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Research ArticleAdult Brain
Open Access

A Diffusion Tensor Imaging Study on White Matter Abnormalities in Patients with Type 2 Diabetes Using Tract-Based Spatial Statistics

Y. Xiong, Y. Sui, Z. Xu, Q. Zhang, M.M. Karaman, K. Cai, T.M. Anderson, W. Zhu, J. Wang and X.J. Zhou
American Journal of Neuroradiology August 2016, 37 (8) 1462-1469; DOI: https://doi.org/10.3174/ajnr.A4740
Y. Xiong
aFrom the Departments of Radiology (Y.X., W.Z.)
dCenter for Magnetic Resonance Research (Y.X., Y.S., M.M.K., K.C., X.J.Z.)
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Y. Sui
dCenter for Magnetic Resonance Research (Y.X., Y.S., M.M.K., K.C., X.J.Z.)
fBioengineering (Y.S., X.J.Z.)
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Z. Xu
cDepartment of Pathophysiology (Z.X., J.W.), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Q. Zhang
bNeurology (Q.Z.), Tongji Hospital
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M.M. Karaman
dCenter for Magnetic Resonance Research (Y.X., Y.S., M.M.K., K.C., X.J.Z.)
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K. Cai
dCenter for Magnetic Resonance Research (Y.X., Y.S., M.M.K., K.C., X.J.Z.)
eDepartments of Radiology (K.C., T.M.A., X.J.Z.)
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T.M. Anderson
eDepartments of Radiology (K.C., T.M.A., X.J.Z.)
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W. Zhu
aFrom the Departments of Radiology (Y.X., W.Z.)
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J. Wang
cDepartment of Pathophysiology (Z.X., J.W.), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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X.J. Zhou
dCenter for Magnetic Resonance Research (Y.X., Y.S., M.M.K., K.C., X.J.Z.)
eDepartments of Radiology (K.C., T.M.A., X.J.Z.)
fBioengineering (Y.S., X.J.Z.)
gNeurosurgery (X.J.Z.), University of Illinois Hospital and Health Sciences System, Chicago, Illinois.
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    Fig 1.

    Selected ROIs in the individual fiber analysis according to a Johns Hopkins University–ICBM labels 1-mm template. “.R and .L” in the text indicate right and left side, respectively. In the telencephalon, ALIC indicates anterior limb of internal capsule; ACR, anterior corona radiata; g/b/s CC, corpus callosum (genu/body/splenium); CCG, cingulum (cingulate gyrus); CH, cingulum (hippocampus); EC, external capsule; PCR, posterior corona radiata; PTR, posterior thalamic radiation (including optic radiation); RIC, retrolenticular part of internal capsule; SCR, superior corona radiata; SS, sagittal striatum (including the inferior longitudinal fasciculus and inferior fronto-occipital fasciculus). In the cerebellum and brain stem, CP, indicates cerebellar peduncle; CT, corticospinal tract; MCP, middle cerebellar peduncle; and PCT, pontine crossing tract (a part of MCP).

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    Fig 2.

    Differences in FA, MD, axial diffusivity (λ1), and radial diffusivity (λ23) between the DM-MCI and the DM-NC groups in 3 representative sections (see On-line Fig 1 for a complete set of images with whole-brain coverage). All results were obtained from an FSL TBSS analysis. A Montreal Neurological Institute-152 T1 1-mm brain standard space was used as a background image (gray-scale). Green indicates the FA skeleton with a threshold of 0.2 highlighting the fibers used in the comparison; blue–light-blue (thickened for better visibility), regions with decreased FA, MD, λ1, or λ23; and red-yellow (thickened for better visibility), regions with increased FA, MD, λ1, or λ23.

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    Fig 3.

    Group differences in FA, MD, axial diffusivity (λ1), and radial diffusivity (λ23) between the DM-MCI and the HC groups in 3 representative sections (see On-line Fig 2 for a complete set of images with whole-brain coverage). All other details are the same as in the legend for Fig 2.

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    Fig 4.

    Group differences in FA, MD, axial diffusivity (λ1), and radial diffusivity (λ23) between the DM-NC and the HC groups in 3 representative sections (see On-line Fig 3 for a complete set of images with whole-brain coverage). All other details are the same as in the legend for Fig 2.

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    Fig 5.

    Differences in FA (A) and MD (B) values for specific fiber tracts in an atlas-based ROI analysis between the DM-MCI (blue) and the DM-NC (orange) groups. All fibers in the figure show a statistically significant difference (P < .05). The bar height indicates the mean, and the line on top of the bar represents the SD. L indicates left; R, right; ALIC, anterior limb of internal capsule; ACR, anterior corona radiata; CH, cingulum (hippocampus); EC, external capsule; PTR, posterior thalamic radiation (including the optic radiation); RIC, retrolenticular part of internal capsule; SCR, superior corona radiata; SS, sagittal striatum (including the inferior longitudinal fasciculus and inferior fronto-occipital fasciculus).

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    Fig 6.

    A, ROC curves for FA (blue), MD (green), and a combination of FA and MD (red) of the right cingulum (hippocampus) for separating DM-MCI and DM-NC patients. B, Scatterplots of FA versus MD for all patients with DM-NC (red) and DM-MCI (blue). The dashed lines indicate the cutoff values for FA (blue), MD (red), and the combination of FA and MD (black). The black dashed line corresponds to a sensitivity of 0.864 and a specificity of 0.800.

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    Table 1:

    FA values in specific fiber tracts with significant differences among groups (P < .05)

    JHU WM AtlasFA (DM-MCI)FA (DM-NC)FA (HC)P Value
    ALIC.L0.595 ± 0.0250.610 ± 0.021.044
    ACR.R0.472 ± 0.0240.487 ± 0.019.035
    ACR.L0.471 ± 0.0290.488 ± 0.018.022
    PTR.L0.620 ± 0.0380.641 ± 0.027.045
    EC.L0.478 ± 0.0200.490 ± 0.017.043
    CH.R0.585 ± 0.0400.616 ± 0.024.004
    CH.L0.579 ± 0.0270.599 ± 0.026.019
    CT.R0.548 ± 0.0300.569 ± 0.017.003
    CP.R0.590 ± 0.0210.608 ± 0.019.002
    • Note:—R indicates right; L, left; ALIC, anterior limb of internal capsule; ACR, anterior corona radiata; CH, cingulum (hippocampus); EC, external capsule; PTR, posterior thalamic radiation (including the optic radiation); CP, cerebellar peduncle; CT, corticospinal tract; JHU, Johns Hopkins University.

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    Table 2:

    MD values (×10−3 mm2/s) in specific fiber tracts with significant differences among groups (P < .05)

    JHU WM AtlasMD (DM-MCI)MD (DM-NC)MD (HC)P Value
    RIC.L0.780 ± 0.0260.760 ± 0.029.031
    SCR.L0.732 ± 0.0290.712 ± 0.026.021
    SS.R0.839 ± 0.0370.815 ± 0.030.024
    EC.L0.758 ± 0.0290.739 ± 0.026.030
    RIC.R0.773 ± 0.0300.755 ± 0.021.021
    EC.R0.784 ± 0.0440.756 ± 0.027.009
    • Note:—R indicates right; L, left; RIC, the retrolenticular part of internal capsule; SCR, superior corona radiata; SS, sagittal striatum (including the inferior longitudinal fasciculus and inferior fronto-occipital fasciculus); EC, external capsule; JHU, Johns Hopkins University.

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American Journal of Neuroradiology: 37 (8)
American Journal of Neuroradiology
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Y. Xiong, Y. Sui, Z. Xu, Q. Zhang, M.M. Karaman, K. Cai, T.M. Anderson, W. Zhu, J. Wang, X.J. Zhou
A Diffusion Tensor Imaging Study on White Matter Abnormalities in Patients with Type 2 Diabetes Using Tract-Based Spatial Statistics
American Journal of Neuroradiology Aug 2016, 37 (8) 1462-1469; DOI: 10.3174/ajnr.A4740

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A Diffusion Tensor Imaging Study on White Matter Abnormalities in Patients with Type 2 Diabetes Using Tract-Based Spatial Statistics
Y. Xiong, Y. Sui, Z. Xu, Q. Zhang, M.M. Karaman, K. Cai, T.M. Anderson, W. Zhu, J. Wang, X.J. Zhou
American Journal of Neuroradiology Aug 2016, 37 (8) 1462-1469; DOI: 10.3174/ajnr.A4740
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