Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi'an 710038, Shaanxi, China.
Department of Clinical Nutrition, Xijing Hospital, Fourth Military Medical University, 169 Changle Road, Xi'an 710032, Shaanxi, China.
Neuroimage Clin. 2019;22:101802. doi: 10.1016/j.nicl.2019.101802. Epub 2019 Mar 27.
Previous studies presumed that the disturbed neurovascular coupling to be a critical risk factor of cognitive impairments in type 2 diabetes mellitus (T2DM), but distinct clinical manifestations were lacked. Consequently, we decided to investigate the neurovascular coupling in T2DM patients by exploring the MRI relationship between neuronal activity and the corresponding cerebral blood perfusion.
Degree centrality (DC) map and amplitude of low-frequency fluctuation (ALFF) map were used to represent neuronal activity. Cerebral blood flow (CBF) map was used to represent cerebral blood perfusion. Correlation coefficients were calculated to reflect the relationship between neuronal activity and cerebral blood perfusion.
At the whole gray matter level, the manifestation of neurovascular coupling was investigated by using 4 neurovascular biomarkers. We compared these biomarkers and found no significant changes. However, at the brain region level, neurovascular biomarkers in T2DM patients were significantly decreased in 10 brain regions. ALFF-CBF in left hippocampus and fractional ALFF-CBF in left amygdala were positively associated with the executive function, while ALFF-CBF in right fusiform gyrus was negatively related to the executive function. The disease severity was negatively related to the memory and executive function. The longer duration of T2DM was related to the milder depression, which suggests T2DM-related depression may not be a physiological condition but be a psychological condition.
Correlations between neuronal activity and cerebral perfusion maps may be a method for detecting neurovascular coupling abnormalities, which could be used for diagnosis in the future. Trial registry number: This study has been registered in ClinicalTrials.gov (NCT02420470) on April 2, 2015 and published on July 29, 2015.
先前的研究认为,神经血管耦联障碍是 2 型糖尿病(T2DM)认知障碍的一个关键危险因素,但缺乏明显的临床表现。因此,我们决定通过探索 MRI 中神经元活动与相应脑血流灌注之间的关系,来研究 T2DM 患者的神经血管耦联。
采用度中心度(DC)图和低频振幅(ALFF)图来代表神经元活动,脑血流(CBF)图来代表脑血流灌注。计算相关系数来反映神经元活动与脑血流灌注之间的关系。
在整个灰质水平上,我们使用 4 种神经血管生物标志物来研究神经血管耦联的表现。我们比较了这些生物标志物,没有发现明显的变化。然而,在大脑区域水平上,T2DM 患者的神经血管生物标志物在 10 个大脑区域显著降低。左海马的 ALFF-CBF 和左杏仁核的分数 ALFF-CBF 与执行功能呈正相关,而右梭状回的 ALFF-CBF 与执行功能呈负相关。疾病严重程度与记忆和执行功能呈负相关。T2DM 病程越长,抑郁程度越轻,这表明 T2DM 相关的抑郁可能不是一种生理状态,而是一种心理状态。
神经元活动与脑灌注图之间的相关性可能是一种检测神经血管耦联异常的方法,将来可用于诊断。注册号:本研究于 2015 年 4 月 2 日在 ClinicalTrials.gov(NCT02420470)注册,并于 2015 年 7 月 29 日发表。