Oktem Ece Ozdemir, Sayman Dila, Ayyildiz Sevilay, Oktem Çaglar, Ipek Lutfiye, Ayyildiz Behcet, Aslan Fatih, Altindal Emin Utku, Yagci Nilay, Dikici Rumeysa, Karaca Ramazan, Cankaya Şeyda, Avnioglu Seda, Velioglu Halil Aziz, Yulug Burak
Department of Neurology and Neuroscience, Alanya Alaaddin Keykubat University, Antalya, Turkey.
School of Medicine, TUM-NIC Neuroimaging Center, Technical University of Munich, Munich, Germany.
Brain Behav. 2025 Mar;15(3):e70387. doi: 10.1002/brb3.70387.
Type 2 diabetes mellitus is a ubiquitous chronic inflammatory disease with deleterious effects on various tissues, including the kidney, retina, and peripheral nerves. Studies using histopathology and magnetic resonance imaging have revealed that diabetes-related chronic hyperglycemia may impact the brain's essential functioning by causing microvascular damage. The aim of this study was to examine the cognitive functioning of type 2 diabetic individuals with and without retinopathy by evaluating their morphological, structural, and biochemical differences.
Demographic characteristics, education level, type of diabetes mellitus (DM), disease duration, treatment received, other diabetic complications, such as nephropathy and neuropathy, and detailed medical histories were recorded. All participants underwent an extensive neuropsychological examination with Montreal Cognitive Assessment (MoCA) testing. Brain magnetic resonance imaging was performed to evaluate gray matter volume differences between the groups.
Gray matter volume differences between the groups were observed. Differences were observed after multiple corrections (age, education, and total intracranial volume [TIV]). First, the diabetic retinopathy group exhibited a significantly smaller gray matter volume in the right inferior temporal gyrus than the diabetic group (p = 0.032). In addition, the diabetic retinopathy group exhibited a significantly smaller gray matter volume than the control group in the right insula (lateral and central part) (p = 0.011). In addition, MoCA scores exhibited significant correlation with the two regions emerging as statistically significant in our analyses (the right inferior temporal gyrus and right insula) (p = 0.003, p = 0.002, respectively).
Our results suggest the presence of a neurodegenerative process associated with cognitive dysfunction that is particularly prominent in the retinopathy stage of DM.
2型糖尿病是一种普遍存在的慢性炎症性疾病，对包括肾脏、视网膜和周围神经在内的各种组织都有有害影响。使用组织病理学和磁共振成像的研究表明，糖尿病相关的慢性高血糖可能通过引起微血管损伤来影响大脑的基本功能。本研究的目的是通过评估2型糖尿病患者有无视网膜病变时的形态、结构和生化差异，来检查其认知功能。
记录人口统计学特征、教育水平、糖尿病类型、病程、接受的治疗、其他糖尿病并发症（如肾病和神经病变）以及详细的病史。所有参与者都接受了蒙特利尔认知评估（MoCA）测试的广泛神经心理学检查。进行脑磁共振成像以评估两组之间的灰质体积差异。
观察到两组之间的灰质体积差异。在进行多次校正（年龄、教育程度和总颅内体积[TIV]）后仍存在差异。首先，糖尿病视网膜病变组右侧颞下回的灰质体积明显小于糖尿病组（p = 0.032）。此外，糖尿病视网膜病变组右侧岛叶（外侧和中央部分）的灰质体积明显小于对照组（p = 0.011）。此外，MoCA评分与我们分析中具有统计学意义的两个区域（右侧颞下回和右侧岛叶）显著相关（分别为p = 0.¬003，p = 0.002）。
我们的结果表明存在与认知功能障碍相关的神经退行性过程，这在糖尿病的视网膜病变阶段尤为突出。
