Brain atrophy in type 2 diabetes: regional distribution and influence on cognition

Moran, Chris, Phan, Thanh G., Chen, Jian, Blizzard, Leigh, Beare, Richard, Venn, Alison, Munch, Gerald, Wood, Amanda G., Forbes, Josephine, Greenaway, Timothy M., Pearson, Susan and Srikanth, Velandai (2013) Brain atrophy in type 2 diabetes: regional distribution and influence on cognition. Diabetes Care, 36 12: 4036-4042. doi:10.2337/dc13-0143

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Author Moran, Chris
Phan, Thanh G.
Chen, Jian
Blizzard, Leigh
Beare, Richard
Venn, Alison
Munch, Gerald
Wood, Amanda G.
Forbes, Josephine
Greenaway, Timothy M.
Pearson, Susan
Srikanth, Velandai
Title Brain atrophy in type 2 diabetes: regional distribution and influence on cognition
Journal name Diabetes Care   Check publisher's open access policy
ISSN 0149-5992
Publication date 2013-01-01
Year available 2013
Sub-type Article (original research)
DOI 10.2337/dc13-0143
Open Access Status Not yet assessed
Volume 36
Issue 12
Start page 4036
End page 4042
Total pages 7
Place of publication Alexandria, VA, United States
Publisher American Diabetes Association
Language eng
Formatted abstract
Objective: Type 2 diabetes (T2DM) is associated with brain atrophy and cerebrovascular disease. We aimed to define the regional distribution of brain atrophy in T2DM and to examine whether atrophy or cerebrovascular lesions are feasible links between T2DMand cognitive function.

Research design and methods: This cross-sectional study used magnetic resonance imaging (MRI) scans and cognitive tests in 350 participants with T2DM and 363 participants without T2DM. With voxel-basedmorphometry, we studied the regional distribution of atrophy in T2DM. We measured cerebrovascular lesions (infarcts, microbleeds, and white matter hyperintensity [WMH] volume) and atrophy (gray matter, white matter, and hippocampal volumes) while blinded to T2DM status. With use of multivariable regression, we examined for mediation or effect modification of the association between T2DM and cognitive measures by MRI measures.

Results: T2DM was associated with more cerebral infarcts and lower total gray, white, and hippocampal volumes (all P < 0.05) but not with microbleeds or WMH. T2DM-related gray matter loss was distributed mainly in medial temporal, anterior cingulate, and medial frontal lobes, and white matter loss was distributed in frontal and temporal regions. T2DM was associated with poorer visuospatial construction, planning, visual memory, and speed (P ≤ 0.05) independent of age, sex, education, and vascular risk factors. The strength of these associations was attenuated by almost one-half when adjusted for hippocampal and total gray volumes but was unchanged by adjustment for cerebrovascular lesions or white matter volume.

Conclusions: Cortical atrophy in T2DM resembles patterns seen in preclinical Alzheimer disease. Neurodegeneration rather than cerebrovascular lesions may play a key role in T2DM-related cognitive impairment. 
Keyword Endocrinology & Metabolism
Endocrinology & Metabolism
Q-Index Code C1
Q-Index Status Confirmed Code
Grant ID 403000
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Mater Research Institute-UQ (MRI-UQ)
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 136 times in Thomson Reuters Web of Science Article | Citations
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Created: Mon, 28 Apr 2014, 22:29:17 EST by Dominique Rossouw on behalf of School of Medicine