Liu Kun, Song Jiawen, Jin Jiahui, Huang Xiaoyan, Ye Xinjian, Cui Shihan, Zhou Yongjin, Liu Xiaozheng, Chen Wei, Yan Zhihan, Shan Xiaoou, Fu Yuchuan
Radiology Department, China-USA Neuroimaging Research Institute, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Pediatric Endocrine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Front Psychiatry. 2020 Apr 17;11:284. doi: 10.3389/fpsyt.2020.00284. eCollection 2020.
Type 1 diabetes mellitus (T1DM) causes cognitive changes in children, which may be due to deficits in brain functions. It is unclear whether T1DM children will have brain functional changes during the initial stage of the disease. We aimed to investigate the changes in the functional brain network topology in children with new-onset T1DM. In this study, 35 new-onset T1DM children and 33 age-, sex-matched healthy controls underwent resting-state fMRI. The whole brain functional connectivity density (FCD) analysis and seed-based functional connectivity (FC) analysis were performed to investigate the changes in functional brain networks in new-onset T1DM children when compared with the controls. Pearson correlational analysis was used to explore the correlation between FCD value of differential brain areas and clinical variables in T1DM children. Compared with the controls, children with new-onset T1DM exhibited significantly decreased FCDs of the right inferior temporal gyrus (ITG) and the right posterior cingulate cortex (PCC). In the subsequent FC analysis, decreased FC was found between right PCC and right cuneus and increased FC was found between right ITG and left orbital part of inferior frontal gyrus in children with new-onset T1DM compared to the controls. The FCD values of right ITG and PCC did not correlate with HbA1c, blood glucose level before imaging, and full-scale intelligence quotient (IQ) in T1DM children. These results revealed that T1DM affect the functional activity of the immature brain at the initial stage. These findings also indicate a decrease in regional brain function and abnormalities in temporal-frontal and limbic-occipital circuitry in children with new-onset T1DM, and highlight the effects of T1DM on children's brain networks involved in visual process and memory, which may contribute to the cognition impairments observed in children with T1DM.
1型糖尿病（T1DM）会导致儿童认知改变，这可能是由于脑功能缺陷所致。目前尚不清楚T1DM儿童在疾病初期是否会出现脑功能变化。我们旨在研究新诊断T1DM儿童功能性脑网络拓扑结构的变化。在本研究中，35名新诊断的T1DM儿童和33名年龄、性别匹配的健康对照者接受了静息态功能磁共振成像（fMRI）检查。进行全脑功能连接密度（FCD）分析和基于种子点的功能连接（FC）分析，以研究新诊断T1DM儿童与对照组相比功能性脑网络的变化。采用Pearson相关分析探讨T1DM儿童差异脑区FCD值与临床变量之间的相关性。与对照组相比，新诊断T1DM儿童右侧颞下回（ITG）和右侧后扣带回皮质（PCC）的FCD显著降低。在随后的FC分析中，发现新诊断T1DM儿童与对照组相比，右侧PCC与右侧楔叶之间的FC降低，右侧ITG与左侧额下回眶部之间的FC增加。T1DM儿童右侧ITG和PCC的FCD值与糖化血红蛋白（HbA1c）、成像前血糖水平和全量表智商（IQ）均无相关性。这些结果表明，T1DM在疾病初期会影响未成熟脑的功能活动。这些发现还表明，新诊断T1DM儿童存在局部脑功能下降以及颞叶-额叶和边缘-枕叶回路异常，并突出了T1DM对参与视觉处理和记忆的儿童脑网络的影响，这可能导致T1DM儿童出现认知障碍。
