White matter tract integrity metrics sensitive to white matter microstructural changes and cognitive performance in type 2 diabetic patients

This study aims to use white matter tract integrity (WMTI) model based on DKI to explore white matter alternations in T2DM. DTI and WMTI metrics were compared between 73 T2DM patients and 57 HCs. The widespread increased extra-axonal diffusivity with limited increased intra-axonal diffusivity in T2DM reflected different degrees of axonal edema, vasogenic edema and/or demyelination. De,⊥ (radial extra-axonal diffusivity) was demonstrated to be the most sensitive parameter in detecting the white matter microstructural changes. De,⊥ in genu of the corpus callosum was correlated with attention performance, which is expected to be a imaging marker reflecting cognitive impairment in T2DM.