Diabetes mellitus exacerbates changes in white matter hyperintensity shapes and volume: A longitudinal study

Abstract INTRODUCTION Although white matter hyperintensity (WMH) can progress over time, little is known about the underlying mechanisms. In addition, type 2 diabetes mellitus (T2DM) exacerbates the accumulation of WMH. Here we aimed to investigate longitudinal changes in WMH shapes and volume in ol...

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Main Authors: Shihao Xu, Yan Wang, Jiahui Chen, Zhiming Pan, Wenjun Wu, Zhipeng Su, Zhen Wang
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Alzheimer’s & Dementia: Translational Research & Clinical Interventions
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Online Access:https://doi.org/10.1002/trc2.70042
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author Shihao Xu
Yan Wang
Jiahui Chen
Zhiming Pan
Wenjun Wu
Zhipeng Su
Zhen Wang
author_facet Shihao Xu
Yan Wang
Jiahui Chen
Zhiming Pan
Wenjun Wu
Zhipeng Su
Zhen Wang
author_sort Shihao Xu
collection DOAJ
description Abstract INTRODUCTION Although white matter hyperintensity (WMH) can progress over time, little is known about the underlying mechanisms. In addition, type 2 diabetes mellitus (T2DM) exacerbates the accumulation of WMH. Here we aimed to investigate longitudinal changes in WMH shapes and volume in older adults with and without T2DM. METHODS Participants underwent baseline and follow‐up magnetic resonance imaging (MRI). WMH volume and shape markers were automatically assessed. We compared WMH volume and shape markers at baseline and follow‐up. RESULTS A total of 200 participants were included at baseline and 181 at follow‐up. The mean age ± SD of our study participants was 69.86 ± 6.03 years; 79 (39.90%) had a history of diabetes mellitus (T2DM) and 73 (36.50%) were male. For shape markers, participants with T2DM showed more complex periventricular (eccentricity, p = 0.027) and deep WMH shape markers (fractal dimension, p = 0.002) than participants without T2DM. At baseline, there were no statistically significant differences (p > 0.05) in WMH volume when participants with T2DM were compared to participants without T2DM. At follow‐up, a more complex shape of periventricular/confluent WMH on follow‐up (concavity index, p = 0.005; inverse sphericity index, p = 0.001). In addition, total (p < 0.001), periventricular (p < 0.001), and deep (p = 0.001) WMH volumes increased significantly. DISCUSSION A more irregular shape of periventricular and deep WMH and higher WMH volumes were associated with T2DM participants. These findings suggest that WMH shape markers may be useful in determining prognosis for cerebral small vessel disease and aid in future preventive treatments. Highlights Patients with diabetes mellitus have more irregular white matter hyperintensity (WMH) shapes and increased WMH volumes. Diabetes mellitus exacerbates the changes in WMH shapes and volumes WMH shape markers might have the potential to aid in future preventive treatments and prevent clinical deterioration.
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spelling doaj-art-9c5d8d3050a0435bac9e6a0af69fd7192025-08-20T03:42:19ZengWileyAlzheimer’s & Dementia: Translational Research & Clinical Interventions2352-87372025-01-01111n/an/a10.1002/trc2.70042Diabetes mellitus exacerbates changes in white matter hyperintensity shapes and volume: A longitudinal studyShihao Xu0Yan Wang1Jiahui Chen2Zhiming Pan3Wenjun Wu4Zhipeng Su5Zhen Wang6Ultrasonography Department First Affiliated Hospital of Wenzhou Medical University Wenzhou Zhejiang Province ChinaNeurology Department First Affiliated Hospital of Wenzhou Medical University Wenzhou Zhejiang Province ChinaNeurology Department First Affiliated Hospital of Wenzhou Medical University Wenzhou Zhejiang Province ChinaNeurology Department First Affiliated Hospital of Wenzhou Medical University Wenzhou Zhejiang Province ChinaEndocrinology Department First Affiliated Hospital of Wenzhou Medical University Wenzhou Zhejiang Province ChinaNeurosurgery Department First Affiliated Hospital of Wenzhou Medical University Wenzhou Zhejiang Province ChinaNeurology Department First Affiliated Hospital of Wenzhou Medical University Wenzhou Zhejiang Province ChinaAbstract INTRODUCTION Although white matter hyperintensity (WMH) can progress over time, little is known about the underlying mechanisms. In addition, type 2 diabetes mellitus (T2DM) exacerbates the accumulation of WMH. Here we aimed to investigate longitudinal changes in WMH shapes and volume in older adults with and without T2DM. METHODS Participants underwent baseline and follow‐up magnetic resonance imaging (MRI). WMH volume and shape markers were automatically assessed. We compared WMH volume and shape markers at baseline and follow‐up. RESULTS A total of 200 participants were included at baseline and 181 at follow‐up. The mean age ± SD of our study participants was 69.86 ± 6.03 years; 79 (39.90%) had a history of diabetes mellitus (T2DM) and 73 (36.50%) were male. For shape markers, participants with T2DM showed more complex periventricular (eccentricity, p = 0.027) and deep WMH shape markers (fractal dimension, p = 0.002) than participants without T2DM. At baseline, there were no statistically significant differences (p > 0.05) in WMH volume when participants with T2DM were compared to participants without T2DM. At follow‐up, a more complex shape of periventricular/confluent WMH on follow‐up (concavity index, p = 0.005; inverse sphericity index, p = 0.001). In addition, total (p < 0.001), periventricular (p < 0.001), and deep (p = 0.001) WMH volumes increased significantly. DISCUSSION A more irregular shape of periventricular and deep WMH and higher WMH volumes were associated with T2DM participants. These findings suggest that WMH shape markers may be useful in determining prognosis for cerebral small vessel disease and aid in future preventive treatments. Highlights Patients with diabetes mellitus have more irregular white matter hyperintensity (WMH) shapes and increased WMH volumes. Diabetes mellitus exacerbates the changes in WMH shapes and volumes WMH shape markers might have the potential to aid in future preventive treatments and prevent clinical deterioration.https://doi.org/10.1002/trc2.70042cerebral small vessel diseasediabetes mellitusmagnetic resonance imagingshape markerswhite matter hyperintensity
spellingShingle Shihao Xu
Yan Wang
Jiahui Chen
Zhiming Pan
Wenjun Wu
Zhipeng Su
Zhen Wang
Diabetes mellitus exacerbates changes in white matter hyperintensity shapes and volume: A longitudinal study
Alzheimer’s & Dementia: Translational Research & Clinical Interventions
cerebral small vessel disease
diabetes mellitus
magnetic resonance imaging
shape markers
white matter hyperintensity
title Diabetes mellitus exacerbates changes in white matter hyperintensity shapes and volume: A longitudinal study
title_full Diabetes mellitus exacerbates changes in white matter hyperintensity shapes and volume: A longitudinal study
title_fullStr Diabetes mellitus exacerbates changes in white matter hyperintensity shapes and volume: A longitudinal study
title_full_unstemmed Diabetes mellitus exacerbates changes in white matter hyperintensity shapes and volume: A longitudinal study
title_short Diabetes mellitus exacerbates changes in white matter hyperintensity shapes and volume: A longitudinal study
title_sort diabetes mellitus exacerbates changes in white matter hyperintensity shapes and volume a longitudinal study
topic cerebral small vessel disease
diabetes mellitus
magnetic resonance imaging
shape markers
white matter hyperintensity
url https://doi.org/10.1002/trc2.70042
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AT zhimingpan diabetesmellitusexacerbateschangesinwhitematterhyperintensityshapesandvolumealongitudinalstudy
AT wenjunwu diabetesmellitusexacerbateschangesinwhitematterhyperintensityshapesandvolumealongitudinalstudy
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