A Preliminary Study On Brain Impairment Of Type 2 Diabetes Patients With IVIM And APT Imaging

BackgroundIn recent years,the diagnosis and treatment of type 2 diabetes mellitus have been greatly improved,extending the survival time of patients.However,the prevalence of central nervous system diseases is increasing,and diabetes mellitus with cognitive dysfunction is gradually attracting people’s attention.Diabetic patients with cognitive dysfunction have difficulty performing complex self-care,making it difficult for them to achieve reasonable glycemic control goals.Currently,there is a lack of effective treatment for cognitive dysfunction,so early recognition of cognitive dysfunction is of great significance for diabetes care.PurposeFrom a medical perspective,this study aims to investigate microstructural changes in various brain regions of type 2 diabetes mellitus patients using IVIM and APT magnetic resonance sequences,and to further explore the pathogenesis of cognitive impairment in diabetes.The goal is to provide new research ideas for early diagnosis and intervention of cognitive impairment in diabetes in clinical practice.MethodsA total of 108 subjects were included between October 2021 and October 2022,including 72 cases of diabetes and 36 controls.The subjects were evaluated by MMSE and MoCA scales,and their brain IVIM and APT scans were performed by 3.0T magnetic resonance imaging.The inter-group differences of IVIM-D,f,D*and APTw values in each brain region of all subjects were compared using the student t-test.pearson correlation coefficient was used to analyze the correlation between IVIM-D,IVIM-f,APTw values and MoCA scale scores in each brain region.p<0.05 was statistically significant.ResultsThere were no significant differences in gender,age,BMI,and education level between the two groups,but there were statistical differences in MMSE and MoCA scores.D values of right temporal lobe white matter and left thalamus in the T2DM group were higher than those in the HC group(p<0.05),there was no significant difference in D values in other brain regions between the two groups(p>0.05).The f values of the left hippocampus,right temporal lobe white matter,and right pontine in the T2DM group were higher than those in the HC group(p<0.05),the f value of the left thalamus in the T2DM group was lower than that in HC group(p<0.05);There were no significant differences in f values in other brain regions between the two groups(p>0.05).There were no significant differences in D*values in all brain regions between the two groups(p>0.05).D values of the left hippocampus,left thalamus,and right caudate nucleus was negatively correlated with the MoCA score in the T2DM group(p<0.05),the D value of the left caudate nucleus in the T2DM group was positively correlated with MoCA score(p<0.05),there was no significant correlation between the D values of other brain regions and MoCA score(p>0.05).There was no significant correlation between the D value and MoCA score in the HC group(p>0.05).f value of the left hippocampus and right caudate nucleus were negatively correlated with the MoCA score in the T2DM group(p<0.05),there was no significant correlation between f values in other brain regions and MoCA score(p>0.05).There was no significant correlation between the f value and MoCA score in the HC group(p>0.05).The APTw values of all brain regions in the T2DM group were higher than those in the HC group except the white matter of the right occipital lobe(p<0.05);Except for the left hippocampus and the left frontal white matter(p>0.05),the APTw value of the other brain areas in T2DM group was negatively correlated with the MoCA score(p<0.05).There was no significant correlation between the APTw value and MoCA score in the HC group(p>0.05).ConclusionThe IVIM parameters in some brain regions of diabetic patients showed significant statistical differences compared to the control group.In addition,the APTw values in multiple brain regions of T2DM patients were increased compared to the control group and had a good correlation with cognitive function scores.These findings suggest that APTw and IVIM imaging parameters can be used to detect diabetes-related brain damage and have the potential to become simple and cost-effective tools for identifying type 2 diabetic patients with cognitive impairment.