Thalamic subregional signatures of cognitive dysfunction in type 2 diabetes mellitus
5 affiliations
- 1The First Clinical Medical College, Guangzhou University of Chinese Medicine
- 2Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine
- 3Department of Imaging Diagnostics, Nanfang Hospital, Southern Medical University
- 4Department of Magnetic Resonance Imaging, Zhanjiang First Hospital of Traditional Chinese Medicine
- 5State Key Laboratory of Traditional Chinese Medicine Syndrome
Abstract
Introduction/Objective: Type 2 diabetes mellitus (T2DM) is associated with brain structural changes and cognitive decline, yet its impact on thalamic subregions remains unclear. This study aimed to identify volume changes in thalamic subregions in individuals with T2DM and to examine their associations with cognitive and diabetes-related clinical parameters.
Methods: In this cross-sectional case-control study, the thalamus was segmented into 25 subregions per hemisphere using FreeSurfer, and the volume of each subregion was calculated. Subregional volumes were compared between patients with T2DM and healthy controls (HC) using a generalized linear model (GLM), and partial correlation analysis was used to examine the associations between these volumetric measures and cognitive indicators.
Results: We identified five subregions of the thalamus that exhibited differences between the normal control and T2DM groups after correction for multiple comparisons. The left mediodorsal medial magnocellular (MDm) subregion showed volumetric reduction in the T2DM group, whereas four subregions, the right and left limitans/suprageniculate (L-Sg) and the right and left lateral pulvinar (PuL), exhibited volumetric enlargement in the T2DM group. Within the T2DM group, left PuL volume was negatively correlated with AVLT immediate recall (r = -0.35, P = 0.022) and right L-Sg volume was positively correlated with the Digit Span Test (DST) forward score (r = 0.31, P = 0.044); neither survived correction for multiple comparisons.
Discussion: In this cross-sectional, single-centre sample, T2DM was associated with nucleus-specific, bidirectional thalamic volume differences in the absence of a whole-thalamus difference: smaller left MDm and larger bilateral L-Sg and PuL volumes. Because only T1-weighted images were analysed, the biological substrate of the larger volumes cannot be determined here; neuroinflammation, oedema and gliosis are plausible but untested hypotheses. The imaging-cognition associations were modest and did not survive correction for multiple comparisons.
Conclusion: Individuals with T2DM showed cross-sectional, region-specific differences in thalamic subnuclear volumes that were not detectable at the level of the whole thalamus. These are observational associations from a modest single-centre sample; their diagnostic, screening or predictive value is not established and requires longitudinal validation with clinically defined cognitive outcomes and independent replication.
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BibTeX
@article{zhao2026thalamic,
title = {{Thalamic subregional signatures of cognitive dysfunction in type 2 diabetes mellitus}},
author = {Kui Zhao and Yuna Chen and Zidong Cao and Limin Ge and Yan Wang and Ziyu Diao and Xuan Huang and Yifan Li and Mingrui Li and Shijun Qiu},
journal = {Frontiers in Endocrinology},
year = {2026},
month = nov,
doi = {10.3389/fendo.2026.1964798},
url = {https://www.frontiersin.org/articles/10.3389/fendo.2026.1964798/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Thalamic subregional signatures of cognitive dysfunction in type 2 diabetes mellitus
AU - Kui Zhao
AU - Yuna Chen
AU - Zidong Cao
AU - Limin Ge
AU - Yan Wang
AU - Ziyu Diao
AU - Xuan Huang
AU - Yifan Li
AU - Mingrui Li
AU - Shijun Qiu
PY - 2026
DA - 2026/11/04
JO - Frontiers in Endocrinology
DO - 10.3389/fendo.2026.1964798
UR - https://www.frontiersin.org/articles/10.3389/fendo.2026.1964798/full
AB - Introduction/Objective: Type 2 diabetes mellitus (T2DM) is associated with brain structural changes and cognitive decline, yet its impact on thalamic subregions remains unclear. This study aimed to identify volume changes in thalamic subregions in individuals with T2DM and to examine their associations with cognitive and diabetes-related clinical parameters. Methods: In this cross-sectional case-control study, the thalamus was segmented into 25 subregions per hemisphere using FreeSurfer, and the volume of each subregion was calculated. Subregional volumes were compared between patients with T2DM and healthy controls (HC) using a generalized linear model (GLM), and partial correlation analysis was used to examine the associations between these volumetric measures and cognitive indicators. Results: We identified five subregions of the thalamus that exhibited differences between the normal control and T2DM groups after correction for multiple comparisons. The left mediodorsal medial magnocellular (MDm) subregion showed volumetric reduction in the T2DM group, whereas four subregions, the right and left limitans/suprageniculate (L-Sg) and the right and left lateral pulvinar (PuL), exhibited volumetric enlargement in the T2DM group. Within the T2DM group, left PuL volume was negatively correlated with AVLT immediate recall (r = -0.35, P = 0.022) and right L-Sg volume was positively correlated with the Digit Span Test (DST) forward score (r = 0.31, P = 0.044); neither survived correction for multiple comparisons. Discussion: In this cross-sectional, single-centre sample, T2DM was associated with nucleus-specific, bidirectional thalamic volume differences in the absence of a whole-thalamus difference: smaller left MDm and larger bilateral L-Sg and PuL volumes. Because only T1-weighted images were analysed, the biological substrate of the larger volumes cannot be determined here; neuroinflammation, oedema and gliosis are plausible but untested hypotheses. The imaging-cognition associations were modest and did not survive correction for multiple comparisons. Conclusion: Individuals with T2DM showed cross-sectional, region-specific differences in thalamic subnuclear volumes that were not detectable at the level of the whole thalamus. These are observational associations from a modest single-centre sample; their diagnostic, screening or predictive value is not established and requires longitudinal validation with clinically defined cognitive outcomes and independent replication.
SN - 1664-2392
ER -