Cortical thickness contributes to cognitive heterogeneity in patients with type 2 diabetes mellitus

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The aim of this study was to investigate cerebral cortical thickness alterations in patients with type 2 diabetes mellitus (T2DM) and their association with mild cognitive impairment (MCI).

Thirty T2DM patients without MCI, 30 T2DM patients with MCI, and 30 healthy controls were recruited. All subjects underwent high-resolution sagittal T1-weighted structural imaging using a 3-dimensional magnetization prepared rapid acquisition gradient echo (MPRAGE) sequence. The cortical thicknesses of the whole brain of the 3 groups were analyzed and compared using analysis of variance (ANOVA) test. Partial correlations between the cortical thicknesses of each brain region and standard laboratory testing data were analyzed for the T2DM without MCI group. The associations between cortical thicknesses and neuropsychological scale scores were also analyzed in the T2DM with MCI group.

Compared with the healthy controls, the T2DM without MCI group showed statistically significant reduction in the cortical thickness of the left posterior cingulate gyrus, right isthmus cingulate gyrus, middle temporal gyrus, paracentral lobule, and transverse temporal gyrus. No significant correlation was found between the standard laboratory testing data and the cortical thicknesses of these cerebral regions. Compared with the T2DM without MCI group, the cortical thickness alterations in the T2DM with MCI group were bidirectional. Increased cortical thickness was found in the left parahippocampal gyrus and the right isthmus cingulate gyrus. Decreased cortical thickness was observed in the left pars triangularis and the right pars opercularis. Significant correlations were found between the cortical thickness of the right pars opercularis and the Complex Figure Test-delayed recall scores (r = 0.464, ρ = 0.015), Trail Making Test A consuming time (r = −0.454, ρ = 0.017), and Montreal Cognitive Assessment scores (r = 0.51, ρ = 0.007).

T2DM could influence the gray matter of several brain regions. The cortical thickness reduction of the right pars opercularis may be a biomarker of cognitive impairment and play an important role in its pathophysiological mechanism.

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