Abstract
Although Type 2 diabetes mellitus (T2DM) is a well-recognized risk factor for dementia, the neural mechanisms that underlie cognitive impairment in T2DM remain unclear. This study uses resting-state functional magnetic resonance imaging (fMRI) to examine attention network alterations in T2DM and their relationships to impaired cognitive performance. Data-driven independent component analysis was applied to resting-state fMRI data from 38 T2DM patients and 32 healthy controls to identify the dorsal attention network (DAN) and ventral attention network (VAN). Correlations were then determined among the resting-state functional connectivity (rsFC), clinical data, and neuropsychological scores. The T2DM patients exhibited decreased rsFC in the left middle frontal gyrus (MFG) and bilateral inferior parietal lobe (IPL) of the DAN, as well as the left IPL and right MFG/IFG of the VAN. In addition, the rsFC of the left MFG was inversely correlated with the Trail Making Test-B scores; the rsFC of the left IPL was positively correlated with the Digit Span Test scores but negatively correlated with HbA1c; and the rsFC in the right precuneus was positively associated with cognitive performance (without Bonferroni correction). In conclusion, T2DM affects resting-state attentional networks, which may be related to reduced attention and a hyperglycemic state.
Highlights
Worldwide prevalence rates of type 2 diabetes mellitus (T2DM) and dementia are rapidly increasing and have become major global health challenges
Using resting-state blood oxygen level-dependent (BOLD) functional magnetic resonance imaging, several studies have showed reduced functional connectivity between the nodes of the default mode network (DMN), such as the posterior cingulated cortex (PCC) and the hippocampus, in T2DM patients compared to normal controls[6,7,8]
No significant differences were observed between groups with respect to age, gender, education level, BMI, blood lipids, blood pressure, white matter hyperintensity (WMH), Items Age, years Gender, female (%) Education levels, years Diabetes duration, years History of smoking (%) BMI, kg/m2 Systolic BP, mmHg Diastolic BP, mmHg HbA1c, % Fasting glucose, mmol/L Postprandial glucose, mmol/L Triglyceride, mmol/l Total cholesterol, mmol/l low-density lipoprotein cholesterol (LDL-C), mmol/l high-density lipoprotein cholesterol (HDL-C), mmol/l White matter hyperintensity Lacunar infarcts (%) Intima-media thickness, mm Blood pressure lowering medications (%) Cholesterol lowering medications (%)
Summary
Worldwide prevalence rates of type 2 diabetes mellitus (T2DM) and dementia are rapidly increasing and have become major global health challenges. Using resting-state blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI), several studies have showed reduced functional connectivity between the nodes of the default mode network (DMN), such as the posterior cingulated cortex (PCC) and the hippocampus, in T2DM patients compared to normal controls[6,7,8]. These resting state functional connectivity (rsFC) studies used seed-based analysis, a hypothesis-driven method, to assess the temporal synchronization of neuronal activity between the seed and other remote areas. We hypothesize that T2DM patients would exhibit reduced functional connectivity in the DAN and VAN and that functional connectivity within these networks would correlate with cognitive tests of attention
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