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Aim: This study aimed to investigate the alterations in whole-brain gray matter density in early stage type 2 diabetes mellitus (T2DM) patients with cognitive impairment using magnetic resonance imaging.Methods: Thirty-six cases of early stage T2DM patients with cognitive impairment (T2DM-CI), 34 cases of early stage T2DM patients without cognitive impairment (T2DM) and 30 cases of healthy controls (HC) were enrolled. Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) scores were used to identify the cognitive impairment. The whole-brain gray matter density was analyzed using 3D-T1 BRAVO imaging, using the voxel-based morphometry method on T1 structure imaging of two groups. Results:The correlation analysis of total gray matter density with MMSE and MoCA scores in the T2DM-CI group was performed. There were no significant differences in MMSE and MoCA scores between the HC and T2DM groups. However, the MMSE and MoCA scores in the T2DM-CI group were significantly reduced compared with the T2DM group. There were no significant differences in age, gender, education, body mass index (BMI) or blood pressure among the three groups. Voxel-based morphometry (VBM) results showed that the density of left triangle part of inferior frontal gyrus, orbital part of inferior frontal gyrus and opercular part of inferior frontal gyrus and left insula in the T2DM-CI group decreased compared with the T2DM group. Correlation analysis results showed that there was a significant positive correlation between total gray matter density and scores of MMSE and MoCA scores in the T2DM-CI group. Conclusion:In conclusion, total gray matter density is positively correlated with the scores of MMSE and MoCA in T2DM patients, which may be an early sign of cognitive impairment in patients with T2DM.

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Background/Study Concept: Acute lacunar stroke (Als) plays a role in death/disability worldwide. Aphasia refers to chronic difficulty with communication in >20% of patients post stroke. We describe pathophysiological features of white matter (WM) abnormalities and their relationship between WM changes and aphasia quotient (AQ) scores in Als.Methods: Diffusion tensor imaging data were acquired in 37 Als patients and 28 healthy controls. Tract-based spatial statistics (TBSS) and correlation analyses were used.Results: Consistent with the hypothesis, Als had decreased fractional anisotropy (FA) and increased mean diffusivity, axial diffusivity and radial diffusivity in the genu, body and splenium of the corpus callosum (CC), superior longitudinal fasciculus (SLF) and corona radiata in the bilateral hemisphere. Reduced FA of SLF was correlated with AQ scores in Als patients.Conclusion: It is hoped that TBSS could shed new insights into aphasia mechanisms in Als to help promote aging-related disease studies.