1. Microstructural White Matter Abnormalities and Cognitive Functioning in Type 2 Diabetes A Diffusion Tensor Imaging Study Featured Article: Yael D. Reijmer, Ph.D., Manon Brundel, M.D., Jeroen de Bresser, M.D., L. Jaap Kappelle, M.D., Alexander Leemans, Ph.D., Geert Jan Biessels, M.D., On Behalf of The Utrecht Vascular Cognitive Impairment Study Group Diabetes Care Volume 36: 137-144 January, 2013

2. STUDY OBJECTIVE To examine whether type 2 diabetes is associated with microstructural abnormalities in specific cerebral white matter tracts Reijmer Y. et al. Diabetes Care 2013;36:137-144

3. STUDY DESIGN AND METHODS 35 nondemented older individuals with type 2 diabetes (mean age 71 ± 5 years) and 35 age-, sex-, and education- matched control subjects underwent a 3 Tesla diffusion- weighted MRI scan and cognitive assessment Tractography performed to reconstruct several white matter tracts Diffusion tensor imaging measures, including fractional anisotropy (FA) and mean diffusivity (MD), compared between groups and related to cognitive performance Reijmer Y. et al. Diabetes Care 2013;36:137-144

5. RESULTS MD significantly increased in all tracts in both hemispheres in patients compared with control subjects (P < 0.05), reflecting microstructural white matter abnormalities in the diabetes group Increased MD associated with slowing of information- processing speed and worse memory performance in the diabetes but not control group after adjustment for age, sex, and estimated IQ (group 3 MD interaction, all P < 0.05) Associations independent of total white matter hyperintensity load and presence of cerebral infarcts Reijmer Y. et al. Diabetes Care 2013;36:137-144

8. CONCLUSIONS Individuals with type 2 diabetes showed microstructural abnormalities in various white matter pathways Abnormalities were related to worse cognitive functioning Reijmer Y. et al. Diabetes Care 2013;36:137-144