Xie Y, Zhang Y, Qin W, Lu S, Ni C, Zhang Q
From the Department of Radiology and Tianjin Key Laboratory of Functional Imaging (Y.X., Y.Z., W.Q., Q.Z.), Tianjin Medical University General Hospital, Tianjin, China.
Departments of Radiology (S.L.).
AJNR Am J Neuroradiol. 2017 Mar;38(3):617-625. doi: 10.3174/ajnr.A5042. Epub 2016 Dec 15.
Increasing DTI studies have demonstrated that white matter microstructural abnormalities play an important role in type 2 diabetes mellitus-related cognitive impairment. In this study, the diffusional kurtosis imaging method was used to investigate WM microstructural alterations in patients with type 2 diabetes mellitus and to detect associations between diffusional kurtosis imaging metrics and clinical/cognitive measurements.
Diffusional kurtosis imaging and cognitive assessments were performed on 58 patients with type 2 diabetes mellitus and 58 controls. Voxel-based intergroup comparisons of diffusional kurtosis imaging metrics were conducted, and ROI-based intergroup comparisons were further performed. Correlations between the diffusional kurtosis imaging metrics and cognitive/clinical measurements were assessed after controlling for age, sex, and education in both patients and controls.
Altered diffusion metrics were observed in the corpus callosum, the bilateral frontal WM, the right superior temporal WM, the left external capsule, and the pons in patients with type 2 diabetes mellitus compared with controls. The splenium of the corpus callosum and the pons had abnormal kurtosis metrics in patients with type 2 diabetes mellitus. Additionally, altered diffusion metrics in the right prefrontal WM were significantly correlated with disease duration and attention task performance in patients with type 2 diabetes mellitus.
With both conventional diffusion and additional kurtosis metrics, diffusional kurtosis imaging can provide additional information on WM microstructural abnormalities in patients with type 2 diabetes mellitus. Our results indicate that WM microstructural abnormalities occur before cognitive decline and may be used as neuroimaging markers for predicting the early cognitive impairment in patients with type 2 diabetes mellitus.
越来越多的扩散张量成像（DTI）研究表明，白质微观结构异常在2型糖尿病相关认知障碍中起重要作用。在本研究中，采用扩散峰度成像方法研究2型糖尿病患者的白质微观结构改变，并检测扩散峰度成像指标与临床/认知测量之间的关联。
对58例2型糖尿病患者和58例对照者进行扩散峰度成像和认知评估。进行基于体素的扩散峰度成像指标组间比较，并进一步进行基于感兴趣区（ROI）的组间比较。在对患者和对照者的年龄、性别和教育程度进行校正后，评估扩散峰度成像指标与认知/临床测量之间的相关性。
与对照组相比，2型糖尿病患者在胼胝体、双侧额叶白质、右侧颞上白质、左侧外囊和脑桥观察到扩散指标改变。2型糖尿病患者胼胝体压部和脑桥的峰度指标异常。此外，2型糖尿病患者右侧前额叶白质的扩散指标改变与病程和注意力任务表现显著相关。
扩散峰度成像结合传统扩散和额外的峰度指标，可为2型糖尿病患者白质微观结构异常提供更多信息。我们的结果表明，白质微观结构异常在认知衰退之前就已出现，可作为预测2型糖尿病患者早期认知障碍的神经影像学标志物。
