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Li M, Li Y, Zhao K, Qin C, Chen Y, Liu Y, Qiu S, Tan X, Liang Y. Abnormal cerebral blood flow and brain function in type 2 diabetes mellitus. Endocrine 2024; 85:433-442. [PMID: 37340286 DOI: 10.1007/s12020-023-03342-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 02/25/2023] [Indexed: 06/22/2023]
Abstract
PURPOSE Type 2 diabetes mellitus (T2DM) lead to impaired cerebral blood perfusion, which leads to changes in brain function and affects the cognitive function of patients. In this study, cerebral blood flow (CBF) was used to evaluate the effect of T2DM on cerebral perfusion, and functional connectivity (FC) analysis was further used to explore whether the FC between the abnormal CBF region and the whole brain was changed. In addition, amplitude of low-frequency fluctuation (ALFF) and degree centrality (DC) were used to investigate the changes in spontaneous activity and connectivity strength of the brain network. METHODS We recruited 40 T2DM patients and 55 healthy controls (HCs). They underwent 3D-T1WI, rs-fMRI, arterial spin labeling (ASL) sequence scans and a series of cognitive tests. Cognitive test scores and brain imaging indicators were compared between the two groups, and the relationships among laboratory indicators, cognitive test scores, and brain imaging indicators were explored in the T2DM group. RESULTS Compared to HCs, The CBF values of Calcarine_L and Precuneus_R in the T2DM group were lower. The DC value of Paracentral_Lobule_L and Precuneus_L, and the ALFF value of Hippocampus_L in the T2DM group were higher. In addition, the CBF values of Calcarine_L was negatively correlated with fasting insulin and HOMA_IR. CONCLUSION This study found that there were regions of cerebral hypoperfusion in T2DM patients, which are associated with insulin resistance. In addition, we found abnormally elevated brain activity and enhanced functional connectivity in T2DM patients, which we speculated was the compensatory mechanism of brain neural activity.
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Affiliation(s)
- Mingrui Li
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Radiology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Magnatic Resonance Imaging, Zhanjiang First Hospital of Traditional Chinese Medicine, Zhanjiang, China
| | - Yifan Li
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Radiology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Kui Zhao
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Radiology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chunhong Qin
- Department of Radiology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuna Chen
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Radiology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yujie Liu
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Radiology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shijun Qiu
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.
- Department of Radiology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
| | - Xin Tan
- Department of Radiology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
| | - Yi Liang
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.
- Department of Radiology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
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Zhang Y, Yin X, Chen YC, Chen H, Jin M, Ma Y, Yong W, Muthaiah VPK, Xia W, Yin X. Aberrant Brain Triple-Network Effective Connectivity Patterns in Type 2 Diabetes Mellitus. Diabetes Ther 2024; 15:1215-1229. [PMID: 38578396 PMCID: PMC11043308 DOI: 10.1007/s13300-024-01565-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 03/12/2024] [Indexed: 04/06/2024] Open
Abstract
INTRODUCTION Aberrant brain functional connectivity network is thought to be related to cognitive impairment in patients with type 2 diabetes mellitus (T2DM). This study aims to investigate the triple-network effective connectivity patterns in patients with T2DM within and between the default mode network (DMN), salience network (SN), and executive control network (ECN) and their associations with cognitive declines. METHODS In total, 92 patients with T2DM and 98 matched healthy controls (HCs) were recruited and underwent resting-state functional magnetic resonance imaging (rs-fMRI). Spectral dynamic causal modeling (spDCM) was used for effective connectivity analysis within the triple network. The posterior cingulate cortex (PCC), medial prefrontal cortex (mPFC), lateral prefrontal cortex (LPFC), supramarginal gyrus (SMG), and anterior insula (AINS) were selected as the regions of interest. Group comparisons were performed for effective connectivity calculated using the fully connected model, and the relationships between effective connectivity alterations and cognitive impairment as well as clinical parameters were detected. RESULTS Compared to HCs, patients with T2DM exhibited increased or decreased effective connectivity patterns within the triple network. Furthermore, diabetes duration was significantly negatively correlated with increased effective connectivity from the r-LPFC to the mPFC, while body mass index (BMI) was significantly positively correlated with increased effective connectivity from the l-LPFC to the l-AINS (r = - 0.353, p = 0.001; r = 0.377, p = 0.004). CONCLUSION These results indicate abnormal effective connectivity patterns within the triple network model in patients with T2DM and provide new insight into the neurological mechanisms of T2DM and related cognitive dysfunction.
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Affiliation(s)
- Yujie Zhang
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, China
| | - Xiao Yin
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, China
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, China
| | - Huiyou Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, China
| | - Mingxu Jin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, China
| | - Yuehu Ma
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, China
| | - Wei Yong
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, China
| | | | - Wenqing Xia
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, China.
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, China.
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Zhang W, Fu L, Bi Y, Liu J, Li X, Zhang X, Zhang Z, Miao Y, Cheng H, Zhang B. Large-scale functional network connectivity mediates the associations between lipids metabolism and cognition in type 2 diabetes. J Cereb Blood Flow Metab 2024; 44:384-396. [PMID: 37795619 PMCID: PMC10870959 DOI: 10.1177/0271678x231204426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/06/2023] [Accepted: 09/04/2023] [Indexed: 10/06/2023]
Abstract
Type 2 diabetes (T2D) is associated with dyslipidemia and mild cognitive impairment. This study investigated the relationships between serum lipids metabolism, cognition, and functional connectivity (FC) within and between brain networks in T2D patients. The study included 102 T2D patients and 45 healthy controls who underwent functional magnetic resonance imaging, lipid profile tests, and cognitive assessments. Thirteen functional networks were identified using independent component analysis. The statistical analyses included multivariate analysis of covariance, partial correlation, canonical correlation, and mediation analyses. We found widely reduced between-network FCs in T2D, especially between the ventral sensorimotor network (SMN) and dorsal attention network (DAN) (p = 0.001) and between the ventral SMN and lateral visual network (VN) (p < 0.001). Moreover, lower between-network FCs were correlated with worse serum lipids metabolism and poorer cognitive performance (all p < 0.05). Importantly, between-network FCs mediated the relationship between lipid metabolism and cognition (β = -0.3136, 95% CI: -0.7660, -0.0186). Within-network analyses revealed altered FCs within the anterior default mode network, DAN, and lateral VN, each positively correlated with global cognition (all p < 0.01). Our results suggest the potential of improving cognitive function by regulating serum lipids in individuals with T2D.
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Affiliation(s)
- Wen Zhang
- Department of Radiology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
- Medical Imaging Center, the Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
| | - Linqing Fu
- Department of Radiology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Yan Bi
- Department of Endocrinology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Jiani Liu
- Department of Radiology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Xin Li
- Department of Radiology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Xin Zhang
- Department of Radiology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
- Medical Imaging Center, the Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
| | - Zhou Zhang
- Department of Endocrinology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Yingwen Miao
- Department of Endocrinology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Haiyan Cheng
- Department of Endocrinology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Bing Zhang
- Department of Radiology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
- Medical Imaging Center, the Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- Institute of Brain Science, Nanjing University, Nanjing, China
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Xu K, Wang J, Liu G, Yan J, Chang M, Jiang L, Zhang J. Altered dynamic effective connectivity of the default mode network in type 2 diabetes. Front Neurol 2024; 14:1324988. [PMID: 38288329 PMCID: PMC10822894 DOI: 10.3389/fneur.2023.1324988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/27/2023] [Indexed: 01/31/2024] Open
Abstract
Introduction Altered functional connectivity of resting-state functional magnetic resonance imaging (rs-fMRI) within default mode network (DMN) regions has been verified to be closely associated with cognitive decline in patients with Type 2 diabetes mellitus (T2DM), but most studies neglected the fluctuations of brain activities-the dynamic effective connectivity (DEC) within DMN of T2DM is still unknown. Methods For the current investigation, 40 healthy controls (HC) and 36 T2DM patients have been recruited as participants. To examine the variation of DEC between T2DM and HC, we utilized the methodologies of independent components analysis (ICA) and multivariate granger causality analysis (mGCA). Results We found altered DEC within DMN only show decrease in state 1. In addition, the causal information flow of diabetic patients major affected areas which are closely associated with food craving and metabolic regulation, and T2DM patients stayed longer in low activity level and exhibited decreased transition rate between states. Moreover, these changes related negatively with the MoCA scores and positively with HbA1C level. Conclusion Our study may offer a fresh perspective on brain dynamic activities to understand the mechanisms underlying T2DM-related cognitive deficits.
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Affiliation(s)
- Kun Xu
- Second Clinical School, Lanzhou University, Lanzhou, China
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
| | - Jun Wang
- Second Clinical School, Lanzhou University, Lanzhou, China
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
| | - Guangyao Liu
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou University Second Hospital, Lanzhou, China
| | - Jiahao Yan
- Second Clinical School, Lanzhou University, Lanzhou, China
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
| | - Miao Chang
- Second Clinical School, Lanzhou University, Lanzhou, China
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
| | - Linzhen Jiang
- Second Clinical School, Lanzhou University, Lanzhou, China
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
| | - Jing Zhang
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou University Second Hospital, Lanzhou, China
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Guimarães P, Serranho P, Duarte JV, Crisóstomo J, Moreno C, Gomes L, Bernardes R, Castelo-Branco M. The hemodynamic response function as a type 2 diabetes biomarker: a data-driven approach. Front Neuroinform 2024; 17:1321178. [PMID: 38250018 PMCID: PMC10796780 DOI: 10.3389/fninf.2023.1321178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/14/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction There is a need to better understand the neurophysiological changes associated with early brain dysfunction in Type 2 diabetes mellitus (T2DM) before vascular or structural lesions. Our aim was to use a novel unbiased data-driven approach to detect and characterize hemodynamic response function (HRF) alterations in T2DM patients, focusing on their potential as biomarkers. Methods We meshed task-based event-related (visual speed discrimination) functional magnetic resonance imaging with DL to show, from an unbiased perspective, that T2DM patients' blood-oxygen-level dependent response is altered. Relevance analysis determined which brain regions were more important for discrimination. We combined explainability with deconvolution generalized linear model to provide a more accurate picture of the nature of the neural changes. Results The proposed approach to discriminate T2DM patients achieved up to 95% accuracy. Higher performance was achieved at higher stimulus (speed) contrast, showing a direct relationship with stimulus properties, and in the hemispherically dominant left visual hemifield, demonstrating biological interpretability. Differences are explained by physiological asymmetries in cortical spatial processing (right hemisphere dominance) and larger neural signal-to-noise ratios related to stimulus contrast. Relevance analysis revealed the most important regions for discrimination, such as extrastriate visual cortex, parietal cortex, and insula. These are disease/task related, providing additional evidence for pathophysiological significance. Our data-driven design allowed us to compute the unbiased HRF without assumptions. Conclusion We can accurately differentiate T2DM patients using a data-driven classification of the HRF. HRF differences hold promise as biomarkers and could contribute to a deeper understanding of neurophysiological changes associated with T2DM.
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Affiliation(s)
- Pedro Guimarães
- University of Coimbra, Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), Coimbra, Portugal
| | - Pedro Serranho
- University of Coimbra, Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), Coimbra, Portugal
- Department of Sciences and Technology, Universidade Aberta, Lisbon, Portugal
| | - João V. Duarte
- University of Coimbra, Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), Coimbra, Portugal
- University of Coimbra, Faculty of Medicine (FMUC), Coimbra, Portugal
| | - Joana Crisóstomo
- University of Coimbra, Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), Coimbra, Portugal
| | - Carolina Moreno
- Department of Endocrinology, University Hospital of Coimbra (CHUC), Coimbra, Portugal
| | - Leonor Gomes
- Department of Endocrinology, University Hospital of Coimbra (CHUC), Coimbra, Portugal
| | - Rui Bernardes
- University of Coimbra, Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), Coimbra, Portugal
- University of Coimbra, Clinical Academic Center of Coimbra (CACC), Faculty of Medicine (FMUC), Coimbra, Portugal
| | - Miguel Castelo-Branco
- University of Coimbra, Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), Coimbra, Portugal
- University of Coimbra, Clinical Academic Center of Coimbra (CACC), Faculty of Medicine (FMUC), Coimbra, Portugal
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Lyu W, Wu Y, Huang H, Chen Y, Tan X, Liang Y, Ma X, Feng Y, Wu J, Kang S, Qiu S, Yap PT. Aberrant dynamic functional network connectivity in type 2 diabetes mellitus individuals. Cogn Neurodyn 2023; 17:1525-1539. [PMID: 37969945 PMCID: PMC10640562 DOI: 10.1007/s11571-022-09899-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 09/11/2022] [Accepted: 10/09/2022] [Indexed: 11/24/2022] Open
Abstract
An increasing number of recent brain imaging studies are dedicated to understanding the neuro mechanism of cognitive impairment in type 2 diabetes mellitus (T2DM) individuals. In contrast to efforts to date that are limited to static functional connectivity, here we investigate abnormal connectivity in T2DM individuals by characterizing the time-varying properties of brain functional networks. Using group independent component analysis (GICA), sliding-window analysis, and k-means clustering, we extracted thirty-one intrinsic connectivity networks (ICNs) and estimated four recurring brain states. We observed significant group differences in fraction time (FT) and mean dwell time (MDT), and significant negative correlation between the Montreal Cognitive Assessment (MoCA) scores and FT/MDT. We found that in the T2DM group the inter- and intra-network connectivity decreases and increases respectively for the default mode network (DMN) and task-positive network (TPN). We also found alteration in the precuneus network (PCUN) and enhanced connectivity between the salience network (SN) and the TPN. Our study provides evidence of alterations of large-scale resting networks in T2DM individuals and shed light on the fundamental mechanisms of neurocognitive deficits in T2DM.
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Affiliation(s)
- Wenjiao Lyu
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong China
- Department of Radiology and Biomedical Research Imaging Center (BRIC), University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Ye Wu
- Department of Radiology and Biomedical Research Imaging Center (BRIC), University of North Carolina at Chapel Hill, Chapel Hill, NC USA
- School of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing, Jiangsu China
| | - Haoming Huang
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong China
| | - Yuna Chen
- Department of Endocrinology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong China
| | - Xin Tan
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong China
| | - Yi Liang
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong China
| | - Xiaomeng Ma
- Department of Radiology, Jingzhou First People’s Hospital of Hubei Province, Jingzhou, Hubei China
| | - Yue Feng
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong China
| | - Jinjian Wu
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong China
| | - Shangyu Kang
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong China
| | - Shijun Qiu
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong China
| | - Pew-Thian Yap
- Department of Radiology and Biomedical Research Imaging Center (BRIC), University of North Carolina at Chapel Hill, Chapel Hill, NC USA
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Chen WY, Zhong YL, Jin H, Huang X. Altered functional connectivity between the default mode network in diabetic retinopathy patients. Neuroreport 2023; 34:309-314. [PMID: 36966810 DOI: 10.1097/wnr.0000000000001895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
Abstract
OBJECTIVES Previous studies have demonstrated that diabetic retinopathy is associated with cognitive impairment. This study aimed to investigate the intrinsic functional connectivity pattern within the default mode network (DMN) and its associations with cognitive impairment in diabetic retinopathy patients using resting-state functional MRI (rs-fMRI). METHODS A total of 34 diabetic retinopathy patients and 37 healthy controls were recruited for rs-fMRI scanning. Both groups were age, gender, and education level matched. The posterior cingulate cortex (PCC) was chosen as the region of interest for detecting functional connectivity changes. RESULTS Compared with the healthy control group, diabetic retinopathy patients showed increased functional connectivity between PCC and left medial superior frontal gyrus and increased functional connectivity between PCC and right precuneus. CONCLUSION Our study highlights that diabetic retinopathy patients show enhanced functional connectivity within DMN, suggesting that a compensatory increase of neural activity might occur in DMN, which offers new insight into the potential neural mechanism of cognitive impairment in diabetic retinopathy patients.
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Affiliation(s)
- Wan Yun Chen
- Department of Ophthalmology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College
- Medical College of Nanchang University, Nanchang, China
| | - Yu Lin Zhong
- Department of Ophthalmology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College
| | - Han Jin
- Department of Ophthalmology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College
| | - Xin Huang
- Department of Ophthalmology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College
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Huang Y, Zhang D, Zhang X, Cheng M, Yang Z, Gao J, Tang M, Ai K, Lei X, Zhang X. Altered functional hubs and connectivity in type 2 diabetes mellitus with and without mild cognitive impairment. Front Neurol 2022; 13:1062816. [PMID: 36578308 PMCID: PMC9792165 DOI: 10.3389/fneur.2022.1062816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/21/2022] [Indexed: 12/14/2022] Open
Abstract
Cognitive impairment in type 2 diabetes mellitus (T2DM) is associated with functional and structural abnormalities of brain networks, especially the damage to hub nodes in networks. This study explored the abnormal hub nodes of brain functional networks in patients with T2DM under different cognitive states. Sixty-five patients with T2DM and 34 healthy controls (HCs) underwent neuropsychological assessment. Then, degree centrality (DC) analysis and seed-based functional connectivity (FC) analysis were performed to identify the abnormal hub nodes and the FC patterns of these hubs in T2DM patients with mild cognitive impairment (MCI) (DMCI group, N = 31) and without MCI (DMCN group, N = 34). Correlation analyzes examined the relationship between abnormal DC and FC and clinical/cognitive variables. Compared with HCs, both T2DM groups showed decreased DC values in the visual cortex, and the T2DM patients with MCI (DMCI) showed more extensive alterations in the right parahippocampal gyrus (PHG), bilateral posterior cingulate cortex (PCC), and left superior frontal gyrus (SFG) regions than T2DM patients with normal cognitive function. Seed-based FC analysis of PHG and PCC nodes showed that functional disconnection mainly occurred in visual and memory connectivity in patients with DMCI. Multiple abnormal DC values correlated with neuropsychological tests in patients with T2DM. In conclusion, this study found that the DMCI group displayed more extensive alterations in hub nodes and FC in vision and memory-related brain regions, suggesting that visual-related regions dysfunctions and disconnection may be involved in the neuropathology of visuospatial function impairment in patients with DMCI.
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Affiliation(s)
- Yang Huang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Dongsheng Zhang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Xin Zhang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Miao Cheng
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Zhen Yang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Jie Gao
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Min Tang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Kai Ai
- Department of Clinical and Technical Support, Philips Healthcare, Xi'an, China
| | - Xiaoyan Lei
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China,Xiaoyan Lei
| | - Xiaoling Zhang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China,*Correspondence: Xiaoling Zhang
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Ni MH, Li ZY, Sun Q, Yu Y, Yang Y, Hu B, Ma T, Xie H, Li SN, Tao LQ, Yuan DX, Zhu JL, Yan LF, Cui GB. Neurovascular decoupling measured with quantitative susceptibility mapping is associated with cognitive decline in patients with type 2 diabetes. Cereb Cortex 2022; 33:5336-5346. [PMID: 36310091 DOI: 10.1093/cercor/bhac422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/26/2022] [Accepted: 09/28/2022] [Indexed: 01/10/2023] Open
Abstract
Abstract
Disturbance of neurovascular coupling (NVC) is suggested to be one potential mechanism in type 2 diabetes mellitus (T2DM) associated mild cognitive impairment (MCI). However, NVC evidence derived from functional magnetic resonance imaging ignores the relationship of neuronal activity with vascular injury. Twenty-seven T2DM patients without MCI and thirty healthy controls were prospectively enrolled. Brain regions with changed susceptibility detected by quantitative susceptibility mapping (QSM) were used as seeds for functional connectivity (FC) analysis. NVC coefficients were estimated using combined degree centrality (DC) with susceptibility or cerebral blood flow (CBF). Partial correlations between neuroimaging indicators and cognitive decline were investigated. In T2DM group, higher susceptibility values in right hippocampal gyrus (R.PHG) were found and were negatively correlated with Naming Ability of Montreal Cognitive Assessment. FC increased remarkably between R.PHG and right middle temporal gyrus (R.MTG), right calcarine gyrus (R.CAL). Both NVC coefficients (DC-QSM and DC-CBF) reduced in R.PHG and increased in R.MTG and R.CAL. Both NVC coefficients in R.PHG and R.MTG increased with the improvement of cognitive ability, especially for executive function. These demonstrated that QSM and DC-QSM coefficients can be promising biomarkers for early evaluation of cognitive decline in T2DM patients and help to better understand the mechanism of NVC.
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Affiliation(s)
- Min-Hua Ni
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University , 569 Xinsi Road, Xi'an 710038, Shaanxi , China
- Faculty of Medical Technology, Shaanxi University of Chinese Medicine , 1 Middle Section of Shiji Road, Xian yang, Shaanxi 712046 , China
| | - Ze-Yang Li
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University , 569 Xinsi Road, Xi'an 710038, Shaanxi , China
| | - Qian Sun
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University , 569 Xinsi Road, Xi'an 710038, Shaanxi , China
| | - Ying Yu
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University , 569 Xinsi Road, Xi'an 710038, Shaanxi , China
| | - Yang Yang
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University , 569 Xinsi Road, Xi'an 710038, Shaanxi , China
| | - Bo Hu
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University , 569 Xinsi Road, Xi'an 710038, Shaanxi , China
| | - Teng Ma
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University , 569 Xinsi Road, Xi'an 710038, Shaanxi , China
| | - Hao Xie
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University , 569 Xinsi Road, Xi'an 710038, Shaanxi , China
| | - Si-Ning Li
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University , 569 Xinsi Road, Xi'an 710038, Shaanxi , China
- Faculty of Medical Technology, Xi’an Medical University , 1 Xinwang Road, Xi'an, Shaanxi 710016 , China
| | - Lan-Qiu Tao
- Student Brigade, Fourth Military Medical University , 169 Changle Road, Xi'an, Shaanxi 710032 , China
| | - Ding-Xin Yuan
- Student Brigade, Fourth Military Medical University , 169 Changle Road, Xi'an, Shaanxi 710032 , China
| | - Jun-Ling Zhu
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University , 569 Xinsi Road, Xi'an 710038, Shaanxi , China
| | - Lin-Feng Yan
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University , 569 Xinsi Road, Xi'an 710038, Shaanxi , China
| | - Guang-Bin Cui
- Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University , 569 Xinsi Road, Xi'an 710038, Shaanxi , China
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10
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Lin L, Zhang J, Liu Y, Hao X, Shen J, Yu Y, Xu H, Cong F, Li H, Wu J. Aberrant brain functional networks in type 2 diabetes mellitus: A graph theoretical and support-vector machine approach. Front Hum Neurosci 2022; 16:974094. [PMID: 36310847 PMCID: PMC9597867 DOI: 10.3389/fnhum.2022.974094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/23/2022] [Indexed: 11/23/2022] Open
Abstract
Objective Type 2 diabetes mellitus (T2DM) is a high risk of cognitive decline and dementia, but the underlying mechanisms are not yet clearly understood. This study aimed to explore the functional connectivity (FC) and topological properties among whole brain networks and correlations with impaired cognition and distinguish T2DM from healthy controls (HC) to identify potential biomarkers for cognition abnormalities. Methods A total of 80 T2DM and 55 well-matched HC were recruited in this study. Subjects’ clinical data, neuropsychological tests and resting-state functional magnetic resonance imaging data were acquired. Whole-brain network FC were mapped, the topological characteristics were analyzed using a graph-theoretic approach, the FC and topological characteristics of the network were compared between T2DM and HC using a general linear model, and correlations between networks and clinical and cognitive characteristics were identified. The support vector machine (SVM) model was used to identify differences between T2DM and HC. Results In patients with T2DM, FC was higher in two core regions [precuneus/posterior cingulated cortex (PCC)_1 and later prefrontal cortex_1] in the default mode network and lower in bilateral superior parietal lobes (within dorsal attention network), and decreased between the right medial frontal cortex and left auditory cortex. The FC of the right frontal medial-left auditory cortex was positively correlated with the Montreal Cognitive Assessment scales and negatively correlated with the blood glucose levels. Long-range connectivity between bilateral auditory cortex was missing in the T2DM. The nodal degree centrality and efficiency of PCC were higher in T2DM than in HC (P < 0.005). The nodal degree centrality in the PCC in the SVM model was 97.56% accurate in distinguishing T2DM patients from HC, demonstrating the reliability of the prediction model. Conclusion Functional abnormalities in the auditory cortex in T2DM may be related to cognitive impairment, such as memory and attention, and nodal degree centrality in the PCC might serve as a potential neuroimaging biomarker to predict and identify T2DM.
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Affiliation(s)
- Lin Lin
- Graduate School, Tianjin Medical University, Tianjin, China
- Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Jindi Zhang
- School of Biomedical Engineering, Dalian University of Technology, Dalian, China
| | - Yutong Liu
- School of Biomedical Engineering, Dalian University of Technology, Dalian, China
| | - Xinyu Hao
- School of Biomedical Engineering, Dalian University of Technology, Dalian, China
- Faculty of Information Technology, University of Jyvaskyla, Jyvaskyla, Finland
| | - Jing Shen
- Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Yang Yu
- Department of Endocrinology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Huashuai Xu
- Faculty of Information Technology, University of Jyvaskyla, Jyvaskyla, Finland
| | - Fengyu Cong
- School of Biomedical Engineering, Dalian University of Technology, Dalian, China
| | - Huanjie Li
- Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
- School of Biomedical Engineering, Dalian University of Technology, Dalian, China
- Huanjie Li,
| | - Jianlin Wu
- Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
- *Correspondence: Jianlin Wu,
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11
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Li ZY, Ma T, Yu Y, Hu B, Han Y, Xie H, Ni MH, Chen ZH, Zhang YM, Huang YX, Li WH, Wang W, Yan LF, Cui GB. Changes of brain function in patients with type 2 diabetes mellitus measured by different analysis methods: A new coordinate-based meta-analysis of neuroimaging. Front Neurol 2022; 13:923310. [PMID: 36090859 PMCID: PMC9449648 DOI: 10.3389/fneur.2022.923310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/11/2022] [Indexed: 11/22/2022] Open
Abstract
Objective Neuroimaging meta-analysis identified abnormal neural activity alterations in patients with type 2 diabetes mellitus (T2DM), but there was no consistency or heterogeneity analysis between different brain imaging processing strategies. The aim of this meta-analysis was to determine consistent changes of regional brain functions in T2DM via the indicators obtained by using different post-processing methods. Methods Since the indicators obtained using varied post-processing methods reflect different neurophysiological and pathological characteristics, we further conducted a coordinate-based meta-analysis (CBMA) of the two categories of neuroimaging literature, which were grouped according to similar data processing methods: one group included regional homogeneity (ReHo), independent component analysis (ICA), and degree centrality (DC) studies, while the other group summarized the literature on amplitude of low-frequency fluctuation (ALFF) and cerebral blood flow (CBF). Results The final meta-analysis included 23 eligible trials with 27 data sets. Compared with the healthy control group, when neuroimaging studies were combined with ReHo, ICA, and DC measurements, the brain activity of the right Rolandic operculum, right supramarginal gyrus, and right superior temporal gyrus in T2DM patients decreased significantly. When neuroimaging studies were combined with ALFF and CBF measurements, there was no clear evidence of differences in the brain function between T2DM and HCs. Conclusion T2DM patients have a series of spontaneous abnormal brain activities, mainly involving brain regions related to learning, memory, and emotion, which provide early biomarkers for clarifying the mechanism of cognitive impairment and neuropsychiatric disorders in diabetes. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=247071, PROSPERO [CRD42021247071].
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Affiliation(s)
- Ze-Yang Li
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Teng Ma
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Ying Yu
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Bo Hu
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Yu Han
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Hao Xie
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Min-Hua Ni
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
- Faculty of Medical Technology, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Zhu-Hong Chen
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Yang-Ming Zhang
- Battalion of the Second Regiment of Cadets of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Yu-Xiang Huang
- Battalion of the Second Regiment of Cadets of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Wen-Hua Li
- Battalion of the Second Regiment of Cadets of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Wen Wang
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
- *Correspondence: Guang-Bin Cui ;
| | - Lin-Feng Yan
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
- Lin-Feng Yan
| | - Guang-Bin Cui
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
- Wen Wang
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12
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Wang J, Zhou S, Deng D, Chen M, Cai H, Zhang C, Liu F, Luo W, Zhu J, Yu Y. Compensatory thalamocortical functional hyperconnectivity in type 2 Diabetes Mellitus. Brain Imaging Behav 2022; 16:2556-2568. [PMID: 35922652 DOI: 10.1007/s11682-022-00710-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2022] [Indexed: 11/26/2022]
Abstract
Type 2 diabetes mellitus (T2DM) is associated with brain damage and cognitive decline. Despite the fact that the thalamus involves aspects of cognition and is typically affected in T2DM, existing knowledge of subregion-level thalamic damage and its associations with cognitive performance in T2DM patients is limited. The thalamus was subdivided into 8 subregions in each hemisphere. Resting-state functional and structural MRI data were collected to calculate resting-state functional connectivity (rsFC) and gray matter volume (GMV) of each thalamic subregion in 62 T2DM patients and 50 healthy controls. Compared with controls, T2DM patients showed increased rsFC of the medial pre-frontal thalamus, posterior parietal thalamus, and occipital thalamus with multiple cortical regions. Moreover, these thalamic functional hyperconnectivity were associated with better cognitive performance and lower glucose variability in T2DM patients. However, there were no group differences in GMV for any thalamic subregions. These findings suggest a possible neural compensation mechanism whereby selective thalamocortical functional hyperconnectivity facilitated by better glycemic control help to preserve cognitive ability in T2DM patients, which may ultimately inform intervention and prevention of T2DM-related cognitive decline in real-world clinical settings.
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Affiliation(s)
- Jie Wang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Shushan District, 230022, Hefei, China
- Research Center of Clinical Medical Imaging, 230032, Hefei, Anhui Province, China
- Anhui Provincial Institute of Translational Medicine, 230032, Hefei, China
| | - Shanlei Zhou
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, 230022, Hefei, China
| | - Datong Deng
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, 230022, Hefei, China
| | - Mimi Chen
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Shushan District, 230022, Hefei, China
- Research Center of Clinical Medical Imaging, 230032, Hefei, Anhui Province, China
- Anhui Provincial Institute of Translational Medicine, 230032, Hefei, China
| | - Huanhuan Cai
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Shushan District, 230022, Hefei, China
- Research Center of Clinical Medical Imaging, 230032, Hefei, Anhui Province, China
- Anhui Provincial Institute of Translational Medicine, 230032, Hefei, China
| | - Cun Zhang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Shushan District, 230022, Hefei, China
| | - Fujun Liu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Shushan District, 230022, Hefei, China
| | - Wei Luo
- Department of Radiology, Chaohu Hospital of Anhui Medical University, 238000, Chaohu, China
| | - Jiajia Zhu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Shushan District, 230022, Hefei, China.
- Research Center of Clinical Medical Imaging, 230032, Hefei, Anhui Province, China.
- Anhui Provincial Institute of Translational Medicine, 230032, Hefei, China.
| | - Yongqiang Yu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Shushan District, 230022, Hefei, China.
- Research Center of Clinical Medical Imaging, 230032, Hefei, Anhui Province, China.
- Anhui Provincial Institute of Translational Medicine, 230032, Hefei, China.
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13
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Tan X, Wu J, Ma X, Kang S, Yue X, Rao Y, Li Y, Huang H, Chen Y, Lyu W, Qin C, Li M, Feng Y, Liang Y, Qiu S. Convolutional Neural Networks for Classification of T2DM Cognitive Impairment Based on Whole Brain Structural Features. Front Neurosci 2022; 16:926486. [PMID: 35928014 PMCID: PMC9344913 DOI: 10.3389/fnins.2022.926486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/22/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose Cognitive impairment is generally found in individuals with type 2 diabetes mellitus (T2DM). Although they may not have visible symptoms of cognitive impairment in the early stages of the disorder, they are considered to be at high risk. Therefore, the classification of these patients is important for preventing the progression of cognitive impairment. Methods In this study, a convolutional neural network was used to construct a model for classifying 107 T2DM patients with and without cognitive impairment based on T1-weighted structural MRI. The Montreal cognitive assessment score served as an index of the cognitive status of the patients. Results The classifier could identify T2DM-related cognitive decline with a classification accuracy of 84.85% and achieved an area under the curve of 92.65%. Conclusions The model can help clinicians analyze and predict cognitive impairment in patients and enable early treatment.
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Affiliation(s)
- Xin Tan
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Medical Imaging Center, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jinjian Wu
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaomeng Ma
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shangyu Kang
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaomei Yue
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yawen Rao
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yifan Li
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Haoming Huang
- Medical Imaging Center, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuna Chen
- Medical Imaging Center, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wenjiao Lyu
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chunhong Qin
- Medical Imaging Center, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Mingrui Li
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yue Feng
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yi Liang
- Medical Imaging Center, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Yi Liang
| | - Shijun Qiu
- Medical Imaging Center, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- *Correspondence: Shijun Qiu
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14
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Wu J, Kang S, Su J, Liu K, Fan L, Ma X, Tan X, Huang H, Feng Y, Chen Y, Lyu W, Zeng L, Qiu S, Hu D. Altered Functional Network Connectivity of Precuneus and Executive Control Networks in Type 2 Diabetes Mellitus Without Cognitive Impairment. Front Neurosci 2022; 16:887713. [PMID: 35833084 PMCID: PMC9271612 DOI: 10.3389/fnins.2022.887713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/08/2022] [Indexed: 11/13/2022] Open
Abstract
In epidemiological studies, type 2 diabetes mellitus (T2DM) has been associated with cognitive impairment and dementia, but studies about functional network connectivity in T2DM without cognitive impairment are limited. This study aimed to explore network connectivity alterations that may help enhance our understanding of damage-associated processes in T2DM. MRI data were analyzed from 82 patients with T2DM and 66 normal controls. Clinical, biochemical, and neuropsychological assessments were conducted in parallel with resting-state functional magnetic resonance imaging, and the cognitive status of the patients was assessed using the Montreal Cognitive Assessment-B (MoCA-B) score. Independent component analysis revealed a positive correlation between the salience network and the visual network and a negative connection between the left executive control network and the default mode network in patients with T2DM. The differences in dynamic brain network connectivity were observed in the precuneus, visual, and executive control networks. Internal network connectivity was primarily affected in the thalamus, inferior parietal lobe, and left precuneus. Hemoglobin A1c level, body mass index, MoCA-B score, and grooved pegboard (R) assessments indicated significant differences between the two groups (p < 0.05). Our findings show that key changes in functional connectivity in diabetes occur in the precuneus and executive control networks that evolve before patients develop cognitive deficits. In addition, the current study provides useful information about the role of the thalamus, inferior parietal lobe, and precuneus, which might be potential biomarkers for predicting the clinical progression, assessing the cognitive function, and further understanding the neuropathology of T2DM.
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Affiliation(s)
- Jinjian Wu
- The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shangyu Kang
- The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jianpo Su
- College of Intelligence Science and Technology, National University of Defense Technology, Changsha, China
| | - Kai Liu
- College of Intelligence Science and Technology, National University of Defense Technology, Changsha, China
| | - Liangwei Fan
- College of Intelligence Science and Technology, National University of Defense Technology, Changsha, China
| | - Xiaomeng Ma
- The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xin Tan
- The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Haoming Huang
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yue Feng
- The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuna Chen
- The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wenjiao Lyu
- The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lingli Zeng
- College of Intelligence Science and Technology, National University of Defense Technology, Changsha, China
| | - Shijun Qiu
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- *Correspondence: Shijun Qiu,
| | - Dewen Hu
- College of Intelligence Science and Technology, National University of Defense Technology, Changsha, China
- Dewen Hu,
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15
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Wang M, Zhang D, Gao J, Qi F, Su Y, Lei Y, Shao Z, Ai K, Tang M, Zhang X. Abnormal functional connectivity in the right dorsal anterior insula associated with cognitive dysfunction in patients with type 2 diabetes mellitus. Brain Behav 2022; 12:e2553. [PMID: 35543304 PMCID: PMC9226846 DOI: 10.1002/brb3.2553] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 02/01/2022] [Accepted: 02/12/2022] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Type 2 diabetes mellitus (T2DM) is a chronic disease with a high incidence worldwide. T2DM can cause cognitive impairment, but its neuropathological basis is unclear. A variety of neuropsychiatric studies have found that abnormal functional connectivity (FC) in the central executive network (CEN), default-mode network (DMN), and salience network (SN) may be the neuropathological basis of cognitive dysfunction. The right dorsal anterior insula (dAI) is the core SN area. It plays an important role in regulating the CEN and the DMN. However, few studies have explored the relationship between cognitive impairment and FC among the right dAI, CEN, and DMN in patients with T2DM. METHODS Resting-state functional magnetic resonance imaging was used to investigate FC between the right dAI and the CEN and DMN in 44 patients with T2DM and 41 sex-, age-, and education-matched healthy controls, as well as its relationship with clinical/cognitive variables. RESULTS In patients with T2DM, FC between the right dAI and multiple brain regions of the CEN and DMN was generally decreased, and FC strength between the right dAI and the inferior frontal gyrus negatively correlated with trail making test A score (r = -0.421, p = 0.004). CONCLUSIONS Patients with T2DM exhibit abnormal FC between the right dAI and the CEN and DMN. This may be one of the neuromechanisms of cognitive impairment in patients with T2DM. In addition, reduced FC between the right dAI and the right inferior frontal gyrus may be related to abnormal attention regulation in patients with T2DM.
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Affiliation(s)
- Man Wang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, People's Republic of China
| | - Dongsheng Zhang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, People's Republic of China
| | - Jie Gao
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, People's Republic of China
| | - Fei Qi
- Xi'an Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Yu Su
- Xi'an Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Yumeng Lei
- Xi'an Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Zhirong Shao
- Xi'an Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Kai Ai
- Philips Healthcare, Xi'an, Shaanxi, People's Republic of China
| | - Min Tang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, People's Republic of China
| | - Xiaoling Zhang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, People's Republic of China
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16
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Liu M, Li J, Li J, Yang H, Yao Q, Zheng X, Zhang Z, Qin J. Altered Spontaneous Brain Activity in Patients With Diabetic Osteoporosis Using Regional Homogeneity: A Resting-State Functional Magnetic Resonance Imaging Study. Front Aging Neurosci 2022; 14:851929. [PMID: 35601621 PMCID: PMC9120436 DOI: 10.3389/fnagi.2022.851929] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 04/06/2022] [Indexed: 12/02/2022] Open
Abstract
Background The pathophysiological mechanism of cognitive impairment by osteoporosis in type 2 diabetes mellitus (T2DM) remains unclear. This study aims to further investigate the regional spontaneous brain activity changes of patients with diabetic osteoporosis (DOP), and the correlation between abnormal brain regions and bone metabolites. Methods A total of 29 subjects with T2DM were recruited, including fourteen patients with DOP and thirteen patients without osteoporosis (Control group). Based on the resting-state functional magnetic resonance imaging (rs-fMRI) datasets acquired from all the subjects, a two-sample t-test was performed on individual normalized regional homogeneity (ReHo) maps. Spearman correlation analysis was performed between the abnormal ReHo regions with the clinical parameters and Montreal Cognitive Assessment (MOCA) scores. Results In the DOP group, we demonstrated the significantly increased ReHo values in the left middle temporal gyrus (MTG), right superior occipital gyrus (SOG), aright superior parietal lobule (SPL), right angular gyrus (AG), and left precuneus (PE). Additionally, we also found a significant positive correlation between increased ReHo values in the left MTG and the average bone mineral density (BMD AVG), and average T scores (T AVG). The ReHo values of the right SOG and right SPL showed a negative correlation with MOCA scores, as well as a negative correlation between increased ReHo values in the right SPL and osteocalcin (OC) level. Conclusion Patients with DOP showed increased spontaneous activity in multiple brain regions. The results indicated that osteoporosis exacerbated cognitive impairment and brain damage. Also, the OC might be considered as a bone marker to track the progression of cognitive impairment.
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17
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Chau ACM, Smith AE, Hordacre B, Kumar S, Cheung EYW, Mak HKF. A scoping review of resting-state brain functional alterations in Type 2 diabetes. Front Neuroendocrinol 2022; 65:100970. [PMID: 34922997 DOI: 10.1016/j.yfrne.2021.100970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 11/18/2021] [Accepted: 12/07/2021] [Indexed: 11/28/2022]
Abstract
Resting-state functional magnetic resonance imaging (rs-fMRI) has been actively used in the last decade to investigate brain functional connectivity alterations in Type 2 Diabetes Mellitus (T2DM) to understand the neuropathophysiology of T2DM in cognitive degeneration. Given the emergence of new analysis techniques, this scoping review aims to map the rs-fMRI analysis techniques that have been applied in the literature and reports the latest rs-fMRI findings that have not been covered in previous reviews. Graph theory, the contemporary rs-fMRI analysis, has been used to demonstrate altered brain topological organisations in people with T2DM, which included altered degree centrality, functional connectivity strength, the small-world architecture and network-based statistics. These alterations were correlated with T2DM patients' cognitive performances. Graph theory also contributes to identify unbiased seeds for seed-based analysis. The expanding rs-fMRI analytical approaches continue to provide new evidence that helps to understand the mechanisms of T2DM-related cognitive degeneration.
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Affiliation(s)
- Anson C M Chau
- Medical Imaging, Medical Radiation Science, Allied Health and Human Performance, University of South Australia, Adelaide, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia.
| | - Ashleigh E Smith
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia.
| | - Brenton Hordacre
- IIMPACT in Health, Allied Health and Human Performance, University of South Australia, Adelaide, Australia.
| | - Saravana Kumar
- IIMPACT in Health, Allied Health and Human Performance, University of South Australia, Adelaide, Australia; Allied Health and Human Performance, University of South Australia, Adelaide, Australia.
| | - Eva Y W Cheung
- School of Medical and Health Sciences, Tung Wah College, Hong Kong.
| | - Henry K F Mak
- Department of Diagnostic Radiology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong; Alzheimer's Disease Research Network, The University of Hong Kong, Hong Kong; State Key Laboratory for Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong.
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18
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Shi AP, Yu Y, Hu B, Li YT, Wang W, Cui GB. Large-scale functional connectivity predicts cognitive impairment related to type 2 diabetes mellitus. World J Diabetes 2022; 13:110-125. [PMID: 35211248 PMCID: PMC8855139 DOI: 10.4239/wjd.v13.i2.110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 12/10/2021] [Accepted: 01/06/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Large-scale functional connectivity (LSFC) patterns in the brain have unique intrinsic characteristics. Abnormal LSFC patterns have been found in patients with dementia, as well as in those with mild cognitive impairment (MCI), and these patterns predicted their cognitive performance. It has been reported that patients with type 2 diabetes mellitus (T2DM) may develop MCI that could progress to dementia. We investigated whether we could adopt LSFC patterns as discriminative features to predict the cognitive function of patients with T2DM, using connectome-based predictive modeling (CPM) and a support vector machine.
AIM To investigate the utility of LSFC for predicting cognitive impairment related to T2DM more accurately and reliably.
METHODS Resting-state functional magnetic resonance images were derived from 42 patients with T2DM and 24 healthy controls. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). Patients with T2DM were divided into two groups, according to the presence (T2DM-C; n = 16) or absence (T2DM-NC; n = 26) of MCI. Brain regions were marked using Harvard Oxford (HOA-112), automated anatomical labeling (AAL-116), and 264-region functional (Power-264) atlases. LSFC biomarkers for predicting MoCA scores were identified using a new CPM technique. Subsequently, we used a support vector machine based on LSFC patterns for among-group differentiation. The area under the receiver operating characteristic curve determined the appearance of the classification.
RESULTS CPM could predict the MoCA scores in patients with T2DM (Pearson’s correlation coefficient between predicted and actual MoCA scores, r = 0.32, P=0.0066 [HOA-112 atlas]; r = 0.32, P=0.0078 [AAL-116 atlas]; r = 0.42, P=0.0038 [Power-264 atlas]), indicating that LSFC patterns represent cognition-level measures in these patients. Positive (anti-correlated) LSFC networks based on the Power-264 atlas showed the best predictive performance; moreover, we observed new brain regions of interest associated with T2DM-related cognition. The area under the receiver operating characteristic curve values (T2DM-NC group vs. T2DM-C group) were 0.65-0.70, with LSFC matrices based on HOA-112 and Power-264 atlases having the highest value (0.70). Most discriminative and attractive LSFCs were related to the default mode network, limbic system, and basal ganglia.
CONCLUSION LSFC provides neuroimaging-based information that may be useful in detecting MCI early and accurately in patients with T2DM.
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Affiliation(s)
- An-Ping Shi
- Department of Radiology, Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, The Affiliated Tangdu Hospital of Air Force Medical University (Fourth Military Medical University), Xi'an 710038, Shaanxi Province, China
| | - Ying Yu
- Department of Radiology, Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, The Affiliated Tangdu Hospital of Air Force Medical University (Fourth Military Medical University), Xi'an 710038, Shaanxi Province, China
| | - Bo Hu
- Department of Radiology, Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, The Affiliated Tangdu Hospital of Air Force Medical University (Fourth Military Medical University), Xi'an 710038, Shaanxi Province, China
| | - Yu-Ting Li
- Department of Radiology, Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, The Affiliated Tangdu Hospital of Air Force Medical University (Fourth Military Medical University), Xi'an 710038, Shaanxi Province, China
| | - Wen Wang
- Department of Radiology, Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, The Affiliated Tangdu Hospital of Air Force Medical University (Fourth Military Medical University), Xi'an 710038, Shaanxi Province, China
| | - Guang-Bin Cui
- Department of Radiology, Department of Radiology and Functional and Molecular Imaging Key Lab of Shaanxi Province, The Affiliated Tangdu Hospital of Air Force Medical University (Fourth Military Medical University), Xi'an 710038, Shaanxi Province, China
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19
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Li Y, Li M, Feng Y, Ma X, Tan X, Chen Y, Qin C, Huang H, Liang Y, Qiu S. Aberrant Brain Spontaneous Activity and Synchronization in Type 2 Diabetes Mellitus Subjects Without Mild Cognitive Impairment. Front Neurosci 2022; 15:749730. [PMID: 34975372 PMCID: PMC8716545 DOI: 10.3389/fnins.2021.749730] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/19/2021] [Indexed: 01/21/2023] Open
Abstract
Objective: We aimed to explore whether the percent amplitude of fluctuation (PerAF) measurement could provide supplementary information for amplitude of low-frequency fluctuation (ALFF) about spontaneous activity alteration in type 2 diabetes mellitus (T2DM) subjects without mild cognitive impairment (MCI). Then we further evaluated the synchronization through the method of functional connectivity (FC) to better demonstrate brain changes in a more comprehensive manner in T2DM. Methods: Thirty T2DM subjects without MCI and thirty well-matched healthy subjects were recruited in this study. Subjects' clinical data, neuropsychological test results, and resting-state functional magnetic resonance imaging (rs-fMRI) data were acquired. Voxel-based group difference comparisons between PerAF and ALFF were conducted. Then, seed-based FC between the recognized brain regions based on PerAF and ALFF and the rest of the whole brain was performed. Results: Compared with healthy group, T2DM group had significantly decreased PerAF in the bilateral middle occipital gyrus and the right calcarine, increased ALFF in the right orbital inferior frontal gyrus and decreased ALFF in the right calcarine. Seed-based FC analysis showed that the right middle occipital gyrus of T2DM subjects exhibited significantly decreased FC with the right caudate nucleus and right putamen. According to the partial correlation analyses, hemoglobin A1c (HbA1c) and immediate memory scores on the auditory verbal learning test (AVLT) were negatively correlated in the T2DM group. However, we found that total cholesterol was positively correlated with symbol digit test (SDT) scores. Conclusion: PerAF and ALFF may have different sensitivities in detecting the abnormal spontaneous brain activity in T2DM subjects. We suggest PerAF values may add supplementary information and indicate additional potential neuronal spontaneous activity in T2DM subjects without MCI, which may provide new insights into the neuroimaging mechanisms underlying early diabetes-associated cognitive decline.
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Affiliation(s)
- Yifan Li
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Mingrui Li
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yue Feng
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaomeng Ma
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xin Tan
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuna Chen
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chunhong Qin
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Haoming Huang
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yi Liang
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shijun Qiu
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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20
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Wan S, Xia WQ, Zhong YL. Aberrant Interhemispheric Functional Connectivity in Diabetic Retinopathy Patients. Front Neurosci 2021; 15:792264. [PMID: 34975389 PMCID: PMC8716762 DOI: 10.3389/fnins.2021.792264] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 11/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Accumulating lines of evidence demonstrated that diabetic retinopathy (DR) patients trigger abnormalities in brain’s functional connectivity (FC), whereas the alterations of interhemispheric coordination pattern occurring in DR are not well understood. Our study was to investigate alterations of interhemispheric coordination in DR patients. Methods: Thirty-four DR individuals (19 males and 15 females: mean age: 52.97 ± 8.35 years) and 37 healthy controls (HCs) (16 males and 21 females; mean age: 53.78 ± 7.24 years) were enrolled in the study. The voxel-mirrored homotopic connectivity (VMHC) method was conducted to investigate the different interhemispheric FC between two groups. Then, the seed-based FC method was applied to assess the different FCs with region of interest (ROI) in the brain regions of decreased VMHC between two groups. Results: Compared with HC groups, DR groups showed decreased VMHC values in the bilateral middle temporal gyrus (MTG), lingual/calcarine/middle occipital gyrus (LING/CAL/MOG), superior temporal gyrus (STG), angular (ANG), postcentral gyrus (PosCG), inferior parietal lobule (IPL), and precentral gyrus (PreCG). Meanwhile, altered FC includes the regions of auditory network, visual network, default mode network, salience network, and sensorimotor network. Moreover, a significant positive correlation was observed between the visual acuity-oculus dexter (OD) and zVMHC values in the bilateral LING/CAL/MOG (r = 0.551, p = 0.001), STG (r = 0.426, p = 0.012), PosCG (r = 0.494, p = 0.003), and IPL (r = 0.459, p = 0.006) in DR patients. Conclusion: Our results highlighted that DR patients were associated with substantial impairment of interhemispheric coordination in auditory network, visual network, default mode network, and sensorimotor network. The VMHC might be a promising therapeutic target in the intervention of brain functional dysfunction in DR patients.
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Affiliation(s)
- Song Wan
- Department of Ophthalmology, Jiangxi Provincial People’s Hospital, Nanchang, China
| | - Wen Qing Xia
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yu Lin Zhong
- Department of Ophthalmology, Jiangxi Provincial People’s Hospital, Nanchang, China
- *Correspondence: Yu Lin Zhong,
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21
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Li M, Li Y, Liu Y, Huang H, Leng X, Chen Y, Feng Y, Ma X, Tan X, Liang Y, Qiu S. Altered Hippocampal Subfields Volumes Is Associated With Memory Function in Type 2 Diabetes Mellitus. Front Neurol 2021; 12:756500. [PMID: 34899576 PMCID: PMC8657943 DOI: 10.3389/fneur.2021.756500] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 11/03/2021] [Indexed: 01/10/2023] Open
Abstract
Objective: Cognitive impairment in type 2 diabetes mellitus (T2DM) patients is related to changes in hippocampal structure and function. However, the alternation of hippocampal subfields volumes and their relationship with cognitive function are unclear. This study explored morphological alterations in the hippocampus and its subfields in T2DM patients and their relationship with cognitive function. Methods: Thirty T2DM patients and 20 healthy controls (HCs) were recruited and underwent 3-dimensional, high-resolution T1-weighted sequence (3D-T1) and a battery of cognitive tests. Freesurfer 6.0 was performed to segment the hippocampus into 12 subregions automatically. Then relationships between hippocampal subfield volumes and neurocognitive scale scores in the T2DM group were evaluated. Results: Immediate memory scores on the auditory verbal learning test (AVLT) and Montreal Cognitive Assessment (MoCA) scores in T2DM patients were lower than in the HCs. T2DM patients showed that volumes of the bilateral hippocampus were significantly reduced, mainly in the bilateral molecular layer, granule cell and molecular layer of the dentate gyrus (GC-ML-DG), cornu ammonis 4 (CA4), fimbria, and left subiculum and the right hippocampus amygdala transition area (HATA) compared to HCs. In addition, T2DM patients showed the FINS was negatively correlated with volume of left GC-ML-DG (r = -0.415, P = 0.035) and left CA4 (r = -0.489, P = 0.011); the FBG was negatively correlated with volume of right fimbria (r = -0.460, P = 0.018); the HOMA-IR was negatively correlated with volume of left GC-ML-DG (r = -0.367, P = 0.046) and left CA4(r = 0.462, P = 0.010). Partial correlation analysis found that the volume of right HATA in T2DM group was positively correlated with AVLT (immediate) scores (r = 0.427, P = 0.03). Conclusion: This study showed the volumes of multiple hippocampal subfields decreased and they were correlated with FINS, FBG and HOMA-IR in T2DM patients. We hypothesized that decreased hippocampal subfields volumes in T2DM patients was related to insulin resistance and impaired vascular function. In addition, we also found that abnormal hippocampal subfields volumes were related to memory function in T2DM patients, suggesting that reduced volumes in specific hippocampal subfields may be the potential mechanism of memory dysfunction in these patients.
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Affiliation(s)
- Mingrui Li
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yifan Li
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yujie Liu
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Haoming Huang
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xi Leng
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuna Chen
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yue Feng
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaomeng Ma
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xin Tan
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yi Liang
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shijun Qiu
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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22
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Deng L, Liu H, Liu H, Liu J, Liu W, Liu Y, Zhang Y, Rong P, Liang Q, Wang W. Concomitant functional impairment and reorganization in the linkage between the cerebellum and default mode network in patients with type 2 diabetes mellitus. Quant Imaging Med Surg 2021; 11:4310-4320. [PMID: 34603986 PMCID: PMC8408787 DOI: 10.21037/qims-21-41] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 05/06/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Increasing evidence shows that the default mode network (DMN) and cerebellum are prone to structural and functional abnormalities in patients with type 2 diabetes mellitus (T2DM). However, the type of change in the functional connection between the DMN and cerebellum is still unknown. METHODS In this study, seed-based functional connectivity (FC) analysis was used to examine the intrinsic FC of the cerebellum-DMN between healthy controls (HCs) and T2DM patients. Pearson correlation analysis was used to explore the relationship between clinical variables and changes in FC. RESULTS Compared with HCs, T2DM patients showed significantly increased FC of the left crus I-left medial superior frontal gyrus, left crus I-right medial superior frontal gyrus, and right crus I-left medial orbitofrontal cortex. Compared with HCs, T2DM patients showed decreased FC of the lobule IX-the right angular gyrus. Moreover, diabetes duration was positively correlated with increased FC of the left crus I-right medial superior frontal gyrus (r=0.438, P=0.007). CONCLUSIONS Concomitant functional impairment and reorganization in the linkage between the cerebellum and DMN in patients with T2DM may be a biomarker of early brain damage that can help us better understand the pathogenesis of cognitive impairment in T2DM.
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Affiliation(s)
- Lingling Deng
- Department of Radiology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Huasheng Liu
- Department of Radiology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Huanghui Liu
- Department of Radiology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Jun Liu
- Department of Radiology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Wen Liu
- Department of Radiology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Yan Liu
- Department of Radiology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Youming Zhang
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Pengfei Rong
- Department of Radiology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Qi Liang
- Department of Radiology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Wei Wang
- Department of Radiology, The Third Xiangya Hospital of Central South University, Changsha, China
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23
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Feng Y, Li Y, Tan X, Liang Y, Ma X, Chen Y, Lv W, Wu J, Kang S, Li M, Qiu S. Altered Gray Matter Volume, Functional Connectivity, and Degree Centrality in Early-Onset Type 2 Diabetes Mellitus. Front Neurol 2021; 12:697349. [PMID: 34566841 PMCID: PMC8459017 DOI: 10.3389/fneur.2021.697349] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 08/12/2021] [Indexed: 12/17/2022] Open
Abstract
Background: Structural and functional brain alterations that underlie cognitive decline have been observed in elderly adults with type 2 diabetes mellitus (T2DM); however, whether these alterations can be observed in patients with early-onset T2DM remains unclear. Therefore, we aimed to describe the abnormalities in brain volume and functional patterns in patients with early-onset T2DM in the present study. Methods: We enrolled 20 patients with early-onset T2DM and 20 healthy controls (HCs). Changes in brain volume were assessed using voxel-based morphology (VBM), while changes in brain function were assessed using degree centrality (DC) and functional connectivity (FC). Results: Compared to HCs, patients with early-onset T2DM exhibited gray matter reductions in the left orbital superior, middle, and inferior frontal gyri as well as the right superior frontal gyrus. The gray matter reductions in the right superior frontal gyrus were negatively associated with the urine albumin to creatinine ratio. Furthermore, increased DC values were observed in the left superior temporal gyrus, left Heschl gyrus, and left hippocampus in patients with early-onset T2DM. An FC analysis of these regions revealed elevated connectivity in the right precuneus, left inferior parietal gyrus, left Heschl gyrus, bilateral post-central gyrus, bilateral insula, bilateral superior temporal gyrus, and bilateral medial and paracingulate gyrus. Furthermore, the FC of the hubs to the superior temporal gyrus, insula, and Heschl gyrus was increased and positively correlated with trail making test-B. Conclusion: Decreased local gray matter volume and increased DC and FC may represent the neurobiological mechanism underlying cognitive dysfunction in patients with early-onset T2DM.
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Affiliation(s)
- Yue Feng
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yifan Li
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xin Tan
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yi Liang
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaomeng Ma
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuna Chen
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wenjiao Lv
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jinjian Wu
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shangyu Kang
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Mingrui Li
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shijun Qiu
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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24
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Zhang D, Wang M, Gao J, Huang Y, Qi F, Lei Y, Ai K, Yan X, Cheng M, Su Y, Lei X, Zhang X. Altered Functional Connectivity of Insular Subregions in Type 2 Diabetes Mellitus. Front Neurosci 2021; 15:676624. [PMID: 34220433 PMCID: PMC8242202 DOI: 10.3389/fnins.2021.676624] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 05/06/2021] [Indexed: 01/09/2023] Open
Abstract
Diabetes-related brain damage can lead to cognitive decline and increase the risk of depression, but the neuropathological mechanism of this phenomenon remains unclear. Different insular subregions have obvious functional heterogeneity, which is related to many aspects of type 2 diabetes mellitus (T2DM)-related brain damage. However, little is known about changes in functional connectivity (FC) in insular subregions in patients with T2DM. Therefore, we aimed to investigate FC between different insular subregions and clinical/cognitive variables in patients with T2DM. Fifty-seven patients with T2DM and 55 healthy controls (HCs) underwent a neuropsychological assessment and resting-state FC examination. We defined three insular subregions, including the bilateral dorsal anterior insula (dAI), bilateral ventral anterior insula (vAI), and bilateral posterior insula (PI). We examined differences in FC between insular subregions and the whole brain in patients with T2DM compared with HCs. A correlation analysis was performed to examine the relationship between FC and clinical/cognitive variables. Compared with HCs, patients with T2DM showed significantly decreased FC between the dAI and the right inferior frontal gyrus, right superior/middle temporal gyrus, right hippocampus, and right precentral gyrus. FC between the vAI and the right supramarginal gyrus, as well as the PI and the right precentral/postcentral gyrus, was reduced in the T2DM group compared with the control group. In the T2DM group, we showed a significant negative correlation between glycated hemoglobin concentration and FC in the dAI and right hippocampus (r = −0.428, P = 0.001) after Bonferroni correction. We conclude that different insular subregions present distinct FC patterns with functional regions and that abnormal FC in these insular subregions may affect cognitive, emotional, and sensorimotor functions in patients with T2DM.
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Affiliation(s)
- Dongsheng Zhang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Man Wang
- Department of Graduate, Xi'an Medical University, Xi'an, China
| | - Jie Gao
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Yang Huang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Fei Qi
- Department of Graduate, Xi'an Medical University, Xi'an, China
| | - Yumeng Lei
- Department of Graduate, Xi'an Medical University, Xi'an, China
| | - Kai Ai
- Department of Clinical Science, Philips Healthcare, Xi'an, China
| | - Xuejiao Yan
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Miao Cheng
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Yu Su
- Department of Graduate, Xi'an Medical University, Xi'an, China
| | - Xiaoyan Lei
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Xiaoling Zhang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
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25
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Qi F, Zhang D, Gao J, Tang M, Wang M, Su Y, Lei Y, Shao Z, Zhang X. Functional Disconnection of the Angular Gyrus Related to Cognitive Impairment in Patients With Type 2 Diabetes Mellitus. Front Hum Neurosci 2021; 15:621080. [PMID: 33613213 PMCID: PMC7886792 DOI: 10.3389/fnhum.2021.621080] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 01/12/2021] [Indexed: 11/25/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is related to a variety of cognitive impairments that may even progress to dementia. Studies have found the angular gyrus (AG) is a cross-modal integration hub that is involved in a variety of cognitive processes. However, few studies have focused on the patterns of resting-state functional connections (rsFCs) of the AG in patients with T2DM. This study explored the functional connection (FC) between the AG and the whole brain and the relationship between the FC and clinical/cognitive variables in patients with T2DM. 44 patients with T2DM and 43 sex-, age-, and education-matched healthy controls underwent resting-state fMRI and received neuropsychological assessments. Compared with the control group, the T2DM group showed abnormal rsFCs between the AG and multiple brain regions. The FC between the left AG and the left medial temporal lobe in the T2DM group was positively correlated with scores on the Montreal Cognitive Assessment, after a Bonferroni correction (r = 0.40, P = 0.009). Collectively, patients with T2DM have abnormal FCs between the AG and extensive brain regions that may be related to various cognitive processes.
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Affiliation(s)
- Fei Qi
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Dongsheng Zhang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Jie Gao
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Min Tang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Man Wang
- Department of Graduate, Xi'an Medical University, Xi'an, China
| | - Yu Su
- Department of Graduate, Xi'an Medical University, Xi'an, China
| | - Yumeng Lei
- Department of Graduate, Xi'an Medical University, Xi'an, China
| | - Zhirong Shao
- Department of Graduate, Xi'an Medical University, Xi'an, China
| | - Xiaoling Zhang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
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26
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Zhuang L, Ni H, Wang J, Liu X, Lin Y, Su Y, Zhang K, Li Y, Peng G, Luo B. Aggregation of Vascular Risk Factors Modulates the Amplitude of Low-Frequency Fluctuation in Mild Cognitive Impairment Patients. Front Aging Neurosci 2020; 12:604246. [PMID: 33408627 PMCID: PMC7779477 DOI: 10.3389/fnagi.2020.604246] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/30/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Several vascular risk factors, including hypertension, diabetes, body mass index, and smoking status are found to be associated with cognitive decline and the risk of Alzheimer's disease (AD). We aimed to investigate whether an aggregation of vascular risk factors modulates the amplitude of low-frequency fluctuation (ALFF) in patients with mild cognitive impairment (MCI). Methods: Forty-three MCI patients and twenty-nine healthy controls (HCs) underwent resting-state functional MRI scans, and spontaneous brain activity was measured by the ALFF technique. The vascular risk profile was represented with the Framingham Heart Study general cardiovascular disease (FHS-CVD) risk score, and each group was further divided into high and low risk subgroups. Two-way ANOVA was performed to explore the main effects of diagnosis and vascular risk and their interaction on ALFF. Results: The main effect of diagnosis on ALFF was found in left middle temporal gyrus (LMTG) and left superior parietal gyrus (LSPG), and the main effect of risk on ALFF was detected in left fusiform gyrus (LFFG), left precuneus (LPCUN), and left cerebellum posterior lobe (LCPL). Patients with MCI exhibited increased ALFF in the LMTG and LSPG than HCs, and participants with high vascular risk showed increased ALFF in the LFFG and LCPL, while decreased ALFF in the LPCUN. An interaction between diagnosis (MCI vs. HC) and FHS-CVD risk (high vs. low) regarding ALFF was observed in the left hippocampus (LHIP). HCs with high vascular risk showed significantly increased ALFF in the LHIP than those with low vascular risk, while MCI patients with high vascular risk showed decreased ALFF in the LHIP than HCs with high vascular risk. Interestingly, the mean ALFF of LHIP positively correlated with word recall test in HCs with high vascular risk (rho = 0.630, P = 0.016), while negatively correlated with the same test in MCI patients with high vascular risk (rho = −0.607, P = 0.001). Conclusions: This study provides preliminary evidence highlighting that the aggregation of vascular risk factors modulates the spontaneous brain activity in MCI patients, and this may serve as a potential imaging mechanism underlying vascular contribution to AD.
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Affiliation(s)
- Liying Zhuang
- Department of Neurology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Department of Neurology, Zhejiang Hospital, Hangzhou, China
| | - Huafu Ni
- Department of Neurology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Department of Neurology, Beilun People's Hospital, Ningbo, China
| | - Junyang Wang
- Department of Neurology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoyan Liu
- Department of Neurology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yajie Lin
- Department of Neurology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yujie Su
- Department of Neurology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Kan Zhang
- Department of Neurology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yaguo Li
- Department of Neurology, Zhejiang Hospital, Hangzhou, China
| | - Guoping Peng
- Department of Neurology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Benyan Luo
- Department of Neurology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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27
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Zhang D, Qi F, Gao J, Yan X, Wang Y, Tang M, Zhe X, Cheng M, Wang M, Xie Q, Su Y, Zhang X. Altered Cerebellar-Cerebral Circuits in Patients With Type 2 Diabetes Mellitus. Front Neurosci 2020; 14:571210. [PMID: 33071743 PMCID: PMC7541847 DOI: 10.3389/fnins.2020.571210] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/19/2020] [Indexed: 12/22/2022] Open
Abstract
The role of the cerebellum in type 2 diabetes mellitus (T2DM) has been receiving increased attention. However, the functional connectivity (FC) between the cerebellar subregions and the cerebral cortex has not been investigated in T2DM. Therefore, the purpose of this study was to investigate cerebellar-cerebral FC and the relationship between FC and clinical/cognitive variables in patients with T2DM. A total of 34 patients with T2DM and 30 healthy controls were recruited for this study to receive a neuropsychological assessment and undergo resting-state FC. We selected four subregions of the cerebellum (bilateral lobules IX, right and left Crus I/II, and left lobule VI) as regions of interest (ROIs) to examine the differences in cerebellar-cerebral circuits in patients with T2DM compared to healthy controls. Correlation analysis was performed to examine the relationship between FC and clinical/cognitive variables in the patients. Compared to healthy controls, patients with T2DM showed significantly decreased cerebellar-cerebral FC in the default-mode network (DMN), executive control network (ECN), and visuospatial network (VSN). In the T2DM group, the FC between the left cerebellar lobule VI and the right precuneus was negatively correlated with the Trail Making Test A (TMT-A) score (r = −0.430, P = 0.013), after a Bonferroni correction. In conclusion, patients with T2DM have altered FC between the cerebellar subregions and the cerebral networks involved in cognitive and emotional processing. This suggests that a range of cerebellar-cerebral circuits may be involved in the neuropathology of T2DM cognitive dysfunction.
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Affiliation(s)
- Dongsheng Zhang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Fei Qi
- Department of Graduate, Xi'an Medical University, Xi'an, China
| | - Jie Gao
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Xuejiao Yan
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Yarong Wang
- Department of Diagnostic Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Min Tang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Xia Zhe
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Miao Cheng
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Man Wang
- Department of Graduate, Xi'an Medical University, Xi'an, China
| | - Qingming Xie
- Department of Graduate, Xi'an Medical University, Xi'an, China
| | - Yu Su
- Department of Graduate, Xi'an Medical University, Xi'an, China
| | - Xiaoling Zhang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
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28
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Li Y, Liang Y, Tan X, Chen Y, Yang J, Zeng H, Qin C, Feng Y, Ma X, Qiu S. Altered Functional Hubs and Connectivity in Type 2 Diabetes Mellitus Without Mild Cognitive Impairment. Front Neurol 2020; 11:1016. [PMID: 33071928 PMCID: PMC7533640 DOI: 10.3389/fneur.2020.01016] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/03/2020] [Indexed: 01/06/2023] Open
Abstract
Background: Type 2 diabetes mellitus (T2DM)-related cognitive decline is associated with neuroimaging changes. However, only a few studies have focused on early functional alteration in T2DM prior to mild cognitive impairment (MCI). This study aimed to investigate the early changes of global connectivity patterns in T2DM by using a resting-state functional magnetic resonance imaging (rs-fMRI) technique. Methods: Thirty-four T2DM subjects and 38 age-, sex-, and education-matched healthy controls (HCs) underwent rs-fMRI in a 3T MRI scanner. Degree centrality (DC) was used to identify the functional hubs of the whole brain in T2DM without MCI. Then the functional connectivity (FC) between hubs and the rest of the brain was assessed by using the hub-based approach. Results: Compared with HCs, T2DM subjects showed increased DC in the right cerebellum lobules III-V. Hub-based FC analysis found that the right cerebellum lobules III-V of T2DM subjects had increased FC with the right cerebellum crus II and lobule VI, the right temporal inferior/middle gyrus, and the right hippocampus. Conclusions: Increased DC in the right cerebellum regions III-V, as well as increased FC within cerebellar regions and ipsilateral cerebrocerebellar regions, may indicate an important pathophysiological mechanism for compensation in T2DM without MCI.
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Affiliation(s)
- Yifan Li
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yi Liang
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xin Tan
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuna Chen
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jinquan Yang
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hui Zeng
- Department of Radiology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
| | - Chunhong Qin
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yue Feng
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaomeng Ma
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shijun Qiu
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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29
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Karvani M, Kapoukranidou D. Implementation of Imaging Methods in Evaluation of T2DM-Correlated Brain Alterations and Cognitive Dysfunction. ACTA INFORMATICA MEDICA : AIM : JOURNAL OF THE SOCIETY FOR MEDICAL INFORMATICS OF BOSNIA & HERZEGOVINA : CASOPIS DRUSTVA ZA MEDICINSKU INFORMATIKU BIH 2020; 28:138-143. [PMID: 32742067 PMCID: PMC7382768 DOI: 10.5455/aim.2020.28.138-143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Introduction: There has been mounting evidence that type 2 diabetes mellitus (T2DM) populations are prone to aberrant brain functionality and cognitive deficits. Hyperglycemic status and insulin resistance, among other factors, have been associated with compromised brain neural congruity, leading to lower cognitive performance. Aim: The aim of the present paper is to provide a comprehensive review of imaging techniques and their applicability in detection of brain changes in the setting of T2DM. Methods: A search of PubMed electronic database was followed. Primary search terms included “imaging methods”, “type 2 diabetes” and “cognitive impairment”. Results: A range of imaging modalities that can be of value in depiction of diabetes-mediated structural and functional brain aberrations. Conclusion: An increasingly body of research points to the adverse effect T2DM exerts on brain integrity and higher cognitive skills. Findings support the role of imaging techniques in delineation of brain divergence in middle-aged and older diabetic populations.
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Affiliation(s)
- Marianna Karvani
- Physiology Department, Health Science School, Medical School, Aristotle University of Thessaloniki, Greece
| | - Dorothea Kapoukranidou
- Physiology Department, Health Science School, Medical School, Aristotle University of Thessaloniki, Greece
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30
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Cardiometabolic determinants of early and advanced brain alterations: Insights from conventional and novel MRI techniques. Neurosci Biobehav Rev 2020; 115:308-320. [DOI: 10.1016/j.neubiorev.2020.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/21/2020] [Accepted: 04/02/2020] [Indexed: 12/11/2022]
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31
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Zhu Y, Lu T, Xie C, Wang Q, Wang Y, Cao X, Su Y, Wang Z, Zhang Z. Functional Disorganization of Small-World Brain Networks in Patients With Ischemic Leukoaraiosis. Front Aging Neurosci 2020; 12:203. [PMID: 32719596 PMCID: PMC7348592 DOI: 10.3389/fnagi.2020.00203] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 06/11/2020] [Indexed: 01/15/2023] Open
Abstract
Cognitive impairment is a key clinical feature of ischemic leukoaraiosis (ILA); however, the underlying neurobiological mechanism is still unclear. ILA has been associated with widespread gray and white matter (WM) damage mainly located in cortical-cortical and cortico-subcortical pathways. A total of 36 patients with ILA (Fazekas rating score ≥2) and 31 healthy controls (HCs) underwent comprehensive neuropsychological assessments (covering four cognitive domains, i.e., information processing speed, episodic memory, executive and visuospatial function) and resting-state functional MRI scans. Graph theory-based analyses were employed to explore the topological organization of the brain connectome in ILA patients, and we further sought to explore the associations of connectome-based metrics and neuropsychological performances. An efficient small-world architecture in the functional brain connectome was observed in the ILA and control groups. Moreover, compared with the HCs, the ILA patients showed increased path length and decreased network efficiency (i.e., global and local efficiency) in their functional brain networks. Further network-based statistic (NBS) analysis revealed a functional-disconnected network in ILA, which is comprised of functional connections linking different brain modules (i.e., default mode, frontoparietal, ventral attention and limbic systems) and connections within single modules (i.e., ventral attention and limbic systems). Intriguingly, the abnormal network metrics correlated with cognitive deficits in ILA patients. Therefore, our findings provide further evidence to support the concept that ILA pathologies could disrupt brain connections, impairing network functioning, and cognition via a “disconnection syndrome.”
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Affiliation(s)
- Yixin Zhu
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Tong Lu
- Department of Radiology, ZhongDa Hospital Affiliated to Southeast University, Nanjing, China
| | - Chunming Xie
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Qing Wang
- Department of Radiology, ZhongDa Hospital Affiliated to Southeast University, Nanjing, China
| | - Yanjuan Wang
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Xuejin Cao
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yuting Su
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zan Wang
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zhijun Zhang
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
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32
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Liu K, Song J, Jin J, Huang X, Ye X, Cui S, Zhou Y, Liu X, Chen W, Yan Z, Shan X, Fu Y. Abnormal Functional Connectivity Density in New-Onset Type 1 Diabetes Mellitus Children: A Resting-State Functional Magnetic Resonance Imaging Study. Front Psychiatry 2020; 11:284. [PMID: 32362844 PMCID: PMC7181059 DOI: 10.3389/fpsyt.2020.00284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/24/2020] [Indexed: 12/25/2022] Open
Abstract
Type 1 diabetes mellitus (T1DM) causes cognitive changes in children, which may be due to deficits in brain functions. It is unclear whether T1DM children will have brain functional changes during the initial stage of the disease. We aimed to investigate the changes in the functional brain network topology in children with new-onset T1DM. In this study, 35 new-onset T1DM children and 33 age-, sex-matched healthy controls underwent resting-state fMRI. The whole brain functional connectivity density (FCD) analysis and seed-based functional connectivity (FC) analysis were performed to investigate the changes in functional brain networks in new-onset T1DM children when compared with the controls. Pearson correlational analysis was used to explore the correlation between FCD value of differential brain areas and clinical variables in T1DM children. Compared with the controls, children with new-onset T1DM exhibited significantly decreased FCDs of the right inferior temporal gyrus (ITG) and the right posterior cingulate cortex (PCC). In the subsequent FC analysis, decreased FC was found between right PCC and right cuneus and increased FC was found between right ITG and left orbital part of inferior frontal gyrus in children with new-onset T1DM compared to the controls. The FCD values of right ITG and PCC did not correlate with HbA1c, blood glucose level before imaging, and full-scale intelligence quotient (IQ) in T1DM children. These results revealed that T1DM affect the functional activity of the immature brain at the initial stage. These findings also indicate a decrease in regional brain function and abnormalities in temporal-frontal and limbic-occipital circuitry in children with new-onset T1DM, and highlight the effects of T1DM on children's brain networks involved in visual process and memory, which may contribute to the cognition impairments observed in children with T1DM.
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Affiliation(s)
- Kun Liu
- Radiology Department, China-USA Neuroimaging Research Institute, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jiawen Song
- Radiology Department, China-USA Neuroimaging Research Institute, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jiahui Jin
- Department of Pediatric Endocrine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiaoyan Huang
- Radiology Department, China-USA Neuroimaging Research Institute, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xinjian Ye
- Radiology Department, China-USA Neuroimaging Research Institute, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Shihan Cui
- Radiology Department, China-USA Neuroimaging Research Institute, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yongjin Zhou
- Radiology Department, China-USA Neuroimaging Research Institute, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiaozheng Liu
- Radiology Department, China-USA Neuroimaging Research Institute, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Wei Chen
- Department of Psychiatry, Sir Run Run Shaw Hospital, Collaborative Innovation Center for Brain Science, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhihan Yan
- Radiology Department, China-USA Neuroimaging Research Institute, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiaoou Shan
- Department of Pediatric Endocrine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yuchuan Fu
- Radiology Department, China-USA Neuroimaging Research Institute, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
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33
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Karvani M, Simos P, Stavrakaki S, Kapoukranidou D. Neurocognitive impairment in type 2 diabetes mellitus. Hormones (Athens) 2019; 18:523-534. [PMID: 31522366 DOI: 10.1007/s42000-019-00128-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 08/05/2019] [Indexed: 12/24/2022]
Abstract
There is emerging evidence that cognitive impairment could be a diabetes mellitus-related complication. It has been suggested that diabetic people are at increased risk of cognitive decline, since the metabolic and vascular disturbances of the disease affect brain function. Additionally, prolonged exposure to olther potential detrimental factors leads to irreversible cognitive decrements over time due to the aging process. Neurocognitive impairment signifies decreased performance in cognitive domains such as verbal and nonverbal memory, both immediate and delayed memory, executive function, attention, visuospatial and psychomotor performance, information processing speed, semantic knowledge, and language abilities. The aim of the present article is to review the existing literature on the issue of the neurocognitive decline in type 2 diabetes. A literature search of databases was performed, using as keywords "diabetes" and "cognitive impairment," and the reference list of papers so identified were examined, with only English language papers being used. Understanding and preventing diabetes-associated cognitive deficits remains a key priority for future research. It is important to ascertain whether interventions to delay diabetes onset or better control of established disease could prevent some of its adverse effects on cognitive skills.
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Affiliation(s)
- Marianna Karvani
- Department of Physiology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - P Simos
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, Herakleion, Crete, Greece
| | - S Stavrakaki
- Department of Italian Language and Literature, School of Philosophy, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - D Kapoukranidou
- Department of Physiology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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