Abstract：Objective: To investigate the microstructure of cortex and gray nucleus in Alzheimer’s disease(AD) with and without type 2 diabetes mellitus(AD+T2DM, AD-T2DM) by measuring and comparing the diffusion kurtosis imaging(DKI) data. Methods: Thirty-five patients who were diagnosed AD by neurology department were included in the study and were divided into AD+T2DM group(13 cases, 6 males, 7 females, average age (74.46±8.26) years) and AD-T2DM group(22 cases, 9 males, 13 females, average age (70.82±8.72) years). The mental status was assessed by MMSE and MoCA scores by two neurologists. MR protocols included conventional MRI and DKI. The raw DKI data were processed using Functool 2 software in ADW 4.6 workstation. Bilateral MK, Ka, Kr, MD, Da, Dr and FA values in the superior frontal gyrus(SFG) and middle temporal gyrus(MTG), hippocampus(HIP), head of caudate nucleus(HCN), putamen(PUT), globus pallidus(GP) and thalamus(THA) were manually measured twice by two radiologists. Two independent sample t-test was used to compare the diffusion parameters in all regions and clinical indexes between the two groups. Spearman correlation analysis was used to analyze the relations between DKI parameters and MMSE or MoCA score. Result: Compared with those in AD-T2DM group, FA value significantly increased only in MTG(P<0.05), and then MD and Da value also increased in HCN and THA(P<0.05) in AD+T2DM group. Only in THA the MK and Ka value significantly decrease(P<0.05) in AD+T2DM compared to AD-T2DM group. In the correlation analysis, there were negative correlations between the diffusion rate of HIP, FA value of MTG and the clinical MMSE score in AD+T2DM group. However, there were negative correlations between the diffusing rate of HIP, FA value in SFG, MTG, THA and clinical MoCA score(P＜0.05). Conclusion: For AD patients, hyperglycemia may aggravate the microstructure damage in gray matter and nucleus, and HCN and THA are probably the parts that most easily affected. DKI parameters also reflect cognitive status to some extent.
董俊伊，苗延巍，王微微，周宇婧，韩 亮，李晓欣，宋清伟，刘爱连. 2型糖尿病对阿尔茨海默病脑灰质的影响：DKI初步研究[J]. 中国临床医学影像杂志, 2019, 30(2): 92-97.
DONG Jun-yi, MIAO Yan-wei, WANG Wei-wei, ZHOU Yu-jing, HAN Liang, LI Xiao-xin, SONG Qing-wei, LIU Ai-lian. The effect of type 2 diabetes mellitus on the gray matter of Alzheimer’s disease: a preliminary study involving DKI. JOURNAL OF CHINA MEDICAL IMAGING, 2019, 30(2): 92-97.
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