Association Between Type 2 Diabetes Mellitus and Cognitive Impairment Mediated by Imaging Markers of the Glymphatic System

Motivation: To investigate whether glymphatic markers and hippocampal atrophy mediate the relationship between type 2 diabetes mellitus (T2DM) and cognitive function. Goal(s): To export the correlations between glymphatic markers and cognitive function in T2DM patients. Approach: Diffusion tensor image analysis along the perivascular space (DTI-ALPS) index, total perivascular spaces (PVS) volume and hippocampal volume were obtained. The relationship between cognitive function and DTI-ALPS index, total PVS volume, hippocampal volume of T2DM patients was analyzed. Results: The T2DM patients had worse general cognitive function, larger total PVS volume, and smaller DTI-ALPS index. The glymphatic markers mediated the relationship between T2DM and cognitive function. Impact: The glymphatic markers is a promising imaging marker for cognitive impairment and may provide clinicians with important information for planning treatment strategies and assessing prognosis in T2DM patients.