White Matter Characteristics of Damage Along Fiber Tracts in Patients with Type 2 Diabetes Mellitus

Abstract

Purpose The white matter (WM) of the brain of type 2 diabetes mellitus (T2DM) patients is susceptible to neurodegenerative processes, but the specific types and positions of microstructural lesions along the fiber tracts remain unclear. Methods In this study 61 T2DM patients and 61 healthy controls were recruited and underwent diffusion spectrum imaging (DSI). The results were reconstructed with diffusion tensor imaging (DTI) and neurite orientation dispersion and density imaging (NODDI). WM microstructural abnormalities were identified using tract-based spatial statistics (TBSS). Pointwise WM tract differences were detected through automatic fiber quantification (AFQ). The relationships between WM tract abnormalities and clinical characteristics were explored with partial correlation analysis. Results TBSS revealed widespread WM lesions in T2DM patients with decreased fractional anisotropy and axial diffusivity and an increased orientation dispersion index (ODI). The AFQ results showed microstructural abnormalities in T2DM patients in specific portions of the right superior longitudinal fasciculus (SLF), right arcuate fasciculus (ARC), left anterior thalamic radiation (ATR), and forceps major (FMA). In the right ARC of T2DM patients, an aberrant ODI was positively correlated with fasting insulin and insulin resistance, and an abnormal intracellular volume fraction was negatively correlated with fasting blood glucose. Additionally, negative associations were found between blood pressure and microstructural abnormalities in the right ARC, left ATR, and FMA in T2DM patients. Conclusion Using AFQ, together with DTI and NODDI, various kinds of microstructural alterations in the right SLF, right ARC, left ATR, and FMA can be accurately identified and may be associated with insulin and glucose status and blood pressure in T2DM patients.

White matter microstructure alterations in type 2 diabetes mellitus and its correlation with cerebral small vessel disease and cognitive performance

“…In our study, compared with HCs, T2DM patients showed an extensive increase in the mean MD, AD, and RD values of association fibers and CF. Specifically, the MD values of CF_Major, CF_Minor, right IFOF, and right ILF increased, consistent with previous studies 32 , 41 , 42 increased. In the node-wise comparison, the nodes 11–16 of MD in right IFOF in T2DM patients were increased.…”

“…The calculation was done based on two-tailed test, α of 0.05, and power of 0.8, the ratio of sample size between T2DM group and HC group was 1:1. Referring to previous studies 15 , 32 – 34 , the diffusion metrics values of bilateral IFOF, CF_Major, CF_Minor were used as the main observation indicators. The data of our preliminary experiment were used for sample size calculation.…”

Insulin effects on core neurotransmitter pathways involved in schizophrenia neurobiology: a meta-analysis of preclinical studies. Implications for the treatment

“…Consistently, in first-episode psychosis and antipsychotic naïve patients, a potential association of insulin resistance with diminished response to antipsychotic treatment can be identified [8]. Further, abnormal neuroimaging findings have been detected in diabetic and pre-diabetic patients without psychiatric illness [177][178][179]. Thus, greater attention should be paid to different patterns of brain functional and structural connectivity in psychotic patients detected in the absence or presence of metabolic abnormalities, with further implications for treatment responsiveness and resistance.…”

The Reduced Gray Matter Volume and Functional Connectivity of the Cerebellum in Type 2 Diabetes Mellitus with High Insulin Resistance

“…Neuroimaging studies have recently highlighted the association between insulin resistance and abnormal brain structure and function in individuals with T2DM [11][12][13][14]. One study revealed a link between lower gray matter density in frontotemporal regions and the homeostatic model assessment of insulin resistance (HOMA-IR) [11].…”

“…One study revealed a link between lower gray matter density in frontotemporal regions and the homeostatic model assessment of insulin resistance (HOMA-IR) [11]. An automatic fiber quantification study also demonstrated a positive correlation between insulin resistance and aberrant orientation dispersion index in the right arcuate fasciculus [12]. Functional magnetic resonance imaging (MRI) studies further supported the connection between the abnormal brain connectivity patterns and HOMA-IR in T2DM [13, 14].…”