Abstract
Type 2 diabetes mellitus (T2DM) patients are highly susceptible to developing dementia, especially for those with mild cognitive impairment (MCI), but its underlying cause is still unclear. In this study, we performed a battery of neuropsychological tests and high-resolution sagittal T1-weighted structural imaging to explore how T2DM affects white matter volume (WMV) and cognition in 30 T2DM-MCI patients, 30 T2DM with normal cognition (T2DM-NC) patients, and 30 age-, sex-, and education-matched healthy control (HC) individuals. The WMV of the whole brain was obtained with automated segmentation methods. Correlations between the WMV of each brain region and neuropsychological tests were analyzed in the T2DM patients. The T2DM-NC patients and HC individuals did not reveal any significant differences in WMV. Compared with the T2DM-NC group, the T2DM-MCI group showed statistically significant reduction in the WMV of seven brain regions, mainly located in the frontotemporal lobe and limbic system, five of which significantly correlated with Montreal Cognitive Assessment (MoCA) scores. Subsequently, we evaluated the discriminative ability of these five regions for MCI in T2DM patients. The WMV of four regions, including left posterior cingulate, precuneus, insula, and right rostral middle frontal gyrus had high diagnostic value for MCI detection in T2DM patients (AUC > 0.7). Among these four regions, left precuneus WMV presented the best diagnostic value (AUC: 0.736; sensitivity: 70.00%; specificity: 73.33%; Youden index: 0.4333), but with no significant difference relative to the minimum AUC. In conclusion, T2DM could give rise to the white matter atrophy of several brain regions. Each WMV of left posterior cingulate, precuneus, insula, and right rostral middle frontal gyrus could be an independent imaging biomarker to detect cognitive impairment at the early stage in T2DM patients and play an important role in its pathophysiological mechanism.
Highlights
Type 2 diabetes mellitus (T2DM) is a common metabolic disorder characterized by insulin resistance and hyperglycemia, which has become a significant health problem throughout the world
T2DM with normal cognition (T2DM-NC) patients presented higher fasting plasma glucose (FPG) and HbA1c and lower high-density lipoprotein (HDL) than healthy control (HC) (Bonferroni correction, P < 0.017); T2DM-mild cognitive impairment (MCI) patients presented higher body mass index (BMI), FPG, and HbA1c and lower HDL than HC (Bonferroni-correction, P < 0.017), while no significant differences were found between T2DM-NC and T2DM-MCI patients
Cognitive function assessed by various neuropsychological tests showed that T2DM-MCI patients performed worst among these three groups, while there was no significant difference between T2DM-NC patients and HC
Summary
Type 2 diabetes mellitus (T2DM) is a common metabolic disorder characterized by insulin resistance and hyperglycemia, which has become a significant health problem throughout the world. It can cause severe multi-systemic dysfunction, such as kidney, eye, peripheral, central nervous system, etc. Mild cognitive impairment (MCI) is considered as a precursor of dementia, which has been an increasingly common target of potential therapeutic trials (Schneider et al, 2009; Brooks and Loewenstein, 2010; Sperling et al, 2011). The effective and preventive treatments are needed at early phases of the dementia spectrum (Jedynak et al, 2012). The early detection of alterations in T2DM patients with MCI is important for patient care and developing future treatment
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
