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Research ArticleFunctional

White Matter Microstructural Abnormalities in Type 2 Diabetes Mellitus: A Diffusional Kurtosis Imaging Analysis

Y. Xie, Y. Zhang, W. Qin, S. Lu, C. Ni and Q. Zhang
American Journal of Neuroradiology March 2017, 38 (3) 617-625; DOI: https://doi.org/10.3174/ajnr.A5042
Y. Xie
aFrom the Department of Radiology and Tianjin Key Laboratory of Functional Imaging (Y.X., Y.Z., W.Q., Q.Z.), Tianjin Medical University General Hospital, Tianjin, China
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Y. Zhang
aFrom the Department of Radiology and Tianjin Key Laboratory of Functional Imaging (Y.X., Y.Z., W.Q., Q.Z.), Tianjin Medical University General Hospital, Tianjin, China
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W. Qin
aFrom the Department of Radiology and Tianjin Key Laboratory of Functional Imaging (Y.X., Y.Z., W.Q., Q.Z.), Tianjin Medical University General Hospital, Tianjin, China
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S. Lu
bDepartments of Radiology (S.L.)
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C. Ni
cCardiology (C.N.), Tianjin Medical University Metabolic Diseases Hospital, Tianjin, China.
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Q. Zhang
aFrom the Department of Radiology and Tianjin Key Laboratory of Functional Imaging (Y.X., Y.Z., W.Q., Q.Z.), Tianjin Medical University General Hospital, Tianjin, China
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Abstract

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.

ABBREVIATIONS:

AD
axial diffusivity
AK
axial kurtosis
CC
corpus callosum
DKI
diffusional kurtosis imaging
FA
fractional anisotropy
HbA1c
glycosylated hemoglobin
lEC
left external capsule
MD
mean diffusivity
MK
mean kurtosis
RD
radial diffusivity
rPF_WM
right prefrontal white matter
RK
radial kurtosis
RT of ANT
reaction time of Attention Network Test
T2DM
type 2 diabetes mellitus
  • © 2017 by American Journal of Neuroradiology
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American Journal of Neuroradiology: 38 (3)
American Journal of Neuroradiology
Vol. 38, Issue 3
1 Mar 2017
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Cite this article
Y. Xie, Y. Zhang, W. Qin, S. Lu, C. Ni, Q. Zhang
White Matter Microstructural Abnormalities in Type 2 Diabetes Mellitus: A Diffusional Kurtosis Imaging Analysis
American Journal of Neuroradiology Mar 2017, 38 (3) 617-625; DOI: 10.3174/ajnr.A5042

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White Matter Microstructural Abnormalities in Type 2 Diabetes Mellitus: A Diffusional Kurtosis Imaging Analysis
Y. Xie, Y. Zhang, W. Qin, S. Lu, C. Ni, Q. Zhang
American Journal of Neuroradiology Mar 2017, 38 (3) 617-625; DOI: 10.3174/ajnr.A5042
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