Abnormal Alterations of Cortical Thickness in 16 Patients with Type 2 Diabetes Mellitus: A Pilot MRI Study△

Abstract

Objective The aim of this study is to investigate the cerebral cortical thickness changes in type 2 diabetes mellitus (T2DM) using a whole brain cortical thickness mapping system based on brain magnetic resonance imaging (MRI).Methods High resolution three-dimensional T1-weighted fast spoiled gradient recalled echo MR images were obtained from 16 patients with T2DM, as well as from 16 normal controls. The whole brain cortical thickness maps were generated, and the cortical thickness of each brain region was calculated according to gyral based regions of interest (ROI) using an automated labeling system by the Freesurfer software. We compared mean cortical thickness at each brain region by the analysis of covariance with age and sex as covariates. The regional difference of the cortical thickness over the whole brain was compared by the analysis of surface-based cortical thickness.Results Mean cortical thicknesses analysis showed bilateral cerebrum in the patients with T2DM (left: 2.52±0.07 mm; right: 2.51±0.08 mm) were significant thinner than those in the normal controls (left: 2.56±0.09 mm; right: 2.56±0.09 mm) (both P<0.05). Regional cortical thinning in T2DM was demonstrated in the paracentral lobule, postcentral gyrus, lateral occipital gyrus, lingual gyrus, precuneus, superior temporal gyrus, middle temporal gyrus, inferior temporal gyrus and posterior cingulate gyrus, compared to the normal controls. The cortical thickness of left middle cingulate and right inferior temporal gyrus were negatively correlated with the disease course.Conclusion A widespread cortical thinning was revealed in patients with T2DM by the analysis of brain cortical thickness on MR. Our finding supports the idea that T2DM could lead to subtle diabetic brain structural changes.Chin Med Sci J 2017; 32(2):75-82.

A novel morphometric signature of brain alterations in type 2 diabetes: Patterns of changed cortical gyrification

“…Consistently, we only observed regional cortical thinning in T2D. These results are in accordance with previous studies of brain atrophy using VBM (Moran et al, 2013;Moulton et al, 2015;Wang et al, 2014) and cortical thickness (Brundel et al, 2010;Chen et al, 2015Chen et al, , 2017Li et al, 2018;Shi et al, 2019) analysis in diabetic populations. In our study, decreased regional GM volumes appeared in several regions in type 2 diabetes patients, mainly in the frontal lobe, as in Moran et al (2013), Moulton et al (2015) and Roy et al (2020), and sub-lobar cortex.…”

“…Decrements in cortical thickness were also already demonstrated with surface-based morphometry (SBM) studies in type 2 diabetes patients (Chen et al, 2017;Moran et al, 2019). Conceptually, the volume of GM and the cortical thickness seem to be influenced by environmental factors related with diabetes progression, such as patients' glycaemic profile, lipid status, vascular complications and insulin taking (Brundel et al, 2010;Bryan et al, 2014;Chen et al, 2015Chen et al, , 2017Shi et al, 2019). Notably, cortical gyrification, which to the best of our knowledge was never assessed in type 2 diabetes, is an interesting surface feature that was initially suggested to be more specifically influenced by genetic and neurodevelopmental factors (Ronan & Fletcher, 2015).…”

“…Furthermore, there was a concomitant GM volume reduction and cortical thinning of the parahippocampal gyrus. A region in the temporal lobe also showed a decrease in cortical thickness (Chen et al, 2017;Li et al, 2018).…”

“…Studies of structural magnetic resonance imaging (MRI) with volumetric analysis at the wholebrain level and voxel-based morphometry (VBM) have shown brain atrophy, including lower total and regional volume of grey matter (GM) and white matter (WM) in type 2 diabetes patients when compared with nondiabetic controls (Moheet et al, 2015;Moran et al, 2013). Decrements in cortical thickness were also already demonstrated with surface-based morphometry (SBM) studies in type 2 diabetes patients (Chen et al, 2017;Moran et al, 2019). Conceptually, the volume of GM and the cortical thickness seem to be influenced by environmental factors related with diabetes progression, such as patients' glycaemic profile, lipid status, vascular complications and insulin taking (Brundel et al, 2010;Bryan et al, 2014;Chen et al, 2015Chen et al, , 2017Shi et al, 2019).…”