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Diabetes. 2014 Nov;63(11):3596-605. doi: 10.2337/db14-0342. Epub 2014 Jun 19.

White matter integrity disruptions associated with cognitive impairments in type 2 diabetic patients.

Author information

  • 1State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, People's Republic of China BABRI Centre, Beijing Normal University, Beijing, People's Republic of China.
  • 2BABRI Centre, Beijing Normal University, Beijing, People's Republic of China Institute of Basic Research in Clinical Medicine, China Academy of Traditional Chinese Medicine, Beijing, People's Republic of China.
  • 3State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, People's Republic of China BABRI Centre, Beijing Normal University, Beijing, People's Republic of China zhang_rzs@bnu.edu.cn.

Abstract

Type 2 diabetes mellitus (T2DM) is associated with a twofold increased risk of dementia and can affect many cognitive abilities, but its underlying cause is still unclear. In this study, we used a combination of a battery of neuropsychological tests and diffusion tensor imaging (DTI) to explore how T2DM affects white matter (WM) integrity and cognition in 38 T2DM patients and 34 age-, sex-, and education-matched normal control subjects. A battery of neuropsychological tests was used to assess a wide range of cognitive functions. Tract-based spatial statistics combined with region of interest-wise (ROI-wise) analysis of mean values of DTI metrics in ROIs was used to compare group differences of DTI metrics on WM skeletons to identify severely disrupted WM tracts in T2DM. We found that T2DM patients showed 1) various cognitive impairments, including executive function, spatial processing, attention, and working memory deficits; 2) widespread WM disruptions, especially in the whole corpus callosum, the left anterior limb of the internal capsule (ALIC.L), and external capsule (EC); and 3) a positive correlation between executive function and WM integrity in the ALIC.L and the left EC. In conclusion, T2DM patients show various cognitive impairments and widespread WM integrity disruptions, which we attribute to demyelination. Moreover, executive dysfunction closely correlates with WM abnormalities.

© 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

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