Neural Regeneration Research ›› 2022, Vol. 17 ›› Issue (3): 618-624.doi: 10.4103/1673-5374.320996

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Assessment of structural brain changes in patients with type 2 diabetes mellitus using the MRI-based brain atrophy and lesion index

Heng Zhao1, 2, #, Fang Wang2, #, Guang-Hua Luo2, Hao Lei2, Fei Peng2, Qiu-Ping Ren2, Wei Chen2, Yan-Fang Wu2, Li-Chun Yin2, Jin-Cai Liu2, *, Shi-Nong Pan1, *   

  1. 1Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China; 2Department of Radiology, The First Affiliated Hospital of University of South China, Hengyang, Hunan Province, China
  • Online:2022-03-15 Published:2021-10-15
  • Contact: Jin-Cai Liu, MD, liujincai6353@163.com; Shi-Nong Pan, MD, cjr.panshinong@vip.163.com.
  • Supported by:
    This study was supported by the National Natural Science Foundation of China, No. 81271538 (to SNP); 345 Talent Project and the Natural Science Foundation of Liaoning Province of China, No. 2019-ZD-0794 (to SNP); the Natural Science Foundation of Hunan Province of China, Nos. 2017JJ2225 (to JCL), 2018JJ2357 (to GHL); Hunan Provincial Science and Technology Innovation Program of China, No. 2017SK50203 (to HZ).

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Abstract: Patients with type 2 diabetes mellitus (T2DM) often have cognitive impairment and structural brain abnormalities. The magnetic resonance imaging (MRI)-based brain atrophy and lesion index can be used to evaluate common brain changes and their correlation with cognitive function, and can therefore also be used to reflect whole-brain structural changes related to T2DM. A total of 136 participants (64 men and 72 women, aged 55–86 years) were recruited for our study between January 2014 and December 2016. All participants underwent MRI and Mini-Mental State Examination assessment (including 42 healthy control, 38 T2DM without cognitive impairment, 26 with cognitive impairment but without T2DM, and 30 T2DM with cognitive impairment participants). The total and sub-category brain atrophy and lesion index scores in patients with T2DM with cognitive impairment were higher than those in healthy controls. Differences in the brain atrophy and lesion index of gray matter lesions and subcortical dilated perivascular spaces were found between non-T2DM patients with cognitive impairment and patients with T2DM and cognitive impairment. After adjusting for age, the brain atrophy and lesion index retained its capacity to identify patients with T2DM with cognitive impairment. These findings suggest that the brain atrophy and lesion index, based on T1-weighted and T2-weighted imaging, is of clinical value for identifying patients with T2DM and cognitive impairment. Gray matter lesions and subcortical dilated perivascular spaces may be potential diagnostic markers of T2DM that is complicated by cognitive impairment. This study was approved by the Medical Ethics Committee of University of South China (approval No. USC20131109003) on November 9, 2013, and was retrospectively registered with the Chinese Clinical Trial Registry (registration No. ChiCTR1900024150) on June 27, 2019.

Key words: brain atrophy and lesion index, cognitive impairments, gray matter lesions, magnetic resonance imaging, Mini-Mental State Examination, structural brain, subcortical dilated perivascular spaces, T1-weighted image, T2-weighted image, type 2 diabetes mellitus

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