Diffusion tensor imaging of white matter in patients with prediabetes by trace‐based spatial statistics

Abstract

Background: Prediabetes is an intermediate state in which blood glucose is higher than normal but does not meet the diagnostic criteria for diabetes. Diffusion tensor imaging (DTI) is an MRI method that can sensitively detect microscopic lesions in the white matter of the brain, but most previous DTI studies only focused on patients with diabetes, and little is known about prediabetes. Purpose: To investigate the changes in the microstructure of brain white matter in prediabetes patients using DTI and trace-based spatial statistics (TBSS). Study Type: Prospective. Population: Sixty subjects (30 patients with prediabetes and 30 healthy volunteers) were enrolled. Field Strength/Sequence: 3.0T/DTI-MRI sequence with single-shot echo-planar imaging sequence (SE-EPI). Assessment: DTI data were collected and analyzed using the TBSS method in the FMRIB software library. Statistical Tests: DTI using a two-sample t-test. Pearson correlation analysis was performed on DTI values and neuropsychology scale results (mini-mental state examination [MMSE], Montreal cognitive assessment [MoCA], self-rating anxiety scale [SAS], and self-rating depression scale [SDS]) Results: Compared with the control group, the fractional anisotropy (FA) values in the right part of the corpus callosum body (bCC) (P = 0.035), the right superior longitudinal fasciculus (SLF.R) (P = 0.047), and the left superior longitudinal fasciculus (SLF.L) in the prediabetic group were reduced (P = 0.040). Data Conclusion: DTI as a noninvasive technique can assess early changes in the white matter microarchitecture of patients with prediabetes. Level of Evidence: 2 Technical Efficacy: Stage 2

Relationship Between Type 2 Diabetes and White Matter Hyperintensity: A Systematic Review

“…Research data suggest that even adolescent T2DM is associated with differences in WM microstructure. A prediabetic study ( 36 ) also found WM microstructural damage in prediabetic patients. The predominant DTI abnormalities in prediabetic patients were mainly the reduction of FA values in the right part of the corpus callosum body (bCC), the right superior longitudinal fasciculus (SLF.R), and the left superior longitudinal fasciculus (SLF.L), suggesting that these areas may be the sites of the first lesion.…”

Brain deficits in prediabetic adults: A systematic review

“…A second DTI study measured FA, mean diffusivity (MD; the overall directionally averaged magnitude of diffusion) (O’Donnell & Westin, 2012), RD, and AD to assess microscopic WM lesions (WMLs) (Liang et al., 2019). Compared to adults with normoglycemia, FA was smaller in the right part of the corpus callosum body, right superior longitudinal fasciculus, and left superior longitudinal fasciculus in prediabetics (Liang et al., 2019). No significant differences were found in MD, RD, or AD values between these groups (Liang et al., 2019).…”

“…Compared to adults with normoglycemia, FA was smaller in the right part of the corpus callosum body, right superior longitudinal fasciculus, and left superior longitudinal fasciculus in prediabetics (Liang et al., 2019). No significant differences were found in MD, RD, or AD values between these groups (Liang et al., 2019).…”

Brain network alterations due to cardiometabolic risk factors

“…Only one study reported an association of prediabetes with larger WMH volumes and presence of lacunar infarcts, but found no significant association with cerebral microbleeds (46). In the case-control study of Liang et al, a lower FA was found in prediabetes compared to controls (53). Using resting-state fMRI, higher normalized local efficiency was found in participants with prediabetes compared to NGM, hinting at reorganization of the functional networks as compensation for potential cognitive decrements (59).…”

“…A minority of studies used advanced MRI techniques to investigate the association of T2DM with white matter microstructure and (both structural and functional) brain connectivity. By use of dMRI, several case-control studies observed lower FA (24,28,37,(47)(48)(49)(50)(51)(52)(53), and higher MD (28,37,47,(49)(50)(51), which indicate altered or impaired fiber microstructure in T2DM. Furthermore, two case-control studies found higher AD (47,51), and higher RD (47,51), similarly indicative of injured white matter by axonal injury and disruption of fibre structure.…”