Journal of magnetic resonance imaging : JMRI · 2026
Thalamic Nuclei Atrophy in Type 1 Diabetes Mellitus Across Disease Duration.
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Fang Hao, Yin Jiajing, Tian Shui, Dai Liuyan, Heng Wenxuan, Zhou Xia, Zhang Ling, Huang Mei, Qu Xinyi, Qin Yao, Lu Shanshan, Zhang Mei
Аннотация
BACKGROUND: Thalamic volume loss is one of the most consistent neuroimaging findings in type 1 diabetes mellitus (T1DM). However, the thalamus comprises multiple nuclei with distinct functions, and whether specific nuclei show differential vulnerability remains unclear.
PURPOSE: To investigate the characteristics of intra-thalamic nuclear atrophy in T1DM and evaluate its association with disease duration.
FIELD STRENGTH/SEQUENCE: 3.0 T/T1-weighted magnetization-prepared-rapid-acquisition-of-gradient-echo (MPRAGE).
STUDY TYPE: Prospective.
POPULATION: Forty-two subjects with T1DM (18-68 years, 17 males/25 females) and 39 healthy controls (18-69 years, 16 males/23 females).
ASSESSMENT: Multi-atlas-based segmentation was used to quantify volumes of 20 thalamic nuclei. Additionally, volumes of anatomical and functional subregions were derived based on topographic and functional nuclear classifications.
STATISTICAL TESTS: Group differences were assessed using general linear models. Associations between thalamic volume loss and disease duration were evaluated via partial correlations and exponential regression models to estimate duration-related atrophy rates. p value < 0.05 was considered significant.
RESULTS: Participants with T1DM showed significant bilateral reductions in total thalamic volume (left: 7.6%, Cohen's d = 0.91; right: 8.0%, Cohen's d = 0.95). The most pronounced atrophy was observed in the anterior, medial, and lateral thalamic subregions, with volume reductions of 15.8%, 8.6%, and 7.3%, respectively, particularly in cognition- and motor-related nuclei (9.4% and 9.2%, respectively). Longer disease duration was significantly associated with smaller thalamic volumes in the bilateral whole thalamus (r left = -0.48 and r right = -0.46), as well as in the Pul (r left = -0.64 and r right = -0.57), VLp (r left = -0.39 and r right = -0.38), and MD-Pf nuclei (r left = -0.55 and r right = -0.37), and in the left LGN (r = -0.43). Estimated disease-duration-related annualized atrophy rates exceeded age-related rates in several left-sided nuclei, including the MD-Pf (-0.67%), Pul (-0.69%), and LGN (-0.75%).
DATA CONCLUSION: T1DM is associated with spatially heterogeneous atrophy of thalamic nuclei, with preferential involvement of the anterior, medial, and lateral subregions. Disease duration seems to accelerate neurodegenerative changes.
EVIDENCE LEVEL: 2.
TECHNICAL EFFICACY: Stage 2.
PURPOSE: To investigate the characteristics of intra-thalamic nuclear atrophy in T1DM and evaluate its association with disease duration.
FIELD STRENGTH/SEQUENCE: 3.0 T/T1-weighted magnetization-prepared-rapid-acquisition-of-gradient-echo (MPRAGE).
STUDY TYPE: Prospective.
POPULATION: Forty-two subjects with T1DM (18-68 years, 17 males/25 females) and 39 healthy controls (18-69 years, 16 males/23 females).
ASSESSMENT: Multi-atlas-based segmentation was used to quantify volumes of 20 thalamic nuclei. Additionally, volumes of anatomical and functional subregions were derived based on topographic and functional nuclear classifications.
STATISTICAL TESTS: Group differences were assessed using general linear models. Associations between thalamic volume loss and disease duration were evaluated via partial correlations and exponential regression models to estimate duration-related atrophy rates. p value < 0.05 was considered significant.
RESULTS: Participants with T1DM showed significant bilateral reductions in total thalamic volume (left: 7.6%, Cohen's d = 0.91; right: 8.0%, Cohen's d = 0.95). The most pronounced atrophy was observed in the anterior, medial, and lateral thalamic subregions, with volume reductions of 15.8%, 8.6%, and 7.3%, respectively, particularly in cognition- and motor-related nuclei (9.4% and 9.2%, respectively). Longer disease duration was significantly associated with smaller thalamic volumes in the bilateral whole thalamus (r left = -0.48 and r right = -0.46), as well as in the Pul (r left = -0.64 and r right = -0.57), VLp (r left = -0.39 and r right = -0.38), and MD-Pf nuclei (r left = -0.55 and r right = -0.37), and in the left LGN (r = -0.43). Estimated disease-duration-related annualized atrophy rates exceeded age-related rates in several left-sided nuclei, including the MD-Pf (-0.67%), Pul (-0.69%), and LGN (-0.75%).
DATA CONCLUSION: T1DM is associated with spatially heterogeneous atrophy of thalamic nuclei, with preferential involvement of the anterior, medial, and lateral subregions. Disease duration seems to accelerate neurodegenerative changes.
EVIDENCE LEVEL: 2.
TECHNICAL EFFICACY: Stage 2.