Glymphatic system impairment in Type 2 diabetes mellitus associated with cognitive function

Motivation: T2DM has emerged as an important risk factor for cognitive impairment. However, the neuropathological basis of the cognitive impairment associated with T2DM is still unclear. Goal(s): To investigate whether the impaired glymphatic function is one of the mechanisms in T2DM-associated cognitive dysfunction. Approach: We compared the glymphatic function by calculating the diffusion along the perivascular space based on a diffusion tensor image, namely the DTI-ALPS index between HCs and patients with T2DM and investigated the relationship between DTI-ALPS index and cognitive functions. Results: The lower DTI-ALPS index was found in patients with T2DM, and DTI-ALPS index was correlated with worse cognitive performance. Impact: DTI-ALPS index may be applied as a useful indicator to evaluate the glymphatic system function. The impaired glymphatic system in patients with T2DM may provide a new perspective for understanding the pathophysiology of T2DM related cognitive impairment.