicine, Section on Nephrology (B.I.F.), Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: B I
authors.initials: BI
authors.lastname: Freedman
authors.affiliation: From the Department of Radiology, Section of Neuroradiology (C.T.W., J.A.M.) Advanced Neuroscience Imaging Research Laboratory (C.T.W., J.A.M.) Department of Biomedical Engineering (C.T.W., J.A.M.).
authors.forename: J A
authors.initials: JA
authors.lastname: Maldjian
mesh_terms: D001741:Black or African American; D001284:Atrophy / Q000473:pathology; D001921:Brain / Q000473:pathology*; D003071:Cognition; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male