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Yang XY, Yang CJ, Wang XF, Zhang L, Shi ZY, Jiang DC, Li MZ. Berberine improves cognitive impairment by alleviating brain atrophy and promoting white matter reorganization in diabetic db/db mice: a magnetic resonance imaging-based study. Metab Brain Dis 2024; 39:941-952. [PMID: 38801506 DOI: 10.1007/s11011-024-01361-4] [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: 11/30/2023] [Accepted: 05/23/2024] [Indexed: 05/29/2024]
Abstract
Diabetic cognitive impairment is a common complication in type 2 diabetes. Berberine (BBR) is an isoquinoline alkaloid that has been shown to have neuroprotective effects against diabetes. This study aimed to investigate the effect of BBR on the gray and white matter of the brain by using magnetic resonance imaging (MRI) and to explore the underlying mechanisms. The study used diabetic db/db mice and administered BBR (50 and 100 mg/kg) intragastrically for twelve weeks. Morris water maze was applied to examine cognitive function. T2-weighted imaging (T2WI) was performed to assess brain atrophy, and diffusion tensor imaging (DTI) combined with fiber tracking was conducted to monitor the structural integrity of the white matter, followed by histological immunostaining. Furthermore, the protein expressions of the phosphatidylinositol 3-kinase (PI3K)/ protein kinase B (AKT)/ glycogen synthase kinase-3β (GSK-3β) were detected. The results revealed that BBR significantly improved the spatial learning and memory of the db/db mice. T2WI exhibited ameliorated brain atrophy in the BBR-treated db/db mice, as evidenced by reduced ventricular volume accompanied by increased hippocampal volumes. DTI combined with fiber tracking revealed that BBR increased FA, fiber density and length in the corpus callosum/external capsule of the db/db mice. These imaging findings were confirmed by histological immunostaining. Notably, BBR significantly enhanced the protein levels of phosphorylated AKT at Ser473 and GSK-3β at Ser9. Collectively, this study demonstrated that BBR significantly improved the cognitive function of the diabetic db/db mice through ameliorating brain atrophy and promoting white matter reorganization via AKT/GSK-3β pathway.
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Affiliation(s)
- Xin-Yu Yang
- Department of pharmacy, Beijing Shijitan Hospital, Capital Medical University, No.10 Tieyi Road, Haidian District, Beijing, 100038, China
- Beijing Key Laboratory of Bio-characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038, China
| | - Chun-Jing Yang
- Department of pharmacy, Beijing Shijitan Hospital, Capital Medical University, No.10 Tieyi Road, Haidian District, Beijing, 100038, China
- Beijing Key Laboratory of Bio-characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038, China
| | - Xiao-Fang Wang
- Department of pharmacy, Beijing Shijitan Hospital, Capital Medical University, No.10 Tieyi Road, Haidian District, Beijing, 100038, China
- Beijing Key Laboratory of Bio-characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038, China
| | - Lei Zhang
- Department of pharmacy, Beijing Shijitan Hospital, Capital Medical University, No.10 Tieyi Road, Haidian District, Beijing, 100038, China
- Beijing Key Laboratory of Bio-characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038, China
| | - Zheng-Yuan Shi
- Department of pharmacy, Beijing Shijitan Hospital, Capital Medical University, No.10 Tieyi Road, Haidian District, Beijing, 100038, China
- Beijing Key Laboratory of Bio-characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038, China
| | - De-Chun Jiang
- Department of pharmacy, Beijing Shijitan Hospital, Capital Medical University, No.10 Tieyi Road, Haidian District, Beijing, 100038, China.
- Beijing Key Laboratory of Bio-characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038, China.
| | - Man-Zhong Li
- Department of pharmacy, Beijing Shijitan Hospital, Capital Medical University, No.10 Tieyi Road, Haidian District, Beijing, 100038, China.
- Beijing Key Laboratory of Bio-characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038, China.
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Kim RY, Joo Y, Ha E, Hong H, Suh C, Shim Y, Lee H, Kim Y, Cho JH, Yoon S, Lyoo IK. Alterations in Brain Morphometric Networks and Their Relationship with Memory Dysfunction in Patients with Type 2 Diabetes Mellitus. Exp Neurobiol 2024; 33:107-117. [PMID: 38724480 PMCID: PMC11089400 DOI: 10.5607/en24005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 03/31/2024] [Accepted: 04/09/2024] [Indexed: 05/15/2024] Open
Abstract
Cognitive dysfunction, a significant complication of type 2 diabetes mellitus (T2DM), can potentially manifest even from the early stages of the disease. Despite evidence of global brain atrophy and related cognitive dysfunction in early-stage T2DM patients, specific regions vulnerable to these changes have not yet been identified. The study enrolled patients with T2DM of less than five years' duration and without chronic complications (T2DM group, n=100) and demographically similar healthy controls (control group, n=50). High-resolution T1-weighted magnetic resonance imaging data were subjected to independent component analysis to identify structurally significant components indicative of morphometric networks. Within these networks, the groups' gray matter volumes were compared, and distinctions in memory performance were assessed. In the T2DM group, the relationship between changes in gray matter volume within these networks and declines in memory performance was examined. Among the identified morphometric networks, the T2DM group exhibited reduced gray matter volumes in both the precuneus (Bonferroni-corrected p=0.003) and insular-opercular (Bonferroni-corrected p=0.024) networks relative to the control group. Patients with T2DM demonstrated significantly lower memory performance than the control group (p=0.001). In the T2DM group, reductions in gray matter volume in both the precuneus (r=0.316, p=0.001) and insular-opercular (r=0.199, p=0.047) networks were correlated with diminished memory performance. Our findings indicate that structural alterations in the precuneus and insular-opercular networks, along with memory dysfunction, can manifest within the first 5 years following a diagnosis of T2DM.
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Affiliation(s)
- Rye Young Kim
- Ewha Brain Institute, Ewha Womans University, Seoul 03760, Korea
| | - Yoonji Joo
- Ewha Brain Institute, Ewha Womans University, Seoul 03760, Korea
| | - Eunji Ha
- Ewha Brain Institute, Ewha Womans University, Seoul 03760, Korea
| | - Haejin Hong
- Ewha Brain Institute, Ewha Womans University, Seoul 03760, Korea
| | - Chaewon Suh
- Ewha Brain Institute, Ewha Womans University, Seoul 03760, Korea
| | - Youngeun Shim
- Ewha Brain Institute, Ewha Womans University, Seoul 03760, Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul 03760, Korea
| | - Hyeonji Lee
- Ewha Brain Institute, Ewha Womans University, Seoul 03760, Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul 03760, Korea
| | - Yejin Kim
- Ewha Brain Institute, Ewha Womans University, Seoul 03760, Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul 03760, Korea
| | - Jae-Hyoung Cho
- Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Sujung Yoon
- Ewha Brain Institute, Ewha Womans University, Seoul 03760, Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul 03760, Korea
| | - In Kyoon Lyoo
- Ewha Brain Institute, Ewha Womans University, Seoul 03760, Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul 03760, Korea
- Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul 03760, Korea
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Duan Q, Wang Z, Cheung W, Liu J, Zhang H, Qiao W, Zhang Q. Functional decoding and meta-analytic connectivity modeling in thyroid-associated ophthalmopathy. Heliyon 2024; 10:e23749. [PMID: 38226223 PMCID: PMC10788440 DOI: 10.1016/j.heliyon.2023.e23749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 10/24/2023] [Accepted: 12/12/2023] [Indexed: 01/17/2024] Open
Abstract
Background Thyroid-associated ophthalmopathy (TAO) is an orbital disease closely related to thyroid disease with a long-lasting duration that can be blinding and disabling. Recently, structural and functional neuroimaging studies have been performed in TAO patients, but studies have reported inconsistent results. This quantitative meta-analysis was conducted to identify convergent patterns of abnormal brain function among different studies in TAO. Methods We searched PubMed, EMBASE, Cochrane, and Web of Science, performed reference tracking, and retrieved 15 eligible studies. Peak coordinates were extracted from these studies and subsequently tested for convergence using activation likelihood estimation (ALE). Results Compared to healthy subjects, resting-state brain activity in the whole brain of TAO patients was significantly increased in the left superior frontal gyrus (SFG) and decreased in the left cuneus/precuneus. Functional decoding analysis of the BrainMap database revealed that these regions are predominantly associated with cognitive and emotional impairment. In this study, task-related meta-analytic connectivity modeling (MACM) analysis was used to describe the connectivity and function of the two seed regions. Significant coactivation of these regions was found primarily in the bilateral superior parietal lobule, medial frontal gyrus, left fusiform gyrus, left cingulate gyrus, supplementary motor area and thalamus. Conclusion Our findings underscore the role of the SFG and the cuneus/precuneus in the pathophysiology of TAO, highlighting the crucial impact of working memory deficits.
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Affiliation(s)
- Qidang Duan
- School of Basic Medicine and Life Science, Hainan Medical University, Haikou, 571199, China
| | - Zhihong Wang
- The first people's hospital of lanzhou city, Lanzhou, 730000, China
| | | | - Jing Liu
- Department of Endocrinology and Gerontology, Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Huiyan Zhang
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, 750000, China
| | - Wenjun Qiao
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, 750000, China
| | - Qi Zhang
- Department of Endocrinology and Gerontology, Gansu Provincial Hospital, Lanzhou, 730000, China
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Choi KS, Hwang I, Moon JH, Kim M. Progressive reduction in basal ganglia explains and predicts cerebral structural alteration in type 2 diabetes. J Cereb Blood Flow Metab 2023; 43:2096-2104. [PMID: 37632261 PMCID: PMC10925861 DOI: 10.1177/0271678x231197273] [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: 02/28/2023] [Revised: 06/21/2023] [Accepted: 07/03/2023] [Indexed: 08/27/2023]
Abstract
Type 2 diabetes is consistently reported to be associated with reduced gray matter, mainly in the cortical-striatal-limbic networks. However, little is known about how the progression of diabetes affects cerebral gray matter. To investigate, we collected 543 age- and sex-matched participants of nondiabetes, prediabetes, and diabetes. Voxel-based morphometry using a linear trend model was performed to reveal brain regions associated with disease progression. The Granger causal network of structural covariance was used to assess the causal relationships of brain structural alterations according to disease progression. Multivariate pattern analysis was applied for the stage-specific predictions of hyperglycemia. We detected a linear trend of gray matter volume reduction in the basal ganglia with disease progression (P < 0.05, FWER corrected), which caused a reduction in bilateral temporal gyri, frontal pole, parahippocampus, and bilateral posterior cingulate/precuneus volumes. In addition, the gray matter pattern of the basal ganglia could predict patients with diabetes (accuracy 60.12%, p = 0.002). In conclusion, the basal ganglia is the brain area with progressive gray matter reduction as diabetes progress. The reduced volume in the basal ganglia causes widespread gray matter reductions throughout diabetes progression. These findings indicate that the basal ganglia play a key role in diabetes by affecting the cortical-striatal-limbic network.
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Affiliation(s)
- Kyu Sung Choi
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Inpyeong Hwang
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Joon Ho Moon
- Divison of Endocrinology & Metabolism, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Minchul Kim
- Department of Radiology, Kangnam Sacred Heart Hospital, Hallym University School of Medicine, Seoul, Korea
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Li MZ, Zhang L, Shi ZY, Jiang DC, Yang XY. Magnetic resonance imaging detects cerebral gray and white matter injury correlated with cognitive impairments in diabetic db/db mice. Behav Brain Res 2023; 451:114510. [PMID: 37244436 DOI: 10.1016/j.bbr.2023.114510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/08/2023] [Accepted: 05/25/2023] [Indexed: 05/29/2023]
Abstract
Type-2 diabetes not only causes gray matter injury but also induces widespread white matter damages, which may contribute the cognitive impairments. This study aimed to assess the structural alterations of the gray and white matter in 20-week-old diabetic db/db mice using magnetic resonance imaging including T2-weighted imaging (T2WI) and diffusion tensor imaging (DTI), and to correlate them with the cognitive performance detected by Morris water maze (MWM). The results revealed impaired spatial learning and memory in db/db mice. T2WI detected severe brain atrophy involving the hippocampus and cortex after diabetes. DTI showed reduced fractional anisotropy (FA) in the cortex, hippocampus, corpus callosum/external capsule, and increased radial diffusivity in the corpus callosum/external capsule of the db/db mice. The immunostaining confirmed the MRI findings showing decreased cell density in the cortex, hippocampus, and reduced integrated optical density of Luxol fast blue staining in the corpus callosum/external capsule. The correlational analysis revealed that the T2WI-derived tissue atrophy and DTI-derived FA in the relevant gray matter and white matter significantly correlated with the behavior performance in the MWM test. Collectively, the present in vivo MRI detected varying degrees of structural abnormalities in the gray and white matter of db/db mice, which might be favorable predictors of diabetic cognitive dysfunction. Our findings might provide new clues for identifying gray and white matter damages associated with cognitive decline, which is imperative for the evaluation of potential pharmacological therapies in preclinical phase.
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Affiliation(s)
- Man-Zhong Li
- Department of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China; Beijing Key Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing 100038, China
| | - Lei Zhang
- Department of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China; Beijing Key Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing 100038, China
| | - Zheng-Yuan Shi
- Department of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China; Beijing Key Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing 100038, China
| | - De-Chun Jiang
- Department of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China; Beijing Key Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing 100038, China.
| | - Xin-Yu Yang
- Department of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China; Beijing Key Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing 100038, China.
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Gao Y, Sui C, Chen B, Xin H, Che Y, Zhang X, Wang N, Wang Y, Liang C. Voxel-based morphometry reveals the correlation between gray matter volume and serum P-tau-181 in type 2 diabetes mellitus patients with different HbA1c levels. Front Neurosci 2023; 17:1202374. [PMID: 37255749 PMCID: PMC10225590 DOI: 10.3389/fnins.2023.1202374] [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: 04/15/2023] [Accepted: 04/27/2023] [Indexed: 06/01/2023] Open
Abstract
Introduction Emerging evidence suggested widespread decreased gray matter volume (GMV) and tau hyperphosphorylation were associated with type 2 diabetes mellitus (T2DM). Insulin resistance is one of the mechanisms of neuron degeneration in T2DM; it can decrease the activity of protein kinase B and increase the activity of glycogen synthesis kinase-3β, thus promoting the hyperphosphorylation of tau protein and finally leading to neuronal degeneration. However, the association between GMV and serum tau protein phosphorylated at threonine 181 (P-tau-181) in T2DM patients lacks neuroimaging evidence. We aimed to investigate the difference in brain GMV between T2DM patients with different glycated hemoglobin A1c (HbA1c) levels and healthy control (HC) subjects and the correlation between serum P-tau-181 and GMV in T2DM patients. Methods Clinical parameters, biochemical indicators, and MRI data were collected for 41 T2DM patients with high glycosylated hemoglobin level (HGL), 17 T2DM patients with normal glycosylated hemoglobin level (NGL), and 42 HC subjects. Voxel-based morphometry (VBM) method was applied to investigate GMV differences among groups, and multiple regression analysis was used to examine the correlation between serum P-tau-181 and GMV. Results Compared with HC subjects, the T2DM patients with HGL or NGL all showed significantly decreased GMV. Briefly, the GMV decreased in T2DM patients with HGL was mainly in the bilateral parahippocampal gyrus (PHG), right middle temporal gyrus (MTG), temporal pole (TPOmid), hippocampus (HIP), and left lingual gyrus. The GMV reduction in T2DM patients with NGL was in the right superior temporal gyrus (STG), and there was no significant difference in GMV between the two diabetic groups. The GMV values of bilateral PHG, right MTG, TPOmid, HIP, and STG can significantly (p < 0.0001) distinguish T2DM patients from HC subjects in ROC curve analysis. In addition, we found that serum P-tau-181 levels were positively correlated with GMV in the right superior and middle occipital gyrus and cuneus, and negatively correlated with GMV in the right inferior temporal gyrus in T2DM patients. Conclusion Our study shows that GMV atrophy can be used as a potential biological indicator of T2DM and also emphasizes the important role of P-tau-181 in diabetic brain injury, providing new insights into the neuropathological mechanism of diabetic encephalopathy.
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Affiliation(s)
- Yian Gao
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Chaofan Sui
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Boyao Chen
- College of Radiology, Shandong First Medical University (Shandong Academy of Medical Sciences), Tai’an, Shandong, China
| | - Haotian Xin
- Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yena Che
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xinyue Zhang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Na Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yuanyuan Wang
- Department of Medical Imaging, Binzhou Medical University, Yantai, Shandong, China
| | - Changhu Liang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
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Shang X, Hill E, Liu J, Zhu Z, Ge Z, Wang W, He M. Association of type 1 diabetes and age at diagnosis of type 2 diabetes with brain volume and risk of dementia in the UK Biobank: A prospective cohort study of community-dwelling participants. Diabet Med 2023; 40:e14966. [PMID: 36177651 DOI: 10.1111/dme.14966] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 08/28/2022] [Accepted: 09/25/2022] [Indexed: 01/17/2023]
Abstract
AIMS To investigate the association of type 1 diabetes (T1D) and age at diagnosis of type 2 diabetes (T2D) with brain structure and incident dementia. METHODS Our analysis was based on the UK Biobank. We included 1376 participants with diabetes and 2752 randomly selected controls for brain volume analysis, and 25,141 participants with diabetes and 50,282 randomly selected controls for dementia analysis. Brain volume was measured using magnetic resonance imaging. Dementia was identified using hospital inpatient records and mortality register data until January 2021. RESULTS T2D diagnosed at a younger age was associated with larger reductions in brain volume. After adjustment for glycated haemoglobin (HbA1c) and other covariates, only T2D diagnosed <50 years was associated with smaller total brain volume (β (95% CI): -14.56 (-24.67, -4.44) ml), and grey (-6.47[-12.75, -0.20] ml) and white matter volumes (-8.08[-14.66, -1.51] ml). Corresponding numbers for total brain, grey matter and white matter volumes associated with T1D were -62.86 (-93.71,-32.01), -34.27 (-53.72, -14.83), and -28.59 (-47.65, -9.52) ml, respectively. During a median follow-up of 11.9 years, 2035 new dementia cases were identified. Younger age at diagnosis of T2D was associated with larger excessive risk of dementia, whereas T2D diagnosed <50 years was associated with the largest hazard ratio (HR) (95% CI: 2.03[1.53-2.69]) in the multivariable analysis. The HR (95% CI) for dementia associated with T1D was 2.08 (1.40-3.09). CONCLUSION Individuals with T1D or T2D diagnosed at younger age are at larger excessive risk of brain volume reduction and dementia.
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Affiliation(s)
- Xianwen Shang
- Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Eye Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
- Guangdong Cardiovascular Institute, Guangzhou, China
| | - Edward Hill
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - Jiahao Liu
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Zhuoting Zhu
- Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Eye Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
- Guangdong Cardiovascular Institute, Guangzhou, China
| | - Zongyuan Ge
- Monash e-Research Center, Faculty of Engineering, Airdoc Research, Nvidia AI Technology Research Center, Monash University, Melbourne, Victoria, Australia
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Mingguang He
- Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Eye Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- Centre for Eye Research Australia, Melbourne, Victoria, Australia
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Kang S, Chen Y, Wu J, Liang Y, Rao Y, Yue X, Lyu W, Li Y, Tan X, Huang H, Qiu S. Altered cortical thickness, degree centrality, and functional connectivity in middle-age type 2 diabetes mellitus. Front Neurol 2022; 13:939318. [PMID: 36408505 PMCID: PMC9672081 DOI: 10.3389/fneur.2022.939318] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 10/12/2022] [Indexed: 05/01/2024] Open
Abstract
PURPOSE This study aimed to investigate the changes in brain structure and function in middle-aged patients with type 2 diabetes mellitus (T2DM) using morphometry and blood oxygen level-dependent functional magnetic resonance imaging (BOLD-fMRI). METHODS A total of 44 middle-aged patients with T2DM and 45 matched healthy controls (HCs) were recruited. Surface-based morphometry (SBM) was used to evaluate the changes in brain morphology. Degree centrality (DC) and functional connectivity (FC) were used to evaluate the changes in brain function. RESULTS Compared with HCs, middle-aged patients with T2DM exhibited cortical thickness reductions in the left pars opercularis, left transverse temporal, and right superior temporal gyri. Decreased DC values were observed in the cuneus and precuneus in T2DM. Hub-based FC analysis of these regions revealed lower connectivity in the bilateral hippocampus and parahippocampal gyrus, left precuneus, as well as left frontal sup. CONCLUSION Cortical thickness, degree centrality, as well as functional connectivity were found to have significant changes in middle-aged patients with T2DM. Our observations provide potential evidence from neuroimaging for analysis to examine diabetes-related brain damage.
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Affiliation(s)
- Shangyu Kang
- The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuna Chen
- Department of Endocrinology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jinjian Wu
- The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yi Liang
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yawen Rao
- The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaomei Yue
- 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
| | - Yifan Li
- The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xin Tan
- 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
| | - Shijun Qiu
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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Tripathi S, Verghese J, Callisaya M, Mahoney JR, Srikanth V, Blumen HM. Brain patterns of pace - but not rhythm - are associated with vascular disease in older adults. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2022; 3:100154. [PMID: 36389342 PMCID: PMC9646823 DOI: 10.1016/j.cccb.2022.100154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 11/01/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022]
Abstract
Background Distinct domains of gait such as pace and rhythm are linked to an increased risk for cognitive decline, falls, and dementia in aging. The brain substrates supporting these domains and underlying diseases, however, remain relatively unknown. The current study aimed to identify patterns of gray matter volume (GMV) associated with pace and rhythm, and whether these patterns vary as a function of vascular and non-vascular comorbidities. Methods A cross-sectional sample of 297 older adults (M Age = 72.5 years ± 7.2 years, 43% women) without dementia was drawn from the Tasmanian Study of Cognition and Gait (TASCOG). Factor analyses were used to reduce eight quantitative gait variables into two domains. The "pace" domain was primarily composed of gait speed, stride length, and double support time. The "rhythm" domain was composed of swing time, stance time, and cadence. Multivariate covariance-based analyses adjusted for age, sex, education, total intracranial volume, and presence of mild cognitive impairment identified gray matter volume (GMV) patterns associated with pace and rhythm, as well as participant-specific expression (or factor) scores for each pattern. Results Pace was positively associated with GMV in the right superior temporal sulcus, bilateral supplementary motor areas (SMA), and bilateral cerebellar regions. Rhythm was positively associated with GMV in bilateral SMA, prefrontal, cingulate, and paracingulate cortices. The GMV pattern associated with pace was less expressed in participants with any vascular disease; this association was also found independently with hypertension, diabetes, and myocardial infarction. Conclusion Both pace and rhythm domains of gait were associated with the volume of brain structures that have been linked to controlled and automatic aspects of gait control, as well as with structures involved in multisensory integration. Only the brain structures associated with pace, however, were associated with vascular disease.
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Affiliation(s)
- Susmit Tripathi
- Department of Neurology, Weill Cornell Medicine, New York, NY 10065, USA
| | - Joe Verghese
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA,Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Michele Callisaya
- Peninsula Clinical School, Central Clinical School, Monash University, Victoria, Australia,Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | - Jeannette R. Mahoney
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Velandai Srikanth
- Peninsula Clinical School, Central Clinical School, Monash University, Victoria, Australia,Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | - Helena M. Blumen
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA,Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 10461, USA,Corresponding author at: Department of Medicine (Geriatrics), Department of Neurology (Cognitive & Motor Aging), Albert Einstein College of Medicine, 1225 Morris Park Avenue, Van Etten Building, Room 319 Bronx, NY 10461, USA.
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10
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Yang J, Wang Z, Fu Y, Xu J, Zhang Y, Qin W, Zhang Q. Prediction value of the genetic risk of type 2 diabetes on the amnestic mild cognitive impairment conversion to Alzheimer’s disease. Front Aging Neurosci 2022; 14:964463. [PMID: 36185474 PMCID: PMC9521369 DOI: 10.3389/fnagi.2022.964463] [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: 06/09/2022] [Accepted: 08/23/2022] [Indexed: 11/23/2022] Open
Abstract
Amnestic mild cognitive impairment (aMCI) and Type 2 diabetes mellitus (T2DM) are both important risk factors for Alzheimer’s disease (AD). We aimed to investigate whether a T2DM-specific polygenic risk score (PRSsT2DM) can predict the conversion of aMCI to AD and further explore the underlying neurological mechanism. All aMCI patients were from the Alzheimer’s disease Neuroimaging Initiative (ADNI) database and were divided into conversion (aMCI-C, n = 164) and stable (aMCI-S, n = 222) groups. PRSsT2DM was calculated by PRSice-2 software to explore the predictive efficacy of the aMCI conversion to AD. We found that PRSsT2DM could independently predict the aMCI conversion to AD after removing the common variants of these two diseases. PRSsT2DM was significantly negatively correlated with gray matter volume (GMV) of the right superior frontal gyrus in the aMCI-C group. In all aMCI patients, PRSsT2DM was significantly negatively correlated with the cortical volume of the right superior occipital gyrus. The cortical volume of the right superior occipital gyrus could significantly mediate the association between PRSsT2DM and aMCI conversion. Gene-based analysis showed that T2DM-specific genes are highly expressed in cortical neurons and involved in ion and protein binding, neural development and generation, cell junction and projection, and PI3K-Akt and MAPK signaling pathway, which might increase the aMCI conversion by affecting the Tau phosphorylation and amyloid-beta (Aβ) accumulation. Therefore, the PRSsT2DM could be used as a measure to predict the conversion of aMCI to AD.
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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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Gray and white matter abnormality in patients with T2DM-related cognitive dysfunction: a systemic review and meta-analysis. Nutr Diabetes 2022; 12:39. [PMID: 35970833 PMCID: PMC9378704 DOI: 10.1038/s41387-022-00214-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 07/05/2022] [Accepted: 07/15/2022] [Indexed: 12/03/2022] Open
Abstract
Aims/hypothesis Brain structure abnormality in patients with type 2 diabetes mellitus (T2DM)-related cognitive dysfunction (T2DM-CD) has been reported for decades in magnetic resonance imaging (MRI) studies. However, the reliable results were still unclear. This study aimed to make a systemic review and meta-analysis to find the significant and consistent gray matter (GM) and white matter (WM) alterations in patients with T2DM-CD by comparing with the healthy controls (HCs). Methods Published studies were systemically searched from PubMed, MEDLINE, Cochrane Library and Web of Science databases updated to November 14, 2021. Studies reporting abnormal GM or WM between patients with T2DM-CD and HCs were selected, and their significant peak coordinates (x, y, z) and effect sizes (z-score or t-value) were extracted to perform a voxel-based meta-analysis by anisotropic effect size-signed differential mapping (AES-SDM) 5.15 software. Results Total 15 studies and 16 datasets (1550 participants) from 7531 results were involved in this study. Compared to HCs, patients with T2DM-CD showed significant and consistent decreased GM in right superior frontal gyrus, medial orbital (PFCventmed. R, BA 11), left superior temporal gyrus (STG. L, BA 48), and right calcarine fissure / surrounding cortex (CAL. R, BA 17), as well as decreased fractional anisotropy (FA) in right inferior network, inferior fronto-occipital fasciculus (IFOF. R), right inferior network, longitudinal fasciculus (ILF. R), and undefined area (32, −60, −42) of cerebellum. Meta-regression showed the positive relationship between decreased GM in PFCventmed.R and MoCA score, the positive relationship between decreased GM in STG.L and BMI, as well as the positive relationship between the decreased FA in IFOF.R and age or BMI. Conclusions/interpretation T2DM impairs the cognitive function by affecting the specific brain structures. GM atrophy in PFCventmed. R (BA 11), STG. L (BA 48), and CAL. R (BA 17), as well as WM injury in IFOF. R, ILF. R, and undefined area (32, −60, −42) of cerebellum. And those brain regions may be valuable targets for future researches. Age, BMI, and MoCA score have a potential influence on the altered GM or WM in T2DM-CD.
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13
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Zhang J, Liu Y, Guo X, Guo J, Du Z, He M, Liu Q, Xu D, Liu T, Zhang J, Yuan H, Wang M, Li S. Causal Structural Covariance Network Suggesting Structural Alterations Progression in Type 2 Diabetes Patients. Front Hum Neurosci 2022; 16:936943. [PMID: 35911591 PMCID: PMC9336220 DOI: 10.3389/fnhum.2022.936943] [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: 05/05/2022] [Accepted: 06/16/2022] [Indexed: 12/02/2022] Open
Abstract
Background and Purpose According to reports, type 2 diabetes (T2D) is a progressive disease. However, no known research has examined the progressive brain structural changes associated with T2D. The purpose of this study was to determine whether T2D patients exhibit progressive brain structural alterations and, if so, how the alterations progress. Materials and Methods Structural magnetic resonance imaging scans were collected for 81 T2D patients and 48 sex-and age-matched healthy controls (HCs). Voxel-based morphometry (VBM) and causal structural covariance network (CaSCN) analyses were applied to investigate gray matter volume (GMV) alterations and the likely chronological processes underlying them in T2D. Two sample t-tests were performed to compare group differences, and the differences were corrected using Gaussian random field (GRF) correction (voxel-level p < 0.001, cluster-level p < 0.01). Results Our findings demonstrated that GMV alterations progressed in T2D patients as disease duration increased. In the early stages of the disease, the right temporal pole of T2D patients had GMV atrophy. As the diseases duration prolonged, the limbic system, cerebellum, subcortical structures, parietal cortex, frontal cortex, and occipital cortex progressively exhibited GMV alterations. The patients also exhibited a GMV alterations sequence exerting from the right temporal pole to the limbic-cerebellum-striatal-cortical network areas. Conclusion Our results indicate that the progressive GMV alterations of T2D patients manifested a limbic-cerebellum-striatal-cortical sequence. These findings may contribute to a better understanding of the progression and an improvement of current diagnosis and intervention strategies for T2D.
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Affiliation(s)
- Jiang Zhang
- College of Electrical Engineering, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yuyan Liu
- College of Electrical Engineering, Sichuan University, Chengdu, China
| | - Xiaonan Guo
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
- Hebei Key Laboratory of Information Transmission and Signal Processing, Yanshan University, Qinhuangdao, China
| | - Jing Guo
- MOE Key Lab for Neuroinformation, The Clinical Hospital of Chengdu Brain Science Institute, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhengcong Du
- School of Information Science and Technology, Xichang University, Xichang, China
| | - Muyuan He
- College of Electrical Engineering, Sichuan University, Chengdu, China
| | - Qihong Liu
- College of Biomedical Engineering, Sichuan University, Chengdu, China
| | - Dundi Xu
- College of Electrical Engineering, Sichuan University, Chengdu, China
| | - Taiyuan Liu
- Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou, China
| | - Junran Zhang
- College of Electrical Engineering, Sichuan University, Chengdu, China
- *Correspondence: Junran Zhang
| | - Huijuan Yuan
- Department of Endocrinology, Henan Provincial People's Hospital, Zhengzhou, China
- Huijuan Yuan
| | - Meiyun Wang
- Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou, China
- Meiyun Wang
| | - Shasha Li
- The Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
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14
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Meng J, Liu J, Li H, Gao Y, Cao L, He Y, Guo Y, Feng L, Hu X, Li H, Zhang C, He W, Wu Y, Huang X. Impairments in intrinsic functional networks in type 2 diabetes: A meta-analysis of resting-state functional connectivity. Front Neuroendocrinol 2022; 66:100992. [PMID: 35278579 DOI: 10.1016/j.yfrne.2022.100992] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/05/2022] [Accepted: 02/28/2022] [Indexed: 12/27/2022]
Abstract
Type 2 diabetes mellitus (T2DM) is associated with abnormal communication among large-scale brain networks, revealed by resting-state functional connectivity (rsFC), with inconsistent results between studies. We performed a meta-analysis of seed-based rsFC studies to identify consistent network connectivity alterations. Thirty-three datasets from 30 studies (1014 T2DM patients and 902 healthy controls [HC]) were included. Seed coordinates and between-group effects were extracted, and the seeds were divided into networks based on their location. Compared to HC, T2DM patients showed hyperconnectivity and hypoconnectivity within the DMN, DMN hypoconnectivity with the affective network (AN), ventral attention network (VAN) and frontal parietal network, and DMN hyperconnectivity with the VAN and visual network. T2DM patients also showed AN hypoconnectivity with the somatomotor network and hyperconnectivity with the VAN. T2DM illness durations negatively correlated with within-DMN rsFC. These DMN-centered impairments in large-scale brain networks in T2DM patients may help to explain the cognitive deficits associated with T2DM.
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Affiliation(s)
- Jinli Meng
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China; Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital. C.T.), No. 20, Xi Mian Qiao Heng Jie, Wuhou District, Chengdu, Sichuan, China
| | - Jing Liu
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China; Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Hailong Li
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China; Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yingxue Gao
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China; Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Lingxiao Cao
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China; Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yuanyuan He
- Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital. C.T.), No. 20, Xi Mian Qiao Heng Jie, Wuhou District, Chengdu, Sichuan, China
| | - Yongyue Guo
- Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital. C.T.), No. 20, Xi Mian Qiao Heng Jie, Wuhou District, Chengdu, Sichuan, China
| | - Li Feng
- Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital. C.T.), No. 20, Xi Mian Qiao Heng Jie, Wuhou District, Chengdu, Sichuan, China
| | - Xin Hu
- Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital. C.T.), No. 20, Xi Mian Qiao Heng Jie, Wuhou District, Chengdu, Sichuan, China
| | - Hengyan Li
- Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital. C.T.), No. 20, Xi Mian Qiao Heng Jie, Wuhou District, Chengdu, Sichuan, China
| | - Chenghui Zhang
- Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital. C.T.), No. 20, Xi Mian Qiao Heng Jie, Wuhou District, Chengdu, Sichuan, China
| | - Wanlin He
- Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital. C.T.), No. 20, Xi Mian Qiao Heng Jie, Wuhou District, Chengdu, Sichuan, China
| | - Yunhong Wu
- Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital. C.T.), No. 20, Xi Mian Qiao Heng Jie, Wuhou District, Chengdu, Sichuan, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China; Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
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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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Luo A, Xie Z, Wang Y, Wang X, Li S, Yan J, Zhan G, Zhou Z, Zhao Y, Li S. Type 2 diabetes mellitus-associated cognitive dysfunction: Advances in potential mechanisms and therapies. Neurosci Biobehav Rev 2022; 137:104642. [PMID: 35367221 DOI: 10.1016/j.neubiorev.2022.104642] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 03/24/2022] [Accepted: 03/27/2022] [Indexed: 12/22/2022]
Abstract
Type 2 diabetes (T2D) and its target organ injuries cause distressing impacts on personal health and put an enormous burden on the healthcare system, and increasing attention has been paid to T2D-associated cognitive dysfunction (TDACD). TDACD is characterized by cognitive dysfunction, delayed executive ability, and impeded information-processing speed. Brain imaging data suggest that extensive brain regions are affected in patients with T2D. Based on current findings, a wide spectrum of non-specific neurodegenerative mechanisms that partially overlap with the mechanisms of neurodegenerative diseases is hypothesized to be associated with TDACD. However, it remains unclear whether TDACD is a consequence of T2D or a complication that co-occurs with T2D. Theoretically, anti-diabetes methods are promising neuromodulatory approaches to reduce brain injury in patients with T2D. In this review, we summarize potential mechanisms underlying TDACD and promising neurotropic effects of anti-diabetes methods and some neuroprotective natural compounds. Constructing screening or diagnostic tools and developing targeted treatment and preventive strategies would be expected to reduce the burden of TDACD.
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Affiliation(s)
- Ailin Luo
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology.
| | - Zheng Xie
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology.
| | - Yue Wang
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology.
| | - Xuan Wang
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology.
| | - Shan Li
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology.
| | - Jing Yan
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology.
| | - Gaofeng Zhan
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology.
| | - Zhiqiang Zhou
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology.
| | - Yilin Zhao
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology.
| | - Shiyong Li
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology.
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17
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Newby D, Garfield V. Understanding the inter-relationships of type 2 diabetes and hypertension with brain and cognitive health: A UK Biobank study. Diabetes Obes Metab 2022; 24:938-947. [PMID: 35112465 PMCID: PMC9415107 DOI: 10.1111/dom.14658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/13/2022] [Accepted: 01/30/2022] [Indexed: 01/28/2023]
Abstract
AIM To understand the impact of diabetes and co-morbid hypertension on cognitive and brain health. MATERIALS AND METHODS We used data from the UK Biobank cohort consisting of ~500 000 individuals aged 40 to 69 years. Our outcomes included brain structural magnetic resonance imaging variables and cognitive function tests in a maximum of 38 918 individuals. We firstly tested associations with all outcomes between those with diabetes (n = 2043) and without (n = 36 875) and, secondly, compared those with co-morbid diabetes/hypertension (n = 1283) with those with only diabetes (n = 760), hypertension (n = 9649) and neither disease (n = 27 226). Our analytical approach comprised linear regression models, with adjustment for a range of demographic and health factors. Standardized betas are reported. RESULTS Those with diabetes had worse brain and cognitive health for the majority of neuroimaging and cognitive measures, with the exception of g fractional anisotropy (white matter integrity), amygdala, pairs matching and tower rearranging. Compared with individuals with co-morbid diabetes and hypertension, those with only hypertension had better brain health overall, with the largest difference observed in the pallidum (β = .189, 95% CI = 0.241; 0.137), while those with only diabetes differed in total grey volume (β = .150, 95% CI = 0.122; 0.179). Individuals with only diabetes had better verbal and numeric reasoning (β = .129, 95% CI = 0.077; 0.261), whereas those with only hypertension performed better on the symbol-digit substitution task (β = .117, 95% CI = 0.048; 0.186). CONCLUSIONS Individuals with co-morbid diabetes and hypertension have worse brain and cognitive health compared with those with only one of these diseases. These findings potentially suggest that prevention of both diabetes and hypertension may delay changes in brain structure, as well as cognitive decline and dementia diagnosis.
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Affiliation(s)
- Danielle Newby
- Department of PsychiatryUniversity of Oxford, Warneford HospitalOxfordUK
| | - Victoria Garfield
- MRC Unit for Lifelong Health and Ageing at UCL, Department of Population Science and Experimental Medicine, Institute of Cardiovascular ScienceUniversity College LondonLondonUK
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18
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He Y, Li L, Liu J. The whole-brain voxel-based morphometry study in early stage of T2DM patients. Brain Behav 2022; 12:e2497. [PMID: 35138040 PMCID: PMC8933776 DOI: 10.1002/brb3.2497] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/26/2021] [Accepted: 01/02/2022] [Indexed: 11/11/2022] Open
Abstract
AIM This study aimed to investigate the alterations in whole-brain gray matter density in early stage type 2 diabetes mellitus (T2DM) patients with cognitive impairment using magnetic resonance imaging. METHODS Thirty-six cases of early stage T2DM patients with cognitive impairment (T2DM-CI), 34 cases of early stage T2DM patients without cognitive impairment (T2DM) and 30 cases of healthy controls (HC) were enrolled. Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) scores were used to identify the cognitive impairment. The whole-brain gray matter density was analyzed using 3D-T1 BRAVO imaging, using the voxel-based morphometry method on T1 structure imaging of two groups. RESULTS The correlation analysis of total gray matter density with MMSE and MoCA scores in the T2DM-CI group was performed. There were no significant differences in MMSE and MoCA scores between the HC and T2DM groups. However, the MMSE and MoCA scores in the T2DM-CI group were significantly reduced compared with the T2DM group. There were no significant differences in age, gender, education, body mass index (BMI) or blood pressure among the three groups. Voxel-based morphometry (VBM) results showed that the density of left triangle part of inferior frontal gyrus, orbital part of inferior frontal gyrus and opercular part of inferior frontal gyrus and left insula in the T2DM-CI group decreased compared with the T2DM group. Correlation analysis results showed that there was a significant positive correlation between total gray matter density and scores of MMSE and MoCA scores in the T2DM-CI group. CONCLUSION In conclusion, total gray matter density is positively correlated with the scores of MMSE and MoCA in T2DM patients, which may be an early sign of cognitive impairment in patients with T2DM.
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Affiliation(s)
- Yana He
- Department of Medical Imaging, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Liang Li
- Department of Medical Imaging, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jihua Liu
- Department of Medical Imaging, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
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19
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Liu J, Yang X, Li Y, Xu H, Ren J, Zhou P. Cerebral Blood Flow Alterations in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Arterial Spin Labeling Studies. Front Aging Neurosci 2022; 14:847218. [PMID: 35250549 PMCID: PMC8888831 DOI: 10.3389/fnagi.2022.847218] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 01/26/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveArterial spin labeling (ASL) studies have revealed inconsistent regional cerebral blood flow (CBF) alterations in patients with type 2 diabetes mellitus (T2DM). The aim of this systematic review and meta-analysis was to identify concordant regional CBF alterations in T2DM.MethodsA systematic review was conducted to the published literatures comparing cerebral perfusion between patients with T2DM and healthy controls using ASL. The seed-based d mapping (SDM) was further used to perform quantitative meta-analysis on voxel-based literatures and to estimate the regional CBF alterations in patients with T2DM. Metaregression was performed to explore the associations between clinical characteristics and cerebral perfusion alterations.ResultsA total of 13 studies with 14 reports were included in the systematic review and 7 studies with 7 reports were included in the quantitative meta-analysis. The qualitative review found widespread CBF reduction in cerebral lobes in T2DM. The meta-analysis found increased regional CBF in right supplementary motor area and decreased regional CBF in bilateral middle occipital gyrus, left caudate nucleus, right superior parietal gyrus, and left calcarine fissure/surrounding cortex in T2DM.ConclusionThe patterns of cerebral perfusion alterations, characterized by the decreased CBF in occipital and parietal lobes, might be the neuropathology of visual impairment and cognitive aging in T2DM.
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20
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Oh DJ, Jung JJ, Shin SA, Kim H, Park S, Sohn BK, Koo BK, Moon MK, Kim YK, Lee JY. Brain Structural Alterations, Diabetes Biomarkers, and Cognitive Performance in Older Adults With Dysglycemia. Front Neurol 2021; 12:766216. [PMID: 34777234 PMCID: PMC8581483 DOI: 10.3389/fneur.2021.766216] [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: 09/01/2021] [Accepted: 09/30/2021] [Indexed: 12/30/2022] Open
Abstract
Despite the high risk of dementia in older adults with type 2 diabetes, the neuroanatomical correlates of cognitive dysfunction that are particularly affected by diabetes are not well characterized. This study is aimed to examine the structural brain alterations in dysglycemic older adults. Using voxel-based morphometric and tract-based spatial statistics, we examined changes in gray matter volume, white matter volume, and microstructural integrity in older adults with prediabetes and diabetes. We also assessed the correlation of these structural changes with diabetes biomarkers and cognitive performance. A total of 74 non-demented older adults (normal, n = 14; prediabetes, n = 37; and diabetes, n = 23) participated in this study and underwent structural and diffusion magnetic resonance imaging (MRI) scans and neuropsychological tests. Subjects with diabetes showed reduced volume of cerebellar gray matter and frontal white matter and diffuse white matter dysintegrity, while those with prediabetes only showed reduced volume of insular gray matter. Atrophic changes in the cerebellum and frontal lobe and frontal white matter dysintegrity were correlated with chronic hyperglycemia and insulin resistance and worse performance in verbal memory recognition and executive function tests. Our findings suggest that chronic hyperglycemia and insulin resistance may alter brain structures forming the fronto-cerebellar network, which may cause cognitive dysfunction in older adults.
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Affiliation(s)
- Dae Jong Oh
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea.,Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Ji-Jung Jung
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Seong A Shin
- Department of Nuclear Medicine, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Hairin Kim
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Soowon Park
- Division of Teacher Education, College of General Education for Truth, Sincerity and Love, Kyonggi University, Suwon, South Korea
| | - Bo Kyung Sohn
- Department of Psychiatry, Inje University Sanggye Paik Hospital, Seoul, South Korea
| | - Bo Kyung Koo
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.,Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Min Kyong Moon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.,Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Yu Kyeong Kim
- Department of Nuclear Medicine, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Jun-Young Lee
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, South Korea.,Department of Psychiatry and Neuroscience Research Institute, Seoul Nation University College of Medicine, Seoul, South Korea
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21
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Yao L, Yang C, Zhang W, Li S, Li Q, Chen L, Lui S, Kemp GJ, Biswal BB, Shah NJ, Li F, Gong Q. A multimodal meta-analysis of regional structural and functional brain alterations in type 2 diabetes. Front Neuroendocrinol 2021; 62:100915. [PMID: 33862036 DOI: 10.1016/j.yfrne.2021.100915] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/30/2021] [Accepted: 04/11/2021] [Indexed: 02/04/2023]
Abstract
Neuroimaging studies have identified brain structural and functional alterations of type 2 diabetes mellitus (T2DM) patients; however, there is no systematic information on the relations between abnormalities in these two domains. We conducted a multimodal meta-analysis of voxel-based morphometry and regional resting-state functional MRI studies in T2DM, including fifteen structural datasets (693 patients and 684 controls) and sixteen functional datasets (378 patients and 358 controls). We found, in patients with T2DM compared to controls, conjoint decreased regional gray matter volume (GMV) and altered intrinsic activity mainly in the default mode network including bilateral superior temporal gyrus/Rolandic operculum, left middle and inferior temporal gyrus, and left supramarginal gyrus; decreased GMV alone in the limbic system; and functional abnormalities alone in the cerebellum, insula, and visual cortex. This meta-analysis identified complicated patterns of conjoint and dissociated brain alterations in T2DM patients, which may help provide new insight into the neuropathology of T2DM.
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Affiliation(s)
- Li Yao
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, NO. 37 Guoxue Xiang, Chengdu 610041, China; Functional and Molecular Imaging Key Laboratory of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China
| | - Chengmin Yang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, NO. 37 Guoxue Xiang, Chengdu 610041, China; Functional and Molecular Imaging Key Laboratory of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China
| | - Wenjing Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, NO. 37 Guoxue Xiang, Chengdu 610041, China; Functional and Molecular Imaging Key Laboratory of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China
| | - Siyi Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, NO. 37 Guoxue Xiang, Chengdu 610041, China; Functional and Molecular Imaging Key Laboratory of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China
| | - Qian Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, NO. 37 Guoxue Xiang, Chengdu 610041, China; Functional and Molecular Imaging Key Laboratory of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China
| | - Lizhou Chen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, NO. 37 Guoxue Xiang, Chengdu 610041, China; Functional and Molecular Imaging Key Laboratory of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, NO. 37 Guoxue Xiang, Chengdu 610041, China; Functional and Molecular Imaging Key Laboratory of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China
| | - Graham J Kemp
- Liverpool Magnetic Resonance Imaging Centre (LiMRIC) and Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L69 3BX, L3 5TR, United Kingdom
| | - Bharat B Biswal
- Department of Biomedical Engineering, New Jersey Institute of Technology, 323 Dr Martin Luther King Jr Blvd, Newark, NJ 07102, USA; The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, No.4, Section 2, North Jianshe Road, Chengdu 610054, China
| | - Nadim J Shah
- Institute of Neuroscience and Medicine (INM-4), Medical Imaging Physics, Forschungszentrum Jülich GmbH, 52425 Jülich, Germany
| | - Fei Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, NO. 37 Guoxue Xiang, Chengdu 610041, China; Functional and Molecular Imaging Key Laboratory of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China; Institute of Neuroscience and Medicine (INM-4), Medical Imaging Physics, Forschungszentrum Jülich GmbH, 52425 Jülich, Germany.
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, NO. 37 Guoxue Xiang, Chengdu 610041, China; Functional and Molecular Imaging Key Laboratory of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China.
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22
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Yu KKK, Cheing GLY, Cheung C, Kranz GS, Cheung AKK. Gray Matter Abnormalities in Type 1 and Type 2 Diabetes: A Dual Disorder ALE Quantification. Front Neurosci 2021; 15:638861. [PMID: 34163319 PMCID: PMC8215122 DOI: 10.3389/fnins.2021.638861] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 05/07/2021] [Indexed: 12/06/2022] Open
Abstract
Aims/hypothesis: Diabetes mellitus (DM) is associated with comorbid brain disorders. Neuroimaging studies in DM revealed neuronal degeneration in several cortical and subcortical brain regions. Previous studies indicate more pronounced brain alterations in type 2 diabetes mellitus (T2DM) than in type 1 diabetes mellitus (T1DM). However, a comparison of both types of DM in a single analysis has not been done so far. The aim of this meta-analysis was to conduct an unbiased objective investigation of neuroanatomical differences in DM by combining voxel-based morphometry (VBM) studies of T1DM and T2DM using dual disorder anatomical likelihood estimation (ALE) quantification. Methods: PubMed, Web of Science and Medline were systematically searched for publications until June 15, 2020. VBM studies comparing gray matter volume (GMV) differences between DM patients and controls at the whole-brain level were included. Study coordinates were entered into the ALE meta-analysis to investigate the extent to which T1DM, T2DM, or both conditions contribute to gray matter volume differences compared to controls. Results: Twenty studies (comprising of 1,175 patients matched with 1,013 controls) were included, with seven studies on GMV alterations in T1DM and 13 studies on GMV alterations in T2DM. ALE analysis revealed seven clusters of significantly lower GMV in T1DM and T2DM patients relative to controls across studies. Both DM subtypes showed GMV reductions in the left caudate, right superior temporal lobe, and left cuneus. Conversely, GMV reductions associated exclusively with T2DM (>99% contribution) were found in the left cingulate, right posterior lobe, right caudate and left occipital lobe. Meta-regression revealed no significant influence of study size, disease duration, and HbA1c values. Conclusions/interpretation: Our findings suggest a more pronounced gray matter atrophy in T2DM compared to T1DM. The increased risk of microvascular or macrovascular complications, as well as the disease-specific pathology of T2DM may contribute to observed GMV reductions. Systematic Review Registration: [PROSPERO], identifier [CRD42020142525].
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Affiliation(s)
- Kevin K K Yu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong.,University Research Facility in Behavioral and Systems Neuroscience (UBSN), The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Gladys L Y Cheing
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong.,University Research Facility in Behavioral and Systems Neuroscience (UBSN), The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Charlton Cheung
- Department of Psychiatry, The University of Hong Kong, Pokfulam, Hong Kong
| | - Georg S Kranz
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong.,The State Key Laboratory for Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong.,Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Alex Kwok-Kuen Cheung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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23
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Zhang D, Lei Y, Gao J, Qi F, Yan X, Ai K, Zhe X, Cheng M, Wang M, Su Y, Tang M, Zhang X. Right Frontoinsular Cortex: A Potential Imaging Biomarker to Evaluate T2DM-Induced Cognitive Impairment. Front Aging Neurosci 2021; 13:674288. [PMID: 34122050 PMCID: PMC8193040 DOI: 10.3389/fnagi.2021.674288] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 04/27/2021] [Indexed: 01/07/2023] Open
Abstract
Cognitive impairment in type 2 diabetes mellitus (T2DM) is associated with functional and structural abnormalities in the intrinsic brain network. The salience network (SN) is a neurocognitive network that maintains normal cognitive function, but it has received little attention in T2DM. We explored SN changes in patients with T2DM with normal cognitive function (DMCN) and in patients with T2DM with mild cognitive impairment (DMCI). Sixty-five T2DM patients and 31 healthy controls (HCs) underwent a neuropsychological assessment, independent component analysis (ICA), and voxel-based morphometry (VBM) analysis. The ICA extracted the SN for VBM to compare SN functional connectivity (FC) and gray matter (GM) volume (GMV) between groups. A correlation analysis examined the relationship between abnormal FC and GMV and clinical/cognitive variables. Compared with HCs, DMCN patients demonstrated increased FC in the left frontoinsular cortex (FIC), right anterior insula, and putamen, while DMCI patients demonstrated decreased right middle/inferior frontal gyrus FC. Compared with DMCN patients, DMCI patients showed decreased right FIC FC. There was no significant difference in SN GMV in DMCN and DMCI patients compared with HCs. FIC GMV was decreased in the DMCI patients compared with DMCN patients. In addition, right FIC FC and SN GMV positively correlated with Montreal Cognitive Assessment and Mini-Mental State Examination (MMSE) scores. These findings indicate that changes in SN FC, and GMV are complex non-linear processes accompanied by increased cognitive dysfunction in patients with T2DM. The right FIC may be a useful imaging biomarker for supplementary assessment of early cognitive dysfunction in patients with T2DM.
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Affiliation(s)
- Dongsheng Zhang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Yumeng Lei
- Department of Graduate, Xi'an Medical University, Xi'an, China
| | - Jie Gao
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Fei Qi
- Department of Graduate, Xi'an Medical University, Xi'an, China
| | - Xuejiao Yan
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Kai Ai
- Department of Clinical Science, Philips Healthcare, 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
| | - Yu Su
- Department of Graduate, Xi'an Medical University, Xi'an, China
| | - Min Tang
- 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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24
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Paul S, Saha D, Bk B. Mitochondrial Dysfunction and Mitophagy Closely Cooperate in Neurological Deficits Associated with Alzheimer's Disease and Type 2 Diabetes. Mol Neurobiol 2021; 58:3677-3691. [PMID: 33797062 DOI: 10.1007/s12035-021-02365-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 03/19/2021] [Indexed: 12/27/2022]
Abstract
Alzheimer's disease (AD) and type 2 diabetes (T2D) are known to be correlated in terms of their epidemiology, histopathology, and molecular and biochemical characteristics. The prevalence of T2D leading to AD is approximately 50-70%. Moreover, AD is often considered type III diabetes because of the common risk factors. Uncontrolled T2D may affect the brain, leading to memory and learning deficits in patients. In addition, metabolic disorders and impaired oxidative phosphorylation in AD and T2D patients suggest that mitochondrial dysfunction is involved in both diseases. The dysregulation of pathways involved in maintaining mitochondrial dynamics, biogenesis and mitophagy are responsible for exacerbating the impact of hyperglycemia on the brain and neurodegeneration under T2D conditions. The first section of this review describes the recent views on mitochondrial dysfunction that connect these two disease conditions, as the pathways are observed to overlap. The second section of the review highlights the importance of different mitochondrial miRNAs (mitomiRs) involved in the regulation of mitochondrial dynamics and their association with the pathogenesis of T2D and AD. Therefore, targeting mitochondrial biogenesis and mitophagy pathways, along with the use of mitomiRs, could be a potent therapeutic strategy for T2D-related AD. The last section of the review highlights the known drugs targeting mitochondrial function for the treatment of both disease conditions.
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Affiliation(s)
- Sangita Paul
- CSIR-Institute of Genomics and Integrative Biology, Delhi, India.,Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Debarpita Saha
- CSIR-Institute of Genomics and Integrative Biology, Delhi, India
| | - Binukumar Bk
- CSIR-Institute of Genomics and Integrative Biology, Delhi, India. .,Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India.
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25
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Effect of Bushen Huoxue Prescription on Cognitive Dysfunction of KK-Ay Type 2 Diabetic Mice. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:6656362. [PMID: 33777159 PMCID: PMC7981179 DOI: 10.1155/2021/6656362] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/24/2021] [Accepted: 02/18/2021] [Indexed: 11/18/2022]
Abstract
Diabetic cognitive impairment is one of the common complications of type 2 diabetes, which can cause neurological and microvascular damage in the brain. Bushen Huoxue prescription (BSHX), a compound Chinese medicine, has been used clinically to treat diabetes-induced cognitive impairment. However, its underlying mechanisms remain unclear. In this study, KK-Ay diabetic model mouse was administered BSHX daily for 12 weeks. Bodyweight, random blood glucose (RBG), and fasting blood glucose (FBG) were measured every 4 weeks. Triglycerides (TG), cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting serum insulin (FINS), and Morris water maze were tested after 12 weeks of administration. On the day of sacrifice, the hippocampus was collected for pathological staining and advanced glycation end products (AGEs) analysis to evaluate the neuroprotective effect of BSHX. Our results showed that BSHX treatment significantly ameliorated the T2DM related insults, including the increased bodyweight, blood glucose, TG, insulin levels, AGEs, the reduced HDL-C, the impaired spatial memory, and the neurological impairment. Moreover, Western blot analysis showed that increased expression of receptors of AGEs (RAGEs), inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), and activation of nuclear factor-κB (NF-κB) in the hippocampus were significantly inhibited by BSHX treatment. These results indicate that BSHX can significantly ameliorate glucose and lipid metabolism dysfunction, reduce the morphological changes in hippocampus tissues, and improve the cognitive function of KK-Ay mice. These protective effects of BSHX may involve regulation of the AGEs/RAGE/NF-κB signaling pathway.
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26
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Li J, Zhang Q, Zhang N, Guo L. Increased Brain Iron Detection by Voxel-Based Quantitative Susceptibility Mapping in Type 2 Diabetes Mellitus Patients With an Executive Function Decline. Front Neurosci 2021; 14:606182. [PMID: 33519360 PMCID: PMC7843466 DOI: 10.3389/fnins.2020.606182] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/07/2020] [Indexed: 11/13/2022] Open
Abstract
Purpose Brain iron accumulation has been suggested as a pathomechanism in patients with type 2 diabetes mellitus (T2DM) with cognitive impairment. This research aims to examine the total-brain pattern of iron accumulation in relation to executive function decline in patients with T2DM by voxel-based quantitative susceptibility mapping (QSM) analysis. Materials and Methods A total of 32 patients with T2DM and 34 age- and sex-matched healthy controls (HCs) were enrolled in this study. All participants underwent brain magnetic resonance examination, and 48 individuals underwent cognitive function assessments. Imaging data were collected with three-dimensional fast low-angle shot sequences to achieve magnitude as well as phase images. Using voxel-based QSM analysis, we compared the voxel-wise susceptibility values of the whole brain among groups and explored whether the susceptibility values had correlations with cognitive data. Results Among the 66 participants, cognitive function was estimated in 23 patients with T2DM (11 males and 12 females; average age, 64.65 ± 8.44 years) and 25 HCs (13 males and 12 females; average age, 61.20 ± 7.62 years). T2DM patients exhibited significantly (t = 4.288, P < 0.001) lower Montreal Cognitive Assessment (MoCA) scores [T2DM, 27 (27, 28); HCs, 29 (28, 29); normal standard ≥ 26)] and higher Trail-making Test (TMT)-A/TMT-B scores [71 (51, 100)/185 (149, 260)] than HCs [53 (36.5, 63.5)/150 (103, 172.5)] (Z = 2.612, P = 0.009; Z = 2.797, P = 0.005). Subjects with T2DM showed significantly higher susceptibility values than HCs in the caudate/putamen/pallidum, frontal inferior triangular gyrus, and precentral gyrus on the right hemisphere. In contrast (HC > T2DM), no region showed a significant difference in susceptibility values between the groups. The correlation analysis between susceptibility values and cognitive function scores was tested by voxel-based susceptibility value with sex and age as covariates. After multiple comparison correction, in T2DM patients, the left thalamus showed a significant relationship with TMT-A (R 2 = 0.53, P = 0.001). The right thalamus and left thalamus showed a significant relationship with TMT-B (R 2 = 0.35, P = 0.019; and R 2 = 0.38, P = 0.017, respectively). In HCs, the cluster of right precentral/middle frontal gyrus/inferior frontal gyrus/inferior triangular gyrus showed a significant relationship with TMT-B (R 2 = 0.59, P = 0.010). No relationship was found between the susceptibility values with MoCA in the brain region in both two groups. Conclusion Patients with T2DM presented declined cognitive assessments and elevated iron deposition in the striatum and frontal lobe, suggesting that executive function decline in T2DM might be associated with the cerebral iron burden and that changes in susceptibility values may represent a latent quantitative imaging marker for early assessment of cognitive decline in patients with T2DM.
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Affiliation(s)
- Jing Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Qihao Zhang
- Department of Radiology, Weill Cornell Medical College, New York, NY, United States
| | - Nan Zhang
- Shandong Medical Imaging Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Lingfei Guo
- Shandong Medical Imaging Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, China
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27
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Zhou C, Li J, Dong M, Ping L, Lin H, Wang Y, Wang S, Gao S, Yu G, Cheng Y, Xu X. Altered White Matter Microstructures in Type 2 Diabetes Mellitus: A Coordinate-Based Meta-Analysis of Diffusion Tensor Imaging Studies. Front Endocrinol (Lausanne) 2021; 12:658198. [PMID: 34012420 PMCID: PMC8127836 DOI: 10.3389/fendo.2021.658198] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/07/2021] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE Type 2 diabetes mellitus (T2DM) is often accompanied by cognitive decline and depressive symptoms. Numerous diffusion tensor imaging (DTI) studies revealed microstructural white matter (WM) abnormalities in T2DM but the findings were inconsistent. The present study aimed to conduct a coordinate-based meta-analysis (CBMA) to identify statistical consensus of DTI studies in T2DM. METHODS We performed a systematic search on relevant studies that reported fractional anisotropy (FA) differences between T2DM patients and healthy controls (HC). The anisotropic effect size seed-based d mapping (AES-SDM) approach was used to explore WM alterations in T2DM. A meta-regression was then used to analyze potential influences of sample characteristics on regional FA changes. RESULTS A total of eight studies that comprised 245 patients and 200 HC, along with 52 coordinates were extracted. The meta-analysis identified FA reductions in three clusters including the left inferior network, the corpus callosum (CC), and the left olfactory cortex. Besides, FA in the CC was negatively correlated with body mass index (BMI) in the patients group. CONCLUSIONS T2DM could lead to subtle WM microstructural alterations, which might be associated with cognitive deficits or emotional distress symptoms. This provides a better understanding of the pathophysiology of neurodegeneration and complications in T2DM. SYSTEMATIC REVIEW REGISTRATION Registered at PROSPERO (http://www.crd.york.ac.uk/PROSPERO), registration number: CRD42020218737.
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Affiliation(s)
- Cong Zhou
- School of Mental Health, Jining Medical University, Jining, China
- *Correspondence: Cong Zhou,
| | - Jie Li
- Department of Psychiatry, Jining Psychiatric Hospital, Jining, China
| | - Man Dong
- School of Mental Health, Jining Medical University, Jining, China
| | - Liangliang Ping
- Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen, China
| | - Hao Lin
- School of Mental Health, Jining Medical University, Jining, China
| | - Yuxin Wang
- School of Mental Health, Jining Medical University, Jining, China
| | - Shuting Wang
- School of Mental Health, Jining Medical University, Jining, China
| | - Shuo Gao
- School of Mental Health, Jining Medical University, Jining, China
| | - Ge Yu
- School of Mental Health, Jining Medical University, Jining, China
| | - Yuqi Cheng
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xiufeng Xu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China
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Wu J, Tao Z, Song Z, Zhang Y, Sun H, Wang J, Shen J. Validation and psychometric properties of the self-efficacy for Appropriate Medication Use Scale in elderly Chinese patients. Int J Clin Pharm 2020; 43:586-594. [PMID: 33044679 DOI: 10.1007/s11096-020-01167-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 09/26/2020] [Indexed: 11/29/2022]
Abstract
Background Self-efficacy for appropriate medication use is an important construct when evaluating the optimal use of medications. However, no instrument that assesses this construct in elderly Chinese patients has been shown to have valid psychometric properties. Objective To investigate the psychometric properties of the Chinese version of the self-efficacy for Appropriate Medication Use Scale in elderly patients with type 2 diabetes. Setting Geriatric patients were recruited from the endocrinology department of a tertiary hospital in Shanghai, China. Method Self-efficacy was assessed by the Chinese version of the Self-Efficacy for Appropriate Medication Use Scale in subjects who were at least 65 years old. Exploratory and confirmatory factor analyses were used to develop a psychometrically sound model of the scale. Main outcome measures Internal and test-retest reliability; convergent and discriminant validity of the scale; model fit indices of the factor model. Results The two-factor model of the self-efficacy for Appropriate Medication Use Scale was not suitable for elderly patients with respect to both item factor loadings and model fit indices. Conceptually overlapping scale items emerged when the scale was used in these patients. The final model developed appeared to achieve an ideal model fit and presented acceptable convergent and discriminant validity. Conclusions This study presented a Chinese version of the self-efficacy for Appropriate Medication Use Scale with psychometrically sound properties that will enable pharmacists, nurses and physicians to prospectively evaluate the impact of medication self-efficacy on a variety of health outcomes in elderly patients with type 2 diabetes.
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Affiliation(s)
- Jianbo Wu
- Department of Pharmacy, Huadong Hospital, Fudan University, 221 West Yan'an Road, Shanghai, 200040, China
| | - Zhujun Tao
- Department of Pharmacy, Huadong Hospital, Fudan University, 221 West Yan'an Road, Shanghai, 200040, China
| | - Zhongjuan Song
- Department of Pharmacy, Huadong Hospital, Fudan University, 221 West Yan'an Road, Shanghai, 200040, China
| | - Yunxuan Zhang
- Department of Pharmacy, Huadong Hospital, Fudan University, 221 West Yan'an Road, Shanghai, 200040, China
| | - Hua Sun
- Department of Endocrinology, Huadong Hospital, Fudan University, Shanghai, China
| | - Jiaofeng Wang
- Department of Geriatrics, Huadong Hospital, Fudan University, Shanghai, China
| | - Jie Shen
- Department of Pharmacy, Huadong Hospital, Fudan University, 221 West Yan'an Road, Shanghai, 200040, China.
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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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Choi SE, Roy B, Freeby M, Mullur R, Woo MA, Kumar R. Prefrontal cortex brain damage and glycemic control in patients with type 2 diabetes. J Diabetes 2020; 12:465-473. [PMID: 31886635 PMCID: PMC7210044 DOI: 10.1111/1753-0407.13019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 11/25/2019] [Accepted: 12/26/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND This study examined brain tissue integrity in sites that controls cognition (prefrontal cortices; PFC) and its relationships to glycemic outcomes in adults with type 2 diabetes mellitus (T2DM). METHODS We examined 28 T2DM patients (median age 57.1 years; median body mass index [BMI] 30.6 kg/m2 ;11 males) and 47 healthy controls (median age 55.0 years; median BMI 25.8 kg/m2 ; 29 males) for cognition (Montreal Cognitive Assessment [MoCA]), glycemic control (hemoglobin A1c [HbA1c]), and PFC tissue status via brain magnetic resonance imaging (MRI). High-resolution T1-weighted images were collected using a 3.0-Tesla MRI scanner, and PFC tissue changes (tissue density) were examined with voxel-based morphometry procedures. RESULTS Reduced PFC density values were observed in T2DM patients compared to controls (left, 0.41 ± 0.02 mm3 /voxel vs 0.44 ± 0.02 mm3 /voxel, P < 0.001; right, 0.41 ± 0.03 mm3 /voxel vs 0.45 ± 0.02 mm3 /voxel, P < 0.001). PFC density values were positively correlated with cognition; left PFC region (r = 0.53, P = 0.005) and right PFC region (r = 0.56, P = 0.003), with age and sex as covariates. Significant negative correlations were found between PFC densities and HbA1c values; left PFC region (r = -0.39, P = 0.049) and right PFC region (r = -0.48, P = 0.01), with age and sex as covariates. CONCLUSIONS T2DM patients showed PFC brain tissue damage, which is associated with cognitive deficits and poor glycemic control. Further research is needed to identify causal relationships between HbA1c, cognition, and brain changes in T2DM and to evaluate the impact of interventions to prevent brain tissue injury or neuroregeneration in this high-risk patient population, to eventually preserve or enhance cognition and improve glucose outcomes.
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Affiliation(s)
- Sarah E Choi
- School of Nursing, University of California Los Angeles, Los Angeles, California
| | - Bhaswati Roy
- Department of Anesthesiology, David Geffen School of Medicine, Los Angeles, California
| | - Matthew Freeby
- Division of Endocrinology, Diabetes, & Metabolism, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Rashmi Mullur
- Division of Endocrinology, Diabetes, & Metabolism, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Mary A Woo
- School of Nursing, University of California Los Angeles, Los Angeles, California
| | - Rajesh Kumar
- Department of Anesthesiology, David Geffen School of Medicine, Los Angeles, California
- Radiological Sciences, University of California Los Angeles, Los Angeles, California
- Bioengineering, University of California Los Angeles, Los Angeles, California
- Brain Research Institute, University of California Los Angeles, Los Angeles, California
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31
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Liu J, Fan W, Jia Y, Su X, Wu W, Long X, Sun X, Liu J, Sun W, Zhang T, Gong Q, Shi H, Zhu Q, Wang J. Altered Gray Matter Volume in Patients With Type 1 Diabetes Mellitus. Front Endocrinol (Lausanne) 2020; 11:45. [PMID: 32117070 PMCID: PMC7031205 DOI: 10.3389/fendo.2020.00045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 01/24/2020] [Indexed: 02/05/2023] Open
Abstract
Background and Purpose: Many imaging studies have reported structure alterations in patients with type 1 diabetes mellitus (T1DM) by using voxel-based morphometry (VBM). Nevertheless, the results reported were inconsistent and had not been reviewed quantitatively. Accordingly, the quantitative meta-analysis which including VBM studies of patients with T1DM was conducted. Materials and Methods: The gray matter volume alterations in patients with T1DM was estimated by using the software seed-based d mapping. Meantime, the meta-regression was applied to detect the effects of some demographics and clinical characteristics. Results: Six studies were finally included, which with 6 datasets comprising 414 T1DM patients and 216 healthy controls. The pooled meta-analyses detected that patients with T1DM showed robustly increased gray matter volume in the left dorsolateral superior frontal gyrus and middle frontal gyrus and a decreased gray matter volume in the right lingual gyrus, cerebellum, precuneus, the left inferior temporal gyrus, and middle temporal gyrus. The meta-regression showed that the mean age, the female patient's ratio, duration of illness and HbAlc% for T1DM patients were not linearly related with gray matter alterations. Conclusion: This meta-analysis demonstrates that gray matter volume decreases in T1DM patients were mainly locates in the cortical regions and cerebellum.
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Affiliation(s)
- Jia Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Wenliang Fan
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Yuxi Jia
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Xiaoyun Su
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Wenjun Wu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Xi Long
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Xin Sun
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Jie Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Wengang Sun
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | | | - Qiyong Gong
- Department of Radiology, Huaxi MR Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Haojun Shi
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
- *Correspondence: Haojun Shi
| | - Qing Zhu
- Department of Neurology, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
- Qing Zhu
| | - Jing Wang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
- Jing Wang
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Buss SS, Padmanabhan J, Saxena S, Pascual-Leone A, Fried PJ. Atrophy in Distributed Networks Predicts Cognition in Alzheimer's Disease and Type 2 Diabetes. J Alzheimers Dis 2019; 65:1301-1312. [PMID: 30149455 DOI: 10.3233/jad-180570] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) and type 2 diabetes (T2DM) are common causes of cognitive decline among older adults and share strong epidemiological links. Distinct patterns of cortical atrophy are observed in AD and T2DM, but robust comparisons between structure-function relationships across these two disease states are lacking. OBJECTIVE To compare how atrophy within distributed brain networks is related to cognition across the spectrum of cognitive aging. METHODS The relationship between structural MRI changes and cognition was studied in 22 mild-to-moderate AD, 28 T2DM, and 27 healthy participants. Cortical thickness measurements were obtained from networks of interest (NOIs) matching the limbic, default, and frontoparietal resting-state networks. Composite cognitive scores capturing domains of global cognition, memory, and executive function were created. Associations between cognitive scores and the NOIs were assessed using linear regression, with age as a covariate. Within-network General Linear Model (GLM) analysis was run in Freesurfer 6.0 to visualize differences in patterns of cortical atrophy related to cognitive function in each group. A secondary analysis examined hemispheric differences in each group. RESULTS Across all groups, cortical atrophy within the limbic NOI was significantly correlated with Global Cognition (p = 0.009) and Memory Composite (p = 0.002). Within-network GLM analysis and hemispheric analysis revealed qualitatively different patterns of atrophy contributing to cognitive dysfunction between AD and T2DM. CONCLUSION Brain network atrophy is related to cognitive function across AD, T2DM, and healthy participants. Differences in cortical atrophy patterns were seen between AD and T2DM, highlighting neuropathological differences.
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Affiliation(s)
- Stephanie S Buss
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Jaya Padmanabhan
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Sadhvi Saxena
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alvaro Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.,Institut Guttman, Universitat Autonoma de Barcelona, Badalona, Barcelona, Spain
| | - Peter J Fried
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Drummen M, Heinecke A, Dorenbos E, Vreugdenhil A, Raben A, Westerterp-Plantenga MS, Adam TC. Reductions in body weight and insulin resistance are not associated with changes in grey matter volume or cortical thickness during the PREVIEW study. J Neurol Sci 2019; 403:106-111. [PMID: 31255969 DOI: 10.1016/j.jns.2019.06.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 05/10/2019] [Accepted: 06/13/2019] [Indexed: 02/05/2023]
Abstract
INTRODUCTION The effect of changes in body weight or insulin resistance on grey matter volume and cortical thickness change are unclear. The present observational study assessed effects of an 8-week weight loss period (≥8% of body weight), and a subsequent 22-month weight maintenance period on grey matter volume and cortical thickness. METHODS A total of 24 participants (12f/12 m; age 52.8 ± 10.6 years) with overweight/obesity and pre-diabetes were recruited. T1-weighted magnetic resonance imaging was used to determine grey matter volume and cortical thickness at baseline, after the weight loss period and after a medium to high dietary protein weight maintenance period. RESULTS At baseline, global grey matter volume was inversely associated with HOMA-IR, adjusted for sex and age (r = -0.42; p = .049). During the weight loss period participants decreased their BMI (32.1 ± 3.3 to 28.1 ± 2.8 kg/m2, p < .01), body-fat (41.6 ± 6.4 to 35.0 ± 8.0%, p < .01) and insulin resistance (HOMA-IR: 4.0 ± 2.0 to 1.8 ± 0.9, p < .01). During the 22-month weight maintenance period, these parameters gradually increased again (BMI: 29.3 ± 3.8 kg/m2; body-fat: 37.8 ± 9.3%; HOMA-IR: 2.9 ± 1.4, p < .01). Global grey matter volume and cortical thickness did not change significantly during the weight loss or weight maintenance period. Changes in body weight, body-fat percentage or insulin sensitivity were not associated with changes in global grey matter volume. CONCLUSION In conclusion, we confirmed that global grey brain matter volume was inversely associated with insulin resistance at baseline, yet an intervention yielding a decrease in insulin resistance did not lead to changes in global grey brain matter volume or cortical thickness. TRIAL REGISTRATION The trial is registered with ClinicalTrials.gov, NCT01777893.
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Affiliation(s)
- M Drummen
- Department of Nutrition and Movement Sciences, Maastricht University Medical Centre +, Maastricht, the Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, Maastricht University, the Netherlands.
| | - A Heinecke
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - E Dorenbos
- Centre for Overweight Adolescent and Children's Health Care (COACH), Department of Paediatrics, Maastricht University Medical Centre +, the Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, Maastricht University, the Netherlands
| | - A Vreugdenhil
- Centre for Overweight Adolescent and Children's Health Care (COACH), Department of Paediatrics, Maastricht University Medical Centre +, the Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, Maastricht University, the Netherlands
| | - A Raben
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - M S Westerterp-Plantenga
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, Maastricht University, the Netherlands
| | - T C Adam
- Department of Nutrition and Movement Sciences, Maastricht University Medical Centre +, Maastricht, the Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, Maastricht University, the Netherlands
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Dong Y, Wang Q, Yao H, Xiao Y, Wei J, Xie P, Hu J, Chen W, Tang Y, Zhou H, Liu J. A promising structural magnetic resonance imaging assessment in patients with preclinical cognitive decline and diabetes mellitus. J Cell Physiol 2019; 234:16838-16846. [PMID: 30786010 DOI: 10.1002/jcp.28359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 01/30/2019] [Accepted: 02/01/2019] [Indexed: 01/18/2023]
Abstract
Subjective cognitive decline (SCD) is frequently reported in diabetic patients. Diabetes mellitus (DM) is associated with changes in the microstructure of the brain arise in diabetic patients, including changes in gray matter volume (GMV). However, the underlying mechanisms of changes in GMV in DM patients with cognitive impairment remain uncertain. Here, we present an overview of amyloid-β-dependent cognitive impairment in DM patients with SCD. Moreover, we review the evolving insights from studies on the GMV changes in GMV and cognitive dysfunction to which provide the mechanisms of cognitive impairment in T2DM. Ultimately, the novel structural magnetic resonance imaging (MRI) protocol was used for detecting neuroimaging biomarkers that can predict the clinical outcomes in diabetic patients with SCD. A reliable MRI protocol would be helpful to detect neurobiomarkers, and to understand the pathological mechanisms of preclinical cognitive impairment in diabetic patients.
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Affiliation(s)
- Yulan Dong
- Department of Radiology, the First Affiliated Hospital of University of South China, Hengyang, China
| | - Qi Wang
- Department of Radiology, the Hunan Province Hospital, Changsha, China
| | - Hailun Yao
- Institute of Pharmacy and Medical Technology, Hunan Polytechnic of Environment and Biology, Hengyang, Hunan, China
| | - Yawen Xiao
- Department of Radiology, the First Affiliated Hospital of University of South China, Hengyang, China
| | - Jiaohong Wei
- Department of Radiology, the First Affiliated Hospital of University of South China, Hengyang, China
| | - Peihan Xie
- Department of Radiology, the First Affiliated Hospital of University of South China, Hengyang, China
| | - Jun Hu
- Department of Radiology, the First Affiliated Hospital of University of South China, Hengyang, China
| | - Wen Chen
- Department of Radiology, the First Affiliated Hospital of University of South China, Hengyang, China
| | - Yan Tang
- Department of Ultrasound, the First Affiliated Hospital of University of South China, Hengyang, China
| | - Hong Zhou
- Department of Radiology, the First Affiliated Hospital of University of South China, Hengyang, China.,Hengyang Medical College, University of South China, Hengyang, China
| | - Jincai Liu
- Department of Radiology, the First Affiliated Hospital of University of South China, Hengyang, China
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Carey D, Nolan H, Kenny RA, Meaney J. Cortical covariance networks in ageing: Cross-sectional data from the Irish Longitudinal Study on Ageing (TILDA). Neuropsychologia 2019; 122:51-61. [DOI: 10.1016/j.neuropsychologia.2018.11.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 11/24/2018] [Accepted: 11/26/2018] [Indexed: 01/06/2023]
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Liu H, Liu J, Peng L, Feng Z, Cao L, Liu H, Shen H, Hu D, Zeng LL, Wang W. Changes in default mode network connectivity in different glucose metabolism status and diabetes duration. NEUROIMAGE-CLINICAL 2018; 21:101629. [PMID: 30573410 PMCID: PMC6411780 DOI: 10.1016/j.nicl.2018.101629] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 12/01/2018] [Accepted: 12/05/2018] [Indexed: 02/06/2023]
Abstract
Aims/hypotheses It is now generally accepted that diabetes increases the risk for cognitive impairment, but the precise mechanisms are poorly understood. In recent years, resting-state functional magnetic resonance imaging (rs-fMRI) is increasingly used to investigate the neural basis of cognitive dysfunction in type 2 diabetes (T2D) patients. Alterations in brain functional connectivity may underlie diabetes-related cognitive dysfunction and brain damage. The aim of this study was to investigate the changes in default mode network (DMN) connectivity in different glucose metabolism status and diabetes duration. Methods We used a seed-based fMRI analysis to investigate positive and negative DMN connectivity in four groups (39 subjects with normal glucose metabolism [NGM], 23 subjects with impaired glucose metabolism [IGM; i.e., prediabetes], 59 T2D patients with a diabetes duration of <10 years, and 24 T2D patients with a diabetes duration of ≥10 years). Results Negative DMN connectivity increased and then regressed with deteriorating glucose metabolism status and extending diabetes duration. DMN connectivity showed a significant correlation with diabetes duration. Conclusion/interpretation This study suggests that DMN connectivity may exhibit distinct patterns in different glucose metabolism status and diabetes duration, providing some potential neuroimaging evidence for early diagnosis and further understanding of the pathophysiological mechanisms of diabetic brain damage. Subjects include NGM, IGM, and T2D with different glucose metabolism status. DMN connectivity exhibited distinct patterns in different glucose metabolism status. Compensatory enhancement was observed in the negative DMN FC. DMN FC showed a significant correlation with diabetes duration.
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Affiliation(s)
- Huanghui Liu
- Department of Medical Imaging, the Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jun Liu
- Department of Medical Imaging, the Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Limin Peng
- College of Mechatronics and Automation, National University of Defense Technology, Changsha, Hunan, China
| | - Zhichao Feng
- Department of Medical Imaging, the Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Lu Cao
- Department of Medical Imaging, the Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Huasheng Liu
- Department of Medical Imaging, the Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Hui Shen
- College of Mechatronics and Automation, National University of Defense Technology, Changsha, Hunan, China
| | - Dewen Hu
- College of Mechatronics and Automation, National University of Defense Technology, Changsha, Hunan, China
| | - Ling-Li Zeng
- College of Mechatronics and Automation, National University of Defense Technology, Changsha, Hunan, China.
| | - Wei Wang
- Department of Medical Imaging, the Third Xiangya Hospital of Central South University, Changsha, Hunan, China.
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Changes of brain structure in Parkinson’s disease patients with mild cognitive impairment analyzed via VBM technology. Neurosci Lett 2017; 658:121-132. [DOI: 10.1016/j.neulet.2017.08.028] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 08/08/2017] [Accepted: 08/11/2017] [Indexed: 12/30/2022]
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