Regional Brain Structure Alterations in Diabetes but Not Prediabetes
Authors' conclusion
This study illuminates DM as a powerful force in cerebral architecture, challenging the notion of a gradual decline beginning in PreDM. These insights not only underscore the critical importance of DM prevention but also hint at the brain's remarkable resilience in the face of early metabolic challenges.
Study context
- Population
- Participants across 3 glycemic states (DM, PreDM, controls) with brain MRI (T1-weighted and FLAIR), cognitive assessments, grip strength and gait speed
- Participants
- 512 participants
- Exposure
- DM vs PreDM vs controls
- DMn = 122
- PreDMn = 109
- Controlsn = 281reference
- Outcome
- Regional GMV and tract-specific WMH
Main finding
As reported in the abstract
- Substantial gray matter volume (GMV) changes in DM, especially bilateral cerebellum, right precentral gyrus and left postcentral gyrus
- P < .001 uncorrected with cluster size > 500
- Significantly higher white matter hyperintensity (WMH) index across 20 tracts in DM brains
- P < .05; FDR-corrected
- Glycemic levels positively correlated with WMH index in multiple tracts
- P < .05; FDR-corrected
Observational data: associations, not effects.
Further findings
Association of brain changes with cognition and motor function
- Brain changes associated with decreased Montreal Cognitive Assessment scores
- P = 0.04
- Brain changes associated with decreased gait speed
- P < 0.05
- Brain changes associated with decreased right-hand grip strength
- P < 0.05
- Effects not seen in the PreDM group
Original publication
Regional Brain Structure Alterations in Diabetes but Not Prediabetes. J Clin Endocrinol Metab. Published 30 April 2025. doi:10.
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