Feng Yue, Li Yifan, Tan Xin, Liang Yi, Ma Xiaomeng, Chen Yuna, Lv Wenjiao, Wu Jinjian, Kang Shangyu, Li Mingrui, Qiu Shijun
First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.
Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
Front Neurol. 2021 Sep 9;12:697349. doi: 10.3389/fneur.2021.697349. eCollection 2021.
Structural and functional brain alterations that underlie cognitive decline have been observed in elderly adults with type 2 diabetes mellitus (T2DM); however, whether these alterations can be observed in patients with early-onset T2DM remains unclear. Therefore, we aimed to describe the abnormalities in brain volume and functional patterns in patients with early-onset T2DM in the present study. We enrolled 20 patients with early-onset T2DM and 20 healthy controls (HCs). Changes in brain volume were assessed using voxel-based morphology (VBM), while changes in brain function were assessed using degree centrality (DC) and functional connectivity (FC). Compared to HCs, patients with early-onset T2DM exhibited gray matter reductions in the left orbital superior, middle, and inferior frontal gyri as well as the right superior frontal gyrus. The gray matter reductions in the right superior frontal gyrus were negatively associated with the urine albumin to creatinine ratio. Furthermore, increased DC values were observed in the left superior temporal gyrus, left Heschl gyrus, and left hippocampus in patients with early-onset T2DM. An FC analysis of these regions revealed elevated connectivity in the right precuneus, left inferior parietal gyrus, left Heschl gyrus, bilateral post-central gyrus, bilateral insula, bilateral superior temporal gyrus, and bilateral medial and paracingulate gyrus. Furthermore, the FC of the hubs to the superior temporal gyrus, insula, and Heschl gyrus was increased and positively correlated with trail making test-B. Decreased local gray matter volume and increased DC and FC may represent the neurobiological mechanism underlying cognitive dysfunction in patients with early-onset T2DM.
在2型糖尿病（T2DM）老年患者中已观察到认知功能下降背后的大脑结构和功能改变；然而，这些改变是否能在早发型T2DM患者中观察到仍不清楚。因此，在本研究中，我们旨在描述早发型T2DM患者的脑容量和功能模式异常。我们招募了20例早发型T2DM患者和20名健康对照者（HCs）。使用基于体素的形态学（VBM）评估脑容量变化，同时使用度中心性（DC）和功能连接（FC）评估脑功能变化。与HCs相比，早发型T2DM患者在左侧眶额上回、中回和下回以及右侧额上回出现灰质减少。右侧额上回的灰质减少与尿白蛋白肌酐比值呈负相关。此外，早发型T2DM患者在左侧颞上回、左侧颞横回和左侧海马中观察到DC值增加。对这些区域的FC分析显示，右侧楔前叶、左侧顶下小叶、左侧颞横回、双侧中央后回、双侧脑岛、双侧颞上回以及双侧内侧和扣带旁回的连接性升高。此外，枢纽与颞上回、脑岛和颞横回之间的FC增加，且与连线测验B呈正相关。局部灰质体积减少以及DC和FC增加可能代表早发型T2DM患者认知功能障碍的神经生物学机制。
