Brain Expansion in Patients With Type II Diabetes Following Insulin Therapy: A Preliminary Study With Longitudinal Voxel‐Based Morphometry

ABSTRACT OBJECTIVE We performed a longitudinal analysis based on magnetic resonance (MR) imaging to investigate the brain structural and perfusion changes caused by insulin therapy in patients with type II diabetes. METHODS High resolution three‐dimensional T1‐weighted fast spoiled gradient recalled echo images and flow‐sensitive alternating inversion recovery (FAIR) images were obtained from 11 patients with type II diabetes before and 1 year after initiation of insulin therapy and 11 normal controls. Brain volume changes were investigated by a longitudinal voxel‐based morphometry (VBM), and perfusion changes were evaluated by FAIR imaging between baseline and follow‐up data. RESULTS Significant regional gray matter (GM) expansion located in bilateral frontal, parietal, and left occipital lobes, and regional white matter (WM) expansion was shown in left precentral subcortical WM and right angular subcortical WM after insulin therapy ( P < .05 with FDR correction). Brain hyperperfusion was detected in bilateral frontal cortex, left occipital cortex, and right temporal cortex after insulin therapy ( P < .05). CONCLUSIONS In patients with type II diabetes, brain expansion and hyperperfusion were demonstrated 1 year after initiation of insulin therapy, and insulin therapy could contribute to the brain volume gainment in the patients with type II diabetes.