Case Control Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jul 15, 2025; 16(7): 104424
Published online Jul 15, 2025. doi: 10.4239/wjd.v16.i7.104424
Altered hippocampal subfield volumes are associated with memory and executive function in patients with type 2 diabetes mellitus
Shu-Xian Wu, Xiao-Long Liang, Qin-Qin Zhu, Wei Wang, Li Jiang, Huan-Huan Chen, Shui Tian, Ming Qi
Shu-Xian Wu, Qin-Qin Zhu, Li Jiang, Shui Tian, Ming Qi, Department of Radiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Xiao-Long Liang, Huan-Huan Chen, Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Wei Wang, Department of Radiology, Liyang People's Hospital, Changzhou 213300, Jiangsu Province, China
Co-first authors: Shu-Xian Wu and Xiao-Long Liang.
Co-corresponding authors: Shui Tian and Ming Qi.
Author contributions: Wu SX and Liang XL contribute equally to this study as co-first authors; Tian S and Qi M contribute equally to this study as co-corresponding authors; Qi M, Chen HH and Tian S conceived and designed this study; Wu SX, Liang XL, Zhu QQ, Wang W, Jiang L performed the research; Wu SX, Liang XL analyzed the data; Wu SX, Tian S wrote the paper; all authors reviewed and gave final approval of submission.
Supported by the Bethune Charitable Foundation, No. Z04JKM2022E035; and the Liyang City's 2023 Annual research and development Plan Follows Nanjing Project, No. LC2024001.
Institutional review board statement: This study was abided by the ethical guidelines of the World Medical Association Declaration of Helsinki and was approved by the Local Medical Ethics Committee of the first Affiliated Hospital of Nanjing Medical University.
Informed consent statement: All participants provided written informed consent and were compensated financially for their participation.
Conflict-of-interest statement: All authors report no conflicts of interests.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: The codes and dataset are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ming Qi, MD, Associate Professor, Chief Physician, Department of Radiology, The First Affiliated Hospital with Nanjing Medical University, No. 300 Guangzhou Road, Gulou District, Nanjing 210029, Jiangsu Province, China. qiming@njmu.edu.cn
Received: December 28, 2024
Revised: March 17, 2025
Accepted: June 10, 2025
Published online: July 15, 2025
Processing time: 198 Days and 23.2 Hours
Abstract
BACKGROUND

Increasing evidence has shown that hippocampal damage serves as a marker of early cognitive decline in patients with type 2 diabetes mellitus (T2DM); however, the association between hippocampal subregion volume changes and cognitive decline in different dimensions remains unclear.

AIM

To investigate changes in hippocampal subregion volumes in patients with T2DM and their relationship with cognitive function impairment.

METHODS

Sixty patients with T2DM and 32 healthy controls were recruited. All participants underwent a 3.0 T magnetic resonance scan and a series of clinical assessments. Hippocampal subfield volumes were determined using FreeSurfer 7.4.1. A two-sample t-test was used to evaluate group differences. Partial correlation analysis was performed to assess the relationship between hippocampal subregion volumes and cognitive function. aP < 0.05 was considered statistically significant.

RESULTS

Compared with controls, the volume of right hippocampus-amygdala transition area (t = -3.053, P = 0.003) in patients with T2DM was significantly reduced, which was negatively correlated with the required time of the Trail Making Test (TMT)-A (r = -0.331, P = 0.028) and TMT-B (r = -0.402, P = 0.007) and positively correlated with the scores of Symbol Digit Modalities Test (r = 0.381, P = 0.011), Auditory Verbal Learning Test (AVLT)-N7 (r = 0.309, P = 0.041), and Digital Span Test (r = 0.300, P = 0.048). The volume of the right molecular layer (t = -2.998, P = 0.004) was also significantly reduced, which was positively associated with the scores of AVLT-N7 (r = 0.311, P = 0.045). In addition, the left hippocampal fissure volume (t = 3.617, P = 0.002) was significantly increased in patients with T2DM.

CONCLUSION

Declines in cognitive performance, especially memory and executive function, are linked to changes in the volumes of the right hippocampus-amygdala transition area and right molecular layer in patients with T2DM.

Keywords: Hippocampal subfields; Type 2 diabetes mellitus; Magnetic resonance; Cognitive function; FreeSurfer

Core Tip: This study examines changes in hippocampal subregion volumes in patients with type 2 diabetes mellitus (T2DM) and their relationship with cognitive function impairment. It was found that declines in memory and executive function in patients with T2DM were related to changes in hippocampal subregion volumes, indicating that the hippocampus could serve as a marker for the early diagnosis of cognitive decline in patients with T2DM.