Abstract
It is becoming increasingly evident that type 2 diabetes mellitus can have effects on global and regional brain morphology. Ventricular enlargement reflecting cerebral atrophy has been reported particularly in elderly type 2 diabetes patients. However, little is known about its timing through the disease course and morphological variability. Using the combined volumetric and advanced three-dimensional morphological approach, we identified differences in size and shape of the lateral ventricles between recent-onset type 2 diabetes patients and healthy individuals. High-resolution T1-weighted images were obtained from 23 type 2 diabetes patients whose illness duration was less than 1 year and 23 carefully matched healthy individuals. By volume measurement, we found enlarged lateral and third ventricles in type 2 diabetes patients, relative to healthy individuals (F 1,41 = 7.96, P = 0.007; F 1,41 = 11.16, P = 0.002, respectively). Morphological analysis revealed that the expansion of lateral ventricles in the diabetic brain was prominent in the bilateral frontal horns. The current findings suggest that atrophic changes particularly of the anterior frontal lobe can occur as early as the first year after the clinical diagnosis of type 2 diabetes mellitus.
Highlights
Increasing evidence indicates that type 2 diabetes mellitus resulting from insulin insensitivity can give rise to a wide range of complications in the central nervous system (CNS), including cognitive decline and development of dementia [1,2,3]
All patients were diagnosed as having type 2 diabetes mellitus at the University-affiliated hospital according to the American Diabetes Association criteria [26], and the mean time since the clinical diagnosis of type 2 diabetes mellitus was 4.36 months (SD = 3.25 months, range = 0.5 to 11.9 months), which indicated that the participating type 2 diabetes patients were in a relatively early stage of illness
After the correction for multiple comparisons, type 2 diabetes patients showed a significant localized expansion of the frontal horns of the bilateral lateral ventricles to the surrounding brain regions including the medial frontal lobe (Figure 3). This is the first study to examine the effects of type 2 diabetes mellitus on lateral ventricular morphometric abnormalities using three-dimensional shape analysis complementary to conventional volumetric approach
Summary
Increasing evidence indicates that type 2 diabetes mellitus resulting from insulin insensitivity can give rise to a wide range of complications in the central nervous system (CNS), including cognitive decline and development of dementia [1,2,3]. Several demographic and metabolic risk factors have been supposed to be partly responsible for the type-2-diabetes-related brain abnormalities. Comorbid cardiovascular diseases, and the extent of metabolic insults including hypo- and hyper-glycemia may contribute to the progress of cerebral atrophy in type 2 diabetes patients [6,7,8,9]. It is still unclear whether cerebral atrophic changes could begin early in the course of diabetes, even when these concomitant risk factors might not yet be prominent
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