Abstract
Type 2 diabetes mellitus (T2DM) is related to a variety of cognitive impairments that may even progress to dementia. Studies have found the angular gyrus (AG) is a cross-modal integration hub that is involved in a variety of cognitive processes. However, few studies have focused on the patterns of resting-state functional connections (rsFCs) of the AG in patients with T2DM. This study explored the functional connection (FC) between the AG and the whole brain and the relationship between the FC and clinical/cognitive variables in patients with T2DM. 44 patients with T2DM and 43 sex-, age-, and education-matched healthy controls underwent resting-state fMRI and received neuropsychological assessments. Compared with the control group, the T2DM group showed abnormal rsFCs between the AG and multiple brain regions. The FC between the left AG and the left medial temporal lobe in the T2DM group was positively correlated with scores on the Montreal Cognitive Assessment, after a Bonferroni correction (r = 0.40, P = 0.009). Collectively, patients with T2DM have abnormal FCs between the AG and extensive brain regions that may be related to various cognitive processes.
Highlights
Type 2 diabetes mellitus (T2DM) is a heterogeneous metabolic disorder characterized by reduced insulin sensitivity and relative insulin deficiency, which increases the risk for cognitive decline and dementia, such as Alzheimer’s disease (AD) and vascular dementia (Biessels et al, 2006; Kopf and Frolich, 2009; McCrimmon et al, 2012)
We observed that the bilateral angular gyrus (AG) exhibited abnormal functional connection (FC) with multiple brain regions in patients with T2DM compared to the healthy controls (HCs), and the reduced FC between the left AG and the left medial temporal lobe was positively correlated with the Montreal Cognitive Assessment (MoCA)
We found that the FC values between the left AG and the left medial temporal lobe (MTL) were positively correlated with MoCA scores, which may indicate that the abnormal episodic memory caused by the interruption of functional connectivity may further affect the overall cognitive functioning of patients
Summary
Type 2 diabetes mellitus (T2DM) is a heterogeneous metabolic disorder characterized by reduced insulin sensitivity and relative insulin deficiency, which increases the risk for cognitive decline and dementia, such as Alzheimer’s disease (AD) and vascular dementia (Biessels et al, 2006; Kopf and Frolich, 2009; McCrimmon et al, 2012). A large number of studies have found that various cognitive functions, such as memory, attention, executive function, language comprehension, and problem solving processes, in patients with T2DM have varying degrees of impairment (Ruis et al, 2009; Pasquier, 2010). The human cerebral cortex consists of many neurons that are organized into a complex network that forms the structural substrate for cognitive functioning (Hagmann et al, 2008). Resting-state fMRI is a powerful tool that can effectively enable investigating the neural activity of the human brain and this methedhas been widely used to examine the pathogenesis of various neuropsychiatric disorders (Biswal et al, 1995; Zhang and Raichle, 2010). Resting-state functional connectivity (rsFC) is a commonly used method to evaluate inter-regional functional coupling between different
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