An analysis of brain structural changes in type 2 diabetes using advanced MRI techniques

Document Type

Article

Publication Title

Magnetic Resonance Imaging

Abstract

Background: 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). Methods: 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. Results: 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. Conclusion: 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.

DOI

10.1016/j.mri.2025.110419

Publication Date

9-1-2025

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