Abstract
The spontaneous changes in brain activity in patients with diabetic optic neuropathy using steady-state fMRI. The fractional amplitude of the low-frequency fluctuation method was applied to evaluate neural activity changes. The Hospital Anxiety and Depression Scale was used to assess the anxiety and depression status of participants. The independent sample t-test and chi-squared test were applied to analyze the demographics of diabetic optic neuropathy patients and healthy controls. Receiver operating characteristic curves were applied to analyze the variation in mean fractional amplitude of low-frequency fluctuation values between diabetic optic neuropathy patients and healthy controls. Pearson's correlation analysis analyzed the relationships between the fractional amplitude of low-frequency fluctuation values of brain regions and clinical behaviors in the diabetic optic neuropathy group. The fractional amplitude of low-frequency fluctuation value of diabetic optic neuropathy patients was significantly higher than healthy controls in the right precentral gyrus. However, the fractional amplitude of low-frequency fluctuation values in the right anterior cingulate gyrus and left middle cingulate gyrus were markedly decreased in diabetic optic neuropathy patients. The area under the curve of receiver operating characteristics for each brain region showed high accuracy. Pearson's correlation analysis showed that fractional amplitude of low-frequency fluctuation values of the right anterior cingulate gyrus and left middle cingulate gyrus was negatively correlated with Hospital Anxiety and Depression Scale scores. The fractional amplitude of low-frequency fluctuation values of the left middle cingulate gyrus was negatively correlated with diabetic optic neuropathy disease duration. In conclusion, we found abnormal spontaneous brain activities in regions related to cognitive and emotional dysfunction, eye movement disorder, and vision loss in patients with diabetic optic neuropathy. These results may indicate the underlying neuropathological mechanisms of diabetic optic neuropathy and show that fractional amplitude of low-frequency fluctuation may be an effective method to distinguish patients with diabetic optic neuropathy from healthy individuals.
Highlights
The incidence of diabetes has increased in recent years, making it one of the major diseases affecting public health globally
Statistically significant differences between the groups were found in bestcorrected visual acuity (VA) of each eye, latency, and amplitude of the monocular visual evoked potential (VEP) from each eye, and the HADS score (p < 0.05)
We found a lower fALFF value in right anterior cingulate gyrus (RACG) in diabetic optic neuropathy (DON) patients, which suggests that the abnormality of RACG may be part of the neuropathological mechanism of vision loss in DON patients
Summary
The incidence of diabetes has increased in recent years, making it one of the major diseases affecting public health globally. Diabetes is a metabolic disease with systemic effects. Complications often occur in tissues and organs such as the eyes, kidneys, heart, blood vessels, and nerves [1, 2]. Ocular complications include diabetic retinopathy, macular edema, and cataracts. Neuropathy is a complication of diabetes that affects the central and sensory nerve endings, with manifestations such as skin numbness, diabetic nephropathy, and diabetic foot problems. When the optic nerve is involved, it is known as diabetic optic neuropathy (DON)
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