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Cerebral White Matter Integrity and Resting-state Functional Connectivity in Middle-aged Patients with Type 2 Diabetes

Clinical, Behavioral, and Outcomes Research, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA.
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Diabetes. 2014 Feb;63(2):728-38.
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Appears in Collections:
R01 AG034165/AG/NIA NIH HHS/United States
P30 DK036836/DK/NIDDK NIH HHS/United States
T32 GM084907/GM/NIGMS NIH HHS/United States
Generated Citation:
Hoogenboom W.S., Marder T.J., Flores V.L., Huisman S., Eaton H.P., Schneiderman J.S., Bolo N.R., Simonson D.C., Jacobson A.M., Kubicki M., Shenton M.E., Musen G. Cerebral White Matter Integrity and Resting-state Functional Connectivity in Middle-aged Patients with Type 2 Diabetes. Diabetes. 2014 Feb;63(2):728-38. PMID: 24203723. PMCID: PMC3900542.
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Early detection of brain abnormalities at the pre-clinical stage can be useful for developing preventive interventions to abate cognitive decline. We examined whether middle-aged type 2 diabetic patients show reduced white matter integrity in fiber tracts important for cognition, and whether this abnormality is related to pre-established altered resting-state functional connectivity in the default-mode network. Diabetic and non-diabetic participants underwent fMRI and cognitive assessment. Multiple diffusion measures were calculated using streamline tractography, and correlations with default-mode network functional connectivity were determined. Diabetic patients showed lower fractional anisotropy (a measure of white matter integrity) in the cingulum bundle and uncinate fasciculus -- fiber tracts that connect frontal, temporal, and parietal regions. Controls showed stronger functional connectivity than patients between the posterior cingulate and both left fusiform and medial frontal gyri. Fractional anisotropy of the cingulum bundle was correlated with functional connectivity between the posterior cingulate and medial frontal gyrus for combined groups. Thus, middle-aged patients with type 2 diabetes show white matter abnormalities that correlate with disrupted functional connectivity in the default-mode network, suggesting that common mechanisms may underlie both structural and functional connectivity. Detecting brain abnormalities in middle age enables implementation of therapies to slow progression of neuropathology.

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