Diabetes mellitus exacerbates changes in white matter hyperintensity shapes and volume: A longitudinal study

IF 4.9 Q1 CLINICAL NEUROLOGY

Alzheimer''s and Dementia: Translational Research and Clinical Interventions Pub Date : 2025-02-11 DOI:10.1002/trc2.70042

Shihao Xu, Yan Wang, Jiahui Chen, Zhiming Pan, Wenjun Wu, Zhipeng Su, Zhen Wang

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引用次数: 0

Abstract

INTRODUCTION

Although white matter hyperintensity (WMH) can progress over time, little is known about the underlying mechanisms. In addition, type 2 diabetes mellitus (T2DM) exacerbates the accumulation of WMH. Here we aimed to investigate longitudinal changes in WMH shapes and volume in older adults with and without T2DM.

METHODS

Participants underwent baseline and follow-up magnetic resonance imaging (MRI). WMH volume and shape markers were automatically assessed. We compared WMH volume and shape markers at baseline and follow-up.

RESULTS

A total of 200 participants were included at baseline and 181 at follow-up. The mean age ± SD of our study participants was 69.86 ± 6.03 years; 79 (39.90%) had a history of diabetes mellitus (T2DM) and 73 (36.50%) were male. For shape markers, participants with T2DM showed more complex periventricular (eccentricity, p = 0.027) and deep WMH shape markers (fractal dimension, p = 0.002) than participants without T2DM. At baseline, there were no statistically significant differences (p > 0.05) in WMH volume when participants with T2DM were compared to participants without T2DM. At follow-up, a more complex shape of periventricular/confluent WMH on follow-up (concavity index, p = 0.005; inverse sphericity index, p = 0.001). In addition, total (p < 0.001), periventricular (p < 0.001), and deep (p = 0.001) WMH volumes increased significantly.

DISCUSSION

A more irregular shape of periventricular and deep WMH and higher WMH volumes were associated with T2DM participants. These findings suggest that WMH shape markers may be useful in determining prognosis for cerebral small vessel disease and aid in future preventive treatments.

Highlights

Patients with diabetes mellitus have more irregular white matter hyperintensity (WMH) shapes and increased WMH volumes.
Diabetes mellitus exacerbates the changes in WMH shapes and volumes
WMH shape markers might have the potential to aid in future preventive treatments and prevent clinical deterioration.

Abstract Image

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糖尿病加重白质高强度形状和体积的改变：一项纵向研究

虽然白质高强度（WMH）可以随着时间的推移而发展，但对其潜在机制知之甚少。此外，2型糖尿病（T2DM）加剧了WMH的积累。在这里，我们的目的是研究有和没有T2DM的老年人WMH形状和体积的纵向变化。方法：参与者接受了基线和随访的磁共振成像（MRI）。自动评估WMH体积和形状标记。我们比较了基线和随访时WMH体积和形状标记。结果：基线时共纳入200名参与者，随访时纳入181名参与者。我们研究参与者的平均年龄±SD为69.86±6.03岁；有糖尿病（T2DM）病史的79例（39.90%），男性73例（36.50%）。对于形状标记，T2DM患者比非T2DM患者表现出更复杂的心室周围（偏心率，p = 0.027）和更深的WMH形状标记（分形维数，p = 0.002）。在基线时，没有统计学上的显著差异(p >；与非T2DM患者相比，T2DM患者的WMH体积差异为0.05)。随访时，脑室周围/合流性WMH形状更为复杂(凹度指数，p = 0.005；逆球度指数，p = 0.001)。此外，总(p <；0.001)，心室周围(p <；0.001)，深部WMH体积显著增加（p = 0.001）。T2DM患者心室周围和深部WMH形状更不规则，WMH体积更大。这些发现表明，WMH形状标记物可能有助于确定脑血管疾病的预后，并有助于未来的预防治疗。糖尿病患者有更多不规则的白质高强度（WMH）形状和WMH体积增加。糖尿病加剧了WMH形状和体积的变化，WMH形状标记物可能有助于未来的预防性治疗和预防临床恶化。

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来源期刊

Alzheimer''s and Dementia: Translational Research and Clinical Interventions Medicine-Psychiatry and Mental Health

CiteScore

10.10

自引率

2.10%

发文量

134

审稿时长

10 weeks

期刊介绍： Alzheimer''s & Dementia: Translational Research & Clinical Interventions (TRCI) is a peer-reviewed, open access,journal from the Alzheimer''s Association®. The journal seeks to bridge the full scope of explorations between basic research on drug discovery and clinical studies, validating putative therapies for aging-related chronic brain conditions that affect cognition, motor functions, and other behavioral or clinical symptoms associated with all forms dementia and Alzheimer''s disease. The journal will publish findings from diverse domains of research and disciplines to accelerate the conversion of abstract facts into practical knowledge: specifically, to translate what is learned at the bench into bedside applications. The journal seeks to publish articles that go beyond a singular emphasis on either basic drug discovery research or clinical research. Rather, an important theme of articles will be the linkages between and among the various discrete steps in the complex continuum of therapy development. For rapid communication among a multidisciplinary research audience involving the range of therapeutic interventions, TRCI will consider only original contributions that include feature length research articles, systematic reviews, meta-analyses, brief reports, narrative reviews, commentaries, letters, perspectives, and research news that would advance wide range of interventions to ameliorate symptoms or alter the progression of chronic neurocognitive disorders such as dementia and Alzheimer''s disease. The journal will publish on topics related to medicine, geriatrics, neuroscience, neurophysiology, neurology, psychiatry, clinical psychology, bioinformatics, pharmaco-genetics, regulatory issues, health economics, pharmacoeconomics, and public health policy as these apply to preclinical and clinical research on therapeutics.