Abstract
PurposeTo investigate correlations between altered spontaneous brain activity, diabetic vascular disease, and cognitive function for patients with type 2 diabetes mellitus (T2DM) using resting-state functional magnetic resonance imaging (rs-fMRI).MethodsRs-fMRI was performed for T2DM patients (n = 26) and age-, gender-, and education-matched non-diabetic control subjects (n = 26). Amplitude of low frequency fluctuations (ALFF) were computed from fMRI signals to measure spontaneous neuronal activity. Differences in the ALFF patterns between patients and controls, as well as their correlations with clinical variables, were evaluated.ResultsCompared with healthy controls, T2DM patients exhibited significantly decreased ALFF values mainly in the frontal and parietal lobes, the bilateral thalumi, the posterior lobe of the cerebellum, and increased ALFF values mainly in the visual cortices. Furthermore, lower ALFF values in the left subcallosal gyrus correlated with lower ankle-brachial index values (r = 0.481, p = 0.020), while lower ALFF values in the bilateral medial prefrontal gyri correlated with higher urinary albumin-creatinine ratio (r = −0.418, p = 0.047). In addition, most of the regions with increased ALFF values in the visual cortices were found to negatively correlate with MoCA scores.ConclusionsThese results confirm that ALFF are altered in many brain regions in T2DM patients, and this is associated with the presence of diabetic vascular disease and poor cognitive performance. These findings may provide additional insight into the neurophysiological mechanisms that mediate T2DM-related cognitive dysfunction, and may also serve as a reference for future research.
Highlights
There has been growing concern regarding the brain damage associated with diabetes mellitus, especially cognitive dysfunction associated with type 2 diabetes mellitus (T2DM) [1,2,3]
Based on the results of previous studies that T2DM-related cognitive dysfunction is closely associated with diabetic vascular damage [1,3,6] and Amplitude of low frequency fluctuations (ALFF) sensitivity can detect the spontaneous activity of neurons [25,26], the aim of the current study was to compare ALFF patterns between T2DM patients and healthy controls, and to determine whether alterations in these patterns correlate with diabetic variables, vascular variables such as ankle-brachial index (ABI) and urinary albumin-to-creatinine ratio (UACR), and cognitive dysfunction
Using the ALFF metric of resting-state functional MRI (rs-fMRI), abnormal spontaneous brain activity was detected in various regions of the brain in T2DM patients compared with healthy controls
Summary
There has been growing concern regarding the brain damage associated with diabetes mellitus, especially cognitive dysfunction associated with type 2 diabetes mellitus (T2DM) [1,2,3]. It has been proposed that vascular components may play a key role in the pathogenesis of cognitive dysfunction in diabetics [1,3,6] since vascular components have a central role in mediating VaD and affect the pathogenesis of Alzheimer disease [7] It is well-established that T2DM patients are predisposed to macroand microvascular complications throughout the body, and this can include cerebral small vessel disease (SVD). In elderly T2DM patients, albuminuria was found to be associated with frontal lobe dysfunction independent of cerebral SVD [15] Despite these observations, the exact neuropatho-physiological mechanisms that mediate cognitive impairment related to T2DM and its vascular complications have not been fully elucidated
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