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Microstructural white matter abnormalities and cognitive functioning in type 2 diabetes: a diffusion tensor imaging study.

Reijmer YD, Brundel M, de Bresser J, Kappelle LJ, Leemans A, Biessels GJ, Utrecht Vascular Cognitive Impairment Study Gro - Diabetes Care (2012)

Bottom Line: Diffusion tensor imaging measures, including fractional anisotropy (FA) and mean diffusivity (MD), were compared between groups and related to cognitive performance.MD was significantly increased in all tracts in both hemispheres in patients compared with control subjects (P < 0.05), reflecting microstructural white matter abnormalities in the diabetes group.These abnormalities were related to worse cognitive functioning.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands. y.d.reijmer@umcutrecht.nl

ABSTRACT

Objective: To examine whether type 2 diabetes is associated with microstructural abnormalities in specific cerebral white matter tracts and to relate these microstructural abnormalities to cognitive functioning.

Research design and methods: Thirty-five nondemented older individuals with type 2 diabetes (mean age 71 ± 5 years) and 35 age-, sex-, and education-matched control subjects underwent a 3 Tesla diffusion-weighted MRI scan and a detailed cognitive assessment. Tractography was performed to reconstruct several white matter tracts. Diffusion tensor imaging measures, including fractional anisotropy (FA) and mean diffusivity (MD), were compared between groups and related to cognitive performance.

Results: MD was significantly increased in all tracts in both hemispheres in patients compared with control subjects (P < 0.05), reflecting microstructural white matter abnormalities in the diabetes group. Increased MD was associated with slowing of information-processing speed and worse memory performance in the diabetes but not in the control group after adjustment for age, sex, and estimated IQ (group × MD interaction, all P < 0.05). These associations were independent of total white matter hyperintensity load and presence of cerebral infarcts.

Conclusions: Individuals with type 2 diabetes showed microstructural abnormalities in various white matter pathways. These abnormalities were related to worse cognitive functioning.

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Related in: MedlinePlus

Differences in MD and FA between the control group (□) and the diabetes group (■) ±SEM. High MD values and low FA values indicate reduced white matter tract integrity. *P < 0.05.
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Figure 2: Differences in MD and FA between the control group (□) and the diabetes group (■) ±SEM. High MD values and low FA values indicate reduced white matter tract integrity. *P < 0.05.

Mentions: Significant between-group differences in MD values were observed in the SLF, UF, and ILF in both the left and right hemisphere and in the splenium of the CC demonstrating microstructural white matter abnormalities in patients compared with control subjects (Fig. 2). A between-group difference in FA was found in the right UF (P = 0.046). The between-group differences in MD were driven by increased diffusivity along both the axial direction (parallel to the tract) and radial direction (perpendicular to the tract) for the left and right SLF, left and right UF, left ILF (all P < 0.05), and right ILF (trend P = 0.09; data not shown). Between-group difference in the splenium of the CC was explained by increased axial diffusivity (P = 0.02). Important to note is that the tract volume did not differ between the diabetes and control groups (P > 0.05).


Microstructural white matter abnormalities and cognitive functioning in type 2 diabetes: a diffusion tensor imaging study.

Reijmer YD, Brundel M, de Bresser J, Kappelle LJ, Leemans A, Biessels GJ, Utrecht Vascular Cognitive Impairment Study Gro - Diabetes Care (2012)

Differences in MD and FA between the control group (□) and the diabetes group (■) ±SEM. High MD values and low FA values indicate reduced white matter tract integrity. *P < 0.05.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3526236&req=5

Figure 2: Differences in MD and FA between the control group (□) and the diabetes group (■) ±SEM. High MD values and low FA values indicate reduced white matter tract integrity. *P < 0.05.
Mentions: Significant between-group differences in MD values were observed in the SLF, UF, and ILF in both the left and right hemisphere and in the splenium of the CC demonstrating microstructural white matter abnormalities in patients compared with control subjects (Fig. 2). A between-group difference in FA was found in the right UF (P = 0.046). The between-group differences in MD were driven by increased diffusivity along both the axial direction (parallel to the tract) and radial direction (perpendicular to the tract) for the left and right SLF, left and right UF, left ILF (all P < 0.05), and right ILF (trend P = 0.09; data not shown). Between-group difference in the splenium of the CC was explained by increased axial diffusivity (P = 0.02). Important to note is that the tract volume did not differ between the diabetes and control groups (P > 0.05).

Bottom Line: Diffusion tensor imaging measures, including fractional anisotropy (FA) and mean diffusivity (MD), were compared between groups and related to cognitive performance.MD was significantly increased in all tracts in both hemispheres in patients compared with control subjects (P < 0.05), reflecting microstructural white matter abnormalities in the diabetes group.These abnormalities were related to worse cognitive functioning.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands. y.d.reijmer@umcutrecht.nl

ABSTRACT

Objective: To examine whether type 2 diabetes is associated with microstructural abnormalities in specific cerebral white matter tracts and to relate these microstructural abnormalities to cognitive functioning.

Research design and methods: Thirty-five nondemented older individuals with type 2 diabetes (mean age 71 ± 5 years) and 35 age-, sex-, and education-matched control subjects underwent a 3 Tesla diffusion-weighted MRI scan and a detailed cognitive assessment. Tractography was performed to reconstruct several white matter tracts. Diffusion tensor imaging measures, including fractional anisotropy (FA) and mean diffusivity (MD), were compared between groups and related to cognitive performance.

Results: MD was significantly increased in all tracts in both hemispheres in patients compared with control subjects (P < 0.05), reflecting microstructural white matter abnormalities in the diabetes group. Increased MD was associated with slowing of information-processing speed and worse memory performance in the diabetes but not in the control group after adjustment for age, sex, and estimated IQ (group × MD interaction, all P < 0.05). These associations were independent of total white matter hyperintensity load and presence of cerebral infarcts.

Conclusions: Individuals with type 2 diabetes showed microstructural abnormalities in various white matter pathways. These abnormalities were related to worse cognitive functioning.

Show MeSH
Related in: MedlinePlus