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Feng L, Gao L. The role of neurovascular coupling dysfunction in cognitive decline of diabetes patients. Front Neurosci 2024; 18:1375908. [PMID: 38576869 PMCID: PMC10991808 DOI: 10.3389/fnins.2024.1375908] [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: 01/24/2024] [Accepted: 03/05/2024] [Indexed: 04/06/2024] Open
Abstract
Neurovascular coupling (NVC) is an important mechanism to ensure adequate blood supply to active neurons in the brain. NVC damage can lead to chronic impairment of neuronal function. Diabetes is characterized by high blood sugar and is considered an important risk factor for cognitive impairment. In this review, we provide fMRI evidence of NVC damage in diabetic patients with cognitive decline. Combined with the exploration of the major mechanisms and signaling pathways of NVC, we discuss the effects of chronic hyperglycemia on the cellular structure of NVC signaling, including key receptors, ion channels, and intercellular connections. Studying these diabetes-related changes in cell structure will help us understand the underlying causes behind diabetes-induced NVC damage and early cognitive decline, ultimately helping to identify the most effective drug targets for treatment.
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Affiliation(s)
| | - Ling Gao
- Department of Endocrinology, Renmin Hospital of Wuhan University, Wuhan, China
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Gao J, Pan P, Li J, Tang M, Yan X, Zhang X, Wang M, Ai K, Lei X, Zhang X, Zhang D. Analysis of white matter tract integrity using diffusion kurtosis imaging reveals the correlation of white matter microstructural abnormalities with cognitive impairment in type 2 diabetes mellitus. Front Endocrinol (Lausanne) 2024; 15:1327339. [PMID: 38487342 PMCID: PMC10937453 DOI: 10.3389/fendo.2024.1327339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/13/2024] [Indexed: 03/17/2024] Open
Abstract
Background This study aimed to identify disruptions in white matter integrity in type 2 diabetes mellitus (T2DM) patients by utilizing the white matter tract integrity (WMTI) model, which describes compartment-specific diffusivities in the intra- and extra-axonal spaces, and to investigate the relationship between WMTI metrics and clinical and cognitive measurements. Methods A total of 73 patients with T2DM and 57 healthy controls (HCs) matched for age, sex, and education level were enrolled and underwent diffusional kurtosis imaging and cognitive assessments. Tract-based spatial statistics (TBSS) and atlas-based region of interest (ROI) analysis were performed to compare group differences in diffusional metrics, including fractional anisotropy (FA), mean diffusivity (MD), axonal water fraction (AWF), intra-axonal diffusivity (Daxon), axial extra-axonal space diffusivity (De,//), and radial extra-axonal space diffusivity (De,⊥) in multiple white matter (WM) regions. Relationships between diffusional metrics and clinical and cognitive functions were characterized. Results In the TBSS analysis, the T2DM group exhibited decreased FA and AWF and increased MD, De,∥, and De,⊥ in widespread WM regions in comparison with the HC group, which involved 56.28%, 32.07%, 73.77%, 50.47%, and 75.96% of the mean WM skeleton, respectively (P < 0.05, TFCE-corrected). De,⊥ detected most of the WM changes, which were mainly located in the corpus callosum, internal capsule, external capsule, corona radiata, posterior thalamic radiations, sagittal stratum, cingulum (cingulate gyrus), fornix (stria terminalis), superior longitudinal fasciculus, and uniform fasciculus. Additionally, De,⊥ in the genu of the corpus callosum was significantly correlated with worse performance in TMT-A (β = 0.433, P < 0.001) and a longer disease duration (β = 0.438, P < 0.001). Conclusions WMTI is more sensitive than diffusion tensor imaging in detecting T2DM-related WM microstructure abnormalities and can provide novel insights into the possible pathological changes underlying WM degeneration in T2DM. De,⊥ could be a potential imaging marker in monitoring disease progression in the brain and early intervention treatment for the cognitive impairment in T2DM.
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Affiliation(s)
- Jie Gao
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Peichun Pan
- Department of Graduate, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Jing Li
- Department of Graduate, Xi’an Medical University, Xi’an, China
| | - Min Tang
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Xuejiao Yan
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Xin Zhang
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Man Wang
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Kai Ai
- Department of Clinical Science, Philips Healthcare, Xi’an, China
| | - Xiaoyan Lei
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Xiaoling Zhang
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Dongsheng Zhang
- Department of MRI, Shaanxi Provincial People’s Hospital, Xi’an, China
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Zhou Y, Jing J, Zhang Z, Pan Y, Cai X, Zhu W, Li Z, Liu C, Liu H, Meng X, Cheng J, Wang Y, Li H, Wang S, Niu H, Wen W, Sachdev PS, Wei T, Liu T, Wang Y. Disrupted pattern of rich-club organization in structural brain network from prediabetes to diabetes: A population-based study. Hum Brain Mapp 2024; 45:e26598. [PMID: 38339955 PMCID: PMC10839741 DOI: 10.1002/hbm.26598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 12/22/2023] [Accepted: 01/04/2024] [Indexed: 02/12/2024] Open
Abstract
The network nature of the brain is gradually becoming a consensus in the neuroscience field. A set of highly connected regions in the brain network called "rich-club" are crucial high efficiency communication hubs in the brain. The abnormal rich-club organization can reflect underlying abnormal brain function and metabolism, which receives increasing attention. Diabetes is one of the risk factors for neurological diseases, and most individuals with prediabetes will develop overt diabetes within their lifetime. However, the gradual impact of hyperglycemia on brain structures, including rich-club organization, remains unclear. We hypothesized that the brain follows a special disrupted pattern of rich-club organization in prediabetes and diabetes. We used cross-sectional baseline data from the population-based PolyvasculaR Evaluation for Cognitive Impairment and vaScular Events (PRECISE) study, which included 2218 participants with a mean age of 61.3 ± 6.6 years and 54.1% females comprising 1205 prediabetes, 504 diabetes, and 509 normal control subjects. The rich-club organization and network properties of the structural networks derived from diffusion tensor imaging data were investigated using a graph theory approach. Linear mixed models were used to assess associations between rich-club organization disruptions and the subjects' glucose status. Based on the graphical analysis methods, we observed the disrupted pattern of rich-club organization was from peripheral regions mainly located in frontal areas to rich-club regions mainly located in subcortical areas from prediabetes to diabetes. The rich-club organization disruptions were associated with elevated glucose levels. These findings provided more details of the process by which hyperglycemia affects the brain, contributing to a better understanding of the potential neurological consequences. Furthermore, the disrupted pattern observed in rich-club organization may serve as a potential neuroimaging marker for early detection and monitoring of neurological disorders in individuals with prediabetes or diabetes.
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Affiliation(s)
- Yijun Zhou
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical EngineeringBeihang UniversityBeijingChina
| | - Jing Jing
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijingChina
| | - Zhe Zhang
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijingChina
| | - Yuesong Pan
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijingChina
| | - Xueli Cai
- Department of Neurology, Lishui HospitalZhejiang University School of MedicineLishuiZhejiangChina
| | - Wanlin Zhu
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijingChina
| | - Zixiao Li
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijingChina
| | - Chang Liu
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical EngineeringBeihang UniversityBeijingChina
| | - Hao Liu
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical EngineeringBeihang UniversityBeijingChina
| | - Xia Meng
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijingChina
| | - Jian Cheng
- School of Computer Science and Engineering, Beihang UniversityBeijingChina
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijingChina
| | - Hao Li
- China National Clinical Research Center for Neurological DiseasesBeijingChina
| | - Suying Wang
- Cerebrovascular Research Lab, Lishui Hospital, Zhejiang University School of MedicineLishuiZhejiangChina
| | - Haijun Niu
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical EngineeringBeihang UniversityBeijingChina
| | - Wei Wen
- Division of Psychiatry and Mental Health, Faculty of Medicine and Health, Centre for Healthy Brain Ageing (CHeBA)UNSWSydneyNew South WalesAustralia
- Neuropsychiatric Institute, Prince of Wales HospitalSydneyNew South WalesAustralia
| | - Perminder S. Sachdev
- Division of Psychiatry and Mental Health, Faculty of Medicine and Health, Centre for Healthy Brain Ageing (CHeBA)UNSWSydneyNew South WalesAustralia
- Neuropsychiatric Institute, Prince of Wales HospitalSydneyNew South WalesAustralia
| | - Tiemin Wei
- Department of Cardiology, Lishui HospitalZhejiang University School of MedicineZhejiangChina
| | - Tao Liu
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical EngineeringBeihang UniversityBeijingChina
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijingChina
- Research Unit of Artificial Intelligence in Cerebrovascular DiseaseChinese Academy of Medical Sciences, 2019RU018BeijingChina
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Liu Y, Jiang Y, Du W, Gao B, Gao J, Hu S, Song Q, Wang W, Miao Y. White matter microstructure alterations in type 2 diabetes mellitus and its correlation with cerebral small vessel disease and cognitive performance. Sci Rep 2024; 14:270. [PMID: 38167604 PMCID: PMC10762026 DOI: 10.1038/s41598-023-50768-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 12/25/2023] [Indexed: 01/05/2024] Open
Abstract
Microstructural abnormalities of white matter fiber tracts are considered as one of the etiology of diabetes-induced neurological disorders. We explored the cerebral white matter microstructure alteration accurately, and to analyze its correlation between cerebral small vessel disease (CSVD) burden and cognitive performance in type 2 diabetes mellitus (T2DM). The clinical-laboratory data, cognitive scores [including mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA), California verbal learning test (CVLT), and symbol digit modalities test (SDMT)], CSVD burden scores of the T2DM group (n = 34) and healthy control (HC) group (n = 21) were collected prospectively. Automatic fiber quantification (AFQ) was applied to generate bundle profiles along primary white matter fiber tracts. Diffusion tensor images (DTI) metrics and 100 nodes of white matter fiber tracts between groups were compared. Multiple regression analysis was used to analyze the relationship between DTI metrics and cognitive scores and CSVD burden scores. For fiber-wise and node-wise, DTI metrics in some commissural and association fibers were increased in T2DM. Some white matter fiber tracts DTI metrics were independent predictors of cognitive scores and CSVD burden scores. White matter fiber tracts damage in patients with T2DM may be characterized in specific location, especially commissural and association fibers. Aberrational specific white matter fiber tracts are associated with visuospatial function and CSVD burden.
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Affiliation(s)
- Yangyingqiu Liu
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang, Dalian, China
- Department of Radiology, Zibo Central Hospital, 54 Gongqingtuan Road, Zhangdian, Zibo, China
| | - Yuhan Jiang
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang, Dalian, China
| | - Wei Du
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang, Dalian, China
| | - Bingbing Gao
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang, Dalian, China
| | - Jie Gao
- Department of Neurology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang, Dalian, China
| | - Shuai Hu
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang, Dalian, China
| | - Qingwei Song
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang, Dalian, China
| | - Weiwei Wang
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang, Dalian, China.
| | - Yanwei Miao
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang, Dalian, China.
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Asturias A, Knoblauch T, Rodriguez A, Vanier C, Le Tohic C, Barrett B, Eisenberg M, Gibbert R, Zimmerman L, Parikh S, Nguyen A, Azad S, Germin L, Fazzini E, Snyder T. Diffusion in the corpus callosum predicts persistence of clinical symptoms after mild traumatic brain injury, a multi-scanner study. FRONTIERS IN NEUROIMAGING 2023; 2:1153115. [PMID: 38025312 PMCID: PMC10654678 DOI: 10.3389/fnimg.2023.1153115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 08/23/2023] [Indexed: 12/01/2023]
Abstract
Background Mild traumatic brain injuries (mTBIs) comprise 80% of all TBI, but conventional MRI techniques are often insensitive to the subtle changes and injuries produced in a concussion. Diffusion tensor imaging (DTI) is one of the most sensitive MRI techniques for mTBI studies with outcome and symptom associations described. The corpus callosum (CC) is one of the most studied fiber tracts in TBI and mTBI, but the comprehensive post-mTBI symptom relationship has not fully been explored. Methods This is a retrospective observational study of how quantitative DTI data of the CC and its sub-regions may relate to clinical presentation of symptoms and timing of resolution of symptoms in patients diagnosed with uncomplicated mTBI. DTI and clinical data were obtained retrospectively from 446 (mean age 42 years, range 13-82) civilian patients. From patient medical charts, presentation of the following common post-concussive symptoms was noted: headache, balance issues, cognitive deficits, fatigue, anxiety, depression, and emotional lability. Also recorded was the time between injury and a visit to the physician when improvement or resolution of a particular symptom was reported. FA values from the total CC and 3 subregions of the CC (genu or anterior, mid body, and splenium or posterior) were obtained from hand tracing on the Olea Sphere v3.0 SP12 free-standing workstation. DTI data was obtained from 8 different 3T MRI scanners and harmonized via ComBat harmonization. The statistical models used to explore the association between regional Fractional Anisotropy (FA) values and symptom presentation and time to symptom resolution were logistic regression and interval-censored semi-parametric Cox proportional hazard models, respectively. Subgroups related to age and timing of first scan were also analyzed. Results Patients with the highest FA in the total CC (p = 0.01), anterior CC (p < 0.01), and mid-body CC (p = 0.03), but not the posterior CC (p = 0.91) recovered faster from post-concussive cognitive deficits. Patients with the highest FA in the posterior CC recovered faster from depression (p = 0.04) and emotional lability (p = 0.01). There was no evidence that FA in the CC or any of its sub-regions was associated with symptom presentation or with time to resolution of headache, balance issues, fatigue, or anxiety. Patients with mTBI under 40 had higher FA in the CC and the anterior and mid-body subregions (but not the posterior subregion: p = 1.00) compared to patients 40 or over (p ≤ 0.01). There was no evidence for differences in symptom presentation based on loss of consciousness (LOC) or sex (p ≥ 0.18). Conclusion This study suggests that FA of the CC has diagnostic and prognostic value for clinical assessment of mTBI in a large diverse civilian population, particularly in patients with cognitive symptoms.
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Affiliation(s)
- Alexander Asturias
- Imgen Research Group, Las Vegas, NV, United States
- Touro University Nevada, Henderson, NV, United States
| | - Thomas Knoblauch
- Imgen Research Group, Las Vegas, NV, United States
- Touro University Nevada, Henderson, NV, United States
- School of Integrated Health Sciences, University of Nevada Las Vegas, Las Vegas, NV, United States
| | - Alan Rodriguez
- Imgen Research Group, Las Vegas, NV, United States
- Touro University Nevada, Henderson, NV, United States
| | - Cheryl Vanier
- Imgen Research Group, Las Vegas, NV, United States
- Touro University Nevada, Henderson, NV, United States
| | - Caroline Le Tohic
- Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV, United States
| | - Brandon Barrett
- Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV, United States
| | - Matthew Eisenberg
- Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV, United States
| | | | - Lennon Zimmerman
- Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV, United States
| | | | - Anh Nguyen
- Touro University Nevada, Henderson, NV, United States
| | - Sherwin Azad
- MountainView Hospital, HCA Healthcare, Las Vegas, NV, United States
| | - Leo Germin
- Clinical Neurology Specialists, Las Vegas, NV, United States
| | | | - Travis Snyder
- Imgen Research Group, Las Vegas, NV, United States
- Touro University Nevada, Henderson, NV, United States
- MountainView Hospital, HCA Healthcare, Las Vegas, NV, United States
- SimonMed Imaging, Scottsdale, AZ, United States
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Tang X, Chen Y, Tan H, Fang J, Yu D, Chen C, Li X, Hu Z, Ding L, Zhang Y. Micro- and macro-changes in early-stage type 2 diabetes mellitus without cognitive impairment: a diffusion tensor imaging (DTI) and surface-based morphometry (SBM) study. Front Neurol 2023; 14:1115634. [PMID: 37475732 PMCID: PMC10354865 DOI: 10.3389/fneur.2023.1115634] [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: 12/04/2022] [Accepted: 05/26/2023] [Indexed: 07/22/2023] Open
Abstract
Introduction Brain structure and function changes are considered major brain damages in type 2 diabetes mellitus (T2DM), which likely has a close relationship with cognitive impairment. Many previous studies have shown by using brain structural and functional magnetic resonance imaging (MRI) methods that brain white and gray matter are damaged in T2DM, leading to cognitive impairment. Researches neglected patients of T2DM without cognitive dysfunction might also have brain changes. Methods In this study, subjects with early stage T2DM with no cognitive dysfunction were enrolled to detect brain damages using the tract-based spatial statistics analysis (TBSS) method to demonstrate white matter (WM) micro changes and surface-based morphometry (SBM) method to assess cerebral cortex macro changes. Results The whole-brain TBSS analysis revealed that there were no statistically significant changes in fractional anisotropy (FA) and mean diffusivity (MD), but the FA declined in some area of cerebral WM (p < 0.1). The SBM results showed no changes in cortical thickness (CT), cortical volume (CV), surface area (SA), and cortical sulcal curve (CSC) between these two groups, but pial local gyration index (LGI) was decreased in the precuneus (-log10, p = -3.327). Discussion In conclusion, early stage T2DM patients without cognitive impairment had brain micro and macro structural damages, suggesting the potential use of MRI as an imaging marker to detect brain changes in early stage T2DM, which could not be observed and assessed clinically.
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Affiliation(s)
- Xiangyong Tang
- Department of Medical Imaging, Affiliated Longhua People's Hospital, Southern Medical University, Shenzhen, China
| | - Yanzi Chen
- Department of Medical Imaging, Affiliated Longhua People's Hospital, Southern Medical University, Shenzhen, China
| | - Hui Tan
- Department of Medical Imaging, Second Affiliated Hospital, Shantou University Medical College, Shantou, China
| | - Jinzhi Fang
- Department of Medical Imaging, Affiliated Longhua People's Hospital, Southern Medical University, Shenzhen, China
| | - Dafei Yu
- Department of Medical Imaging, Affiliated Longhua People's Hospital, Southern Medical University, Shenzhen, China
| | - Cuimei Chen
- Department of Medical Imaging, Affiliated Longhua People's Hospital, Southern Medical University, Shenzhen, China
| | - Xiao Li
- Department of Medical Imaging, Affiliated Longhua People's Hospital, Southern Medical University, Shenzhen, China
| | - Ziqi Hu
- Department of Medical Imaging, Affiliated Longhua People's Hospital, Southern Medical University, Shenzhen, China
| | - Ling Ding
- Department of Medical Imaging, Affiliated Longhua People's Hospital, Southern Medical University, Shenzhen, China
| | - Yuzhong Zhang
- Department of Medical Imaging, Affiliated Longhua People's Hospital, Southern Medical University, Shenzhen, China
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Li Z, Jiang Y, Long C, Peng Q, Yue R. The gut microbiota-astrocyte axis: Implications for type 2 diabetic cognitive dysfunction. CNS Neurosci Ther 2023; 29 Suppl 1:59-73. [PMID: 36601656 PMCID: PMC10314112 DOI: 10.1111/cns.14077] [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] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 11/20/2022] [Accepted: 12/18/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Diabetic cognitive dysfunction (DCD) is one of the most insidious complications of type 2 diabetes mellitus, which can seriously affect the ability to self-monitoring of blood glucose and the quality of life in the elderly. Previous pathological studies of cognitive dysfunction have focused on neuronal dysfunction, characterized by extracellular beta-amyloid deposition and intracellular tau hyperphosphorylation. In recent years, astrocytes have been recognized as a potential therapeutic target for cognitive dysfunction and important participants in the central control of metabolism. The disorder of gut microbiota and their metabolites have been linked to a series of metabolic diseases such as diabetes mellitus. The imbalance of intestinal flora has the effect of promoting the occurrence and deterioration of several diabetes-related complications. Gut microbes and their metabolites can drive astrocyte activation. AIMS We reviewed the pathological progress of DCD related to the "gut microbiota-astrocyte" axis in terms of peripheral and central inflammation, intestinal and blood-brain barrier (BBB) dysfunction, systemic and brain energy metabolism disorders to deepen the pathological research progress of DCD and explore the potential therapeutic targets. CONCLUSION "Gut microbiota-astrocyte" axis, unique bidirectional crosstalk in the brain-gut axis, mediates the intermediate pathological process of neurocognitive dysfunction secondary to metabolic disorders in diabetes mellitus.
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Affiliation(s)
- Zi‐Han Li
- Hospital of Chengdu University of Traditional Chinese MedicineChengduChina
| | - Ya‐Yi Jiang
- Hospital of Chengdu University of Traditional Chinese MedicineChengduChina
| | - Cai‐Yi Long
- Hospital of Chengdu University of Traditional Chinese MedicineChengduChina
| | - Qian Peng
- Hospital of Chengdu University of Traditional Chinese MedicineChengduChina
| | - Ren‐Song Yue
- Hospital of Chengdu University of Traditional Chinese MedicineChengduChina
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Wan W, Qin Q, Xie L, Zhang H, Wu F, Stevens RC, Liu Y. GLP-1R Signaling and Functional Molecules in Incretin Therapy. MOLECULES (BASEL, SWITZERLAND) 2023; 28:molecules28020751. [PMID: 36677809 PMCID: PMC9866634 DOI: 10.3390/molecules28020751] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 01/14/2023]
Abstract
Glucagon-like peptide-1 receptor (GLP-1R) is a critical therapeutic target for type 2 diabetes mellitus (T2DM). The GLP-1R cellular signaling mechanism relevant to insulin secretion and blood glucose regulation has been extensively studied. Numerous drugs targeting GLP-1R have entered clinical treatment. However, novel functional molecules with reduced side effects and enhanced therapeutic efficacy are still in high demand. In this review, we summarize the basis of GLP-1R cellular signaling, and how it is involved in the treatment of T2DM. We review the functional molecules of incretin therapy in various stages of clinical trials. We also outline the current strategies and emerging techniques that are furthering the development of novel therapeutic drugs for T2DM and other metabolic diseases.
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Affiliation(s)
- Wenwei Wan
- iHuman Institute, ShanghaiTech University, School of Life Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Qikai Qin
- iHuman Institute, ShanghaiTech University, School of Life Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Linshan Xie
- iHuman Institute, ShanghaiTech University, School of Life Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Hanqing Zhang
- iHuman Institute, ShanghaiTech University, Shanghai 201210, China
| | - Fan Wu
- Structure Therapeutics, South San Francisco, CA 94080, USA
| | - Raymond C. Stevens
- iHuman Institute, ShanghaiTech University, Shanghai 201210, China
- Structure Therapeutics, South San Francisco, CA 94080, USA
- Correspondence: (R.C.S.); (Y.L.)
| | - Yan Liu
- iHuman Institute, ShanghaiTech University, Shanghai 201210, China
- Correspondence: (R.C.S.); (Y.L.)
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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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Reduced white matter microstructural integrity in prediabetes and diabetes: A population-based study. EBioMedicine 2022; 82:104144. [PMID: 35810560 PMCID: PMC9278067 DOI: 10.1016/j.ebiom.2022.104144] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 06/06/2022] [Accepted: 06/22/2022] [Indexed: 11/27/2022] Open
Abstract
Background White matter (WM) microstructural abnormalities have been observed in diabetes. However, evidence of prediabetes is currently lacking. This study aims to investigate the WM integrity in prediabetes and diabetes. We also assess the association of WM abnormalities with glucose metabolism status and continuous glucose measures. Methods The WM integrity was analyzed using cross-sectional baseline data from a population-based PolyvasculaR Evaluation for Cognitive Impairment and vaScular Events (PRECISE) study. The cohort, including a total of 2218 cases with the mean age of 61.3 ± 6.6 years and 54.1% female, consisted of 1205 prediabetes which are categorized into two subgroups (a group of 254 prediabetes with combined impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) and the other group of 951 prediabetes without combined IFG/IGT), 504 diabetes, and 509 normal control subjects. Alterations of WM integrity were determined by diffusion tensor imaging along with tract-based spatial statistics analysis to compare diffusion metrics on WM skeletons between groups. The mixed-effects multivariate linear regression models were used to assess the association between WM microstructural alterations and glucose status. Findings Microstructural abnormalities distributed in local WM tracts in prediabetes with combined IFG/IGT and spread widely in diabetes. These WM abnormalities are associated with higher glucose measures. Interpretation Our findings suggest that WM microstructural abnormalities are already present at the prediabetes with combined IFG/IGT stage. Preventative strategies should begin early to maintain normal glucose metabolism and avert further destruction of WM integrity. Funding Partially supported by National Key R&D Program of China (2016YFC0901002).
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