Mahmood Subia, Dkhar Winniecia, Kadavigere Rajagopal, Sukumar Suresh, Nayak Kaushik, Pradhan Abhimanyu, Ravichandran Sneha, Barnes Neil Abraham, Shettigar Dilip
Department Medical Imaging Technology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India.
Department Medical Imaging Technology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India.
Magn Reson Imaging. 2025 Sep;121:110419. doi: 10.1016/j.mri.2025.110419. Epub 2025 May 8.
T2DM is associated with neurodegenerative changes that can be detected through advanced magnetic resonance imaging. Brain atrophy in T2DM is linked to cognitive decline, yet the extent and pattern of structural brain changes remain underexplored. This study aims to assess volumetric differences in brain structures between diabetic and non-diabetic individuals using voxel-based morphometry (VBM).
A prospective observational study was conducted with 86 participants (43 T2DM case and 43 healthy controls) who underwent high-resolution 3D MRI scans using 3D SPGR and T1-weighted Fast Spin Echo sequences. Image preprocessing and volumetric analysis were performed using Statistical Parametric Mapping (SPM-12) and the Computational Anatomy Toolbox (CAT-12). Brain volumes were analyzed for 24 regions. Statistical analyses were conducted using independent t-tests and linear regression, with p < 0.05 considered significant.
T2DM subjects exhibited significant gray matter (GM) volume reductions compared to controls, particularly in the hippocampus and middle frontal gyrus, as detected in both 3DSPGR and T1 FSE sequences. However, regional differences emerged between imaging modalities: while T1 FSE imaging revealed significant bilateral hippocampal atrophy, 3DSPGR data showed no such difference. Notably, both sequences demonstrated significantly increased volumes in the anterior and posterior temporal lobes in T2DM participants, suggesting possible region-specific hypertrophy.
T2DM is associated with significant brain atrophy, particularly in brain regions associated with cognition. Based on these findings, MRI-based volumetric analysis has the potential to detect and monitor T2DM-related neurodegeneration early, emphasizing the need for routine neuroimaging in diabetic populations. Research on longitudinal assessments will be necessary in the future to gain a deeper understanding of the progression of brain atrophy in diabetics.
2型糖尿病与可通过先进磁共振成像检测到的神经退行性变化相关。2型糖尿病中的脑萎缩与认知衰退有关，但脑结构变化的程度和模式仍未得到充分研究。本研究旨在使用基于体素的形态计量学（VBM）评估糖尿病个体与非糖尿病个体脑结构的体积差异。
对86名参与者（43例2型糖尿病患者和43名健康对照）进行了一项前瞻性观察研究，这些参与者使用三维扰相梯度回波（3D SPGR）和T1加权快速自旋回波序列进行了高分辨率3D MRI扫描。使用统计参数映射（SPM - 12）和计算解剖工具箱（CAT - 12）进行图像预处理和体积分析。对24个区域的脑体积进行了分析。使用独立样本t检验和线性回归进行统计分析，p < 0.05被认为具有统计学意义。
与对照组相比，2型糖尿病受试者的灰质（GM）体积显著减少，特别是在海马体和额中回，这在3D SPGR和T1 FSE序列中均有检测到。然而，成像方式之间出现了区域差异：虽然T1 FSE成像显示双侧海马体明显萎缩，但3D SPGR数据未显示出这种差异。值得注意的是，两个序列均显示2型糖尿病参与者的颞叶前后部体积显著增加，提示可能存在区域特异性肥大。
2型糖尿病与显著的脑萎缩有关，特别是在与认知相关的脑区域。基于这些发现，基于MRI的体积分析有潜力早期检测和监测2型糖尿病相关的神经退行性变，强调了糖尿病患者进行常规神经影像学检查的必要性。未来有必要进行纵向评估研究，以更深入地了解糖尿病患者脑萎缩的进展情况。
