Diffusion Tensor Imaging Identifies Deficits in White Matter Microstructure in Subjects With Type 1 Diabetes That Correlate With Reduced Neurocognitive Function

  1. Christopher T. Kodl1,
  2. Daniel T. Franc2,
  3. Jyothi P. Rao1,
  4. Fiona S. Anderson3,
  5. William Thomas4,
  6. Bryon A. Mueller5,
  7. Kelvin O. Lim56 and
  8. Elizabeth R. Seaquist1
  1. 1Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University Of Minnesota, Minneapolis, Minnesota
  2. 2Medical Scientist Training Program, University Of Minnesota, Minneapolis, Minnesota
  3. 3Division of Pediatric Clinical Neuroscience, Department of Pediatrics, University Of Minnesota, Minneapolis, Minnesota
  4. 4Division of Biostatistics, School of Public Health, University Of Minnesota, Minneapolis, Minnesota
  5. 5Department of Psychiatry, University Of Minnesota, Minneapolis, Minnesota
  6. 6Geriatric Research Education and Clinical Center, Minneapolis VA Medical Center, Minneapolis, Minnesota
  1. Corresponding author: Elizabeth R. Seaquist, seaqu001{at}


OBJECTIVE—Long-standing type 1 diabetes is associated with deficits on neurocognitive testing that suggest central white matter dysfunction. This study investigated whether diffusion tensor imaging (DTI), a type of magnetic resonance imaging that measures white matter integrity quantitatively, could identify white matter microstructural deficits in patients with long-standing type 1 diabetes and whether these differences would be associated with deficits found by neurocognitive tests.

RESEARCH DESIGN AND METHODS—Twenty-five subjects with type 1 diabetes for at least 15 years and 25 age- and sex-matched control subjects completed DTI on a 3.0 Tesla scanner and a battery of neurocognitive tests. Fractional anisotropy was calculated for the major white matter tracts of the brain.

RESULTS—Diabetic subjects had significantly lower mean fractional anisotropy than control subjects in the posterior corona radiata and the optic radiation (P < 0.002). In type 1 diabetic subjects, reduced fractional anisotropy correlated with poorer performance on the copy portion of the Rey-Osterreith Complex Figure Drawing Test and the Grooved Peg Board Test, both of which are believed to assess white matter function. Reduced fractional anisotropy also correlated with duration of diabetes and increased A1C. A history of severe hypoglycemia did not correlate with fractional anisotropy.

CONCLUSIONS—DTI can detect white matter microstructural deficits in subjects with long-standing type 1 diabetes. These deficits correlate with poorer performance on selected neurocognitive tests of white matter function.


  • Published ahead of print at on 11 August 2008.

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    • Accepted August 1, 2008.
    • Received May 30, 2008.
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  1. Diabetes vol. 57 no. 11 3083-3089
  1. All Versions of this Article:
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