Liu Kai, Wang Xiaopeng, Zhang Teng, Wang Wei, Li Ruohan, Lu Li, Deng Yanjia, Xu Kai, Kwok Timothy
Department of Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China.
Department of Neurology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
Front Aging Neurosci. 2022 Mar 25;14:754997. doi: 10.3389/fnagi.2022.754997. eCollection 2022.
Although previous studies have indicated that older people with diabetes mellitus (DM) had an approximately two times larger white matter hyperintensity (WMH) load than those without DM, the influence of WMHs on cognition is uncertain and inconsistent in the literature. It is unclear whether the short-range fibers in the juxtacortical region, traditionally considered to be spared from WMH pathology, are enhanced as an adaptive response to deep WM degeneration in older diabetic people with normal cognition. Moreover, the specific effect of vitamin B deficiency, commonly accompanied by DM, remains to be investigated. This study implemented a specialized analysis of the superficial cortical short-range fiber connectivity density (SFiCD) based on a data-driven framework in 70 older individuals with DM and low serum vitamin B. Moreover, the effects of time and vitamin B supplementation were assessed based on a randomized placebo-controlled trial in 59 individuals. The results demonstrated a higher SFiCD in diabetic individuals with a higher deep WMH load. Additionally, a significant interaction between DWMH load and homocysteine on SFiCD was found. During the 27-month follow-up period, a longitudinal increase in the SFiCD was observed in the bilateral frontal cortices. However, the observed longitudinal SFiCD change was not dependent on vitamin B supplementation; thus, the specific reason for the longitudinal cortical short fiber densification may need further study. Overall, these findings may help us better understand the neurobiology of brain plasticity in older patients with DM, as well as the interplay among DM, WMH, and vitamin B deficiency.
尽管先前的研究表明，患有糖尿病（DM）的老年人的白质高信号（WMH）负荷比未患糖尿病的人大约大两倍，但在文献中，WMH对认知的影响尚不确定且不一致。目前尚不清楚传统上认为不受WMH病理影响的皮质旁区域的短程纤维，是否会作为对认知正常的老年糖尿病患者深部白质变性的适应性反应而增强。此外，通常与糖尿病伴随的维生素B缺乏的具体影响仍有待研究。本研究基于数据驱动框架，对70名患有糖尿病且血清维生素B水平较低的老年人的浅表皮质短程纤维连接密度（SFiCD）进行了专门分析。此外，还基于一项随机安慰剂对照试验，对59名个体评估了时间和维生素B补充的影响。结果表明，深部WMH负荷较高的糖尿病个体的SFiCD较高。此外，还发现深部WMH负荷与同型半胱氨酸对SFiCD有显著交互作用。在27个月的随访期内，双侧额叶皮质的SFiCD出现纵向增加。然而，观察到的SFiCD纵向变化并不依赖于维生素B补充；因此，皮质短纤维纵向致密化的具体原因可能需要进一步研究。总体而言，这些发现可能有助于我们更好地理解老年糖尿病患者脑可塑性的神经生物学，以及糖尿病、WMH和维生素B缺乏之间的相互作用。
