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Advances in brain structural MRI for cognitive impairment associated with microvascular complications of type 2 diabetes mellitus
SUN Ziting  LI Xin  ZHANG Wen  LI Qian  ZHANG Xin  XING Qian  WANG Qiujie  ZHANG Bing 

DOI:10.12015/issn.1674-8034.2026.05.026.


[Abstract] Microvascular complications of type 2 diabetes are the major cause of disability and mortality. Their impact extends beyond peripheral target organs, potentially inducing structural brain alterations through "peripheral-central" interactions, ultimately leading to cognitive impairment. This type of cognitive dysfunction typically has an insidious onset, making early detection challenging with conventional diagnostic methods and often resulting in missed critical intervention windows. In recent years, magnetic resonance imaging has enabled precise multi-dimensional quantification of brain structural changes, including gray matter volume, cortical thickness, white matter integrity, and brain network topological properties, thereby providing imaging biomarkers for early diagnosis. This review systematically summarizes the specific patterns of brain structural alterations associated with the three major microvascular complications of type 2 diabetes mellitus, focusing on the evidence linking each complication's brain injury to cognitive impairment, summarizing the application value of brain structural MRI techniques, and pointing out current limitations and future research directions, in order to provide an imaging basis for early warning, disease evaluation, and precision intervention of cognitive impairment related to this disease.
[Keywords] type 2 diabetes mellitus；diabetic peripheral neuropathy；diabetic retinopathy；diabetic kidney disease；magnetic resonance imaging；cognitive dysfunction；brain structure

SUN Ziting1   LI Xin2   ZHANG Wen2   LI Qian2   ZHANG Xin1, 2   XING Qian3   WANG Qiujie4*   ZHANG Bing1, 2*  

1 Department of Radiology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210008, China

2 Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China

3 Department of Endocrinology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

4 Physical Examination Center, Jilin People's Hosptial, Jilin 132000, China

Corresponding author: WANG Q J, E-mail: 183093636@qq.com ZHANG B, E-mail: zhangbing_nanjing@nju.edu.cn

Conflicts of interest   None.

Received  2025-12-26
Accepted  2026-04-17
DOI: 10.12015/issn.1674-8034.2026.05.026
DOI:10.12015/issn.1674-8034.2026.05.026.

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