He Shuang, Lu Juan-Juan, Wu Jia-Jia, Zheng Mou-Xiong, Ma Jie, Hua Xu-Yun, Xu Jian-Guang
Department of Orthopaedics, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200021, China.
Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
Brain Res. 2025 Jun 1;1856:149586. doi: 10.1016/j.brainres.2025.149586. Epub 2025 Mar 18.
To investigate alterations in brain activity in patients with Type 2 Diabetes and explore the relationship between altered regions and neuropsychological performances.
A total of 36 patients with Type 2 Diabetes and 40 age- and education-matched healthy controls were recruited for this case-control study. All participants underwent resting-state functional magnetic resonance imaging (Resting-state fMRI) and neuropsychological tests. The neuropsychological scales included the Auditory Verbal Learning Test (AVLT), Shape Trajectory Test B (STT-B), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), and Boston Naming Test (BNT), Symbol Digit Modality Test (SDMT), Regional homogeneity (ReHo) and the amplitude of low-frequency fluctuations (ALFF) were used to assess differences in spontaneous regional brain activity. For functional connectivity (FC) analyses, the differences identified among the groups were selected as seed regions. Then, the correlations between neuropsychological scale scores (AVLT, HAMA, HAMD, STT-B, BNT, and SDMT) and ALFF/ReHo values were specifically analyzed in the focal regions that exhibited significant alterations between the T2DM and control groups, as detailed in Tables 2 and 3.
Patients with Type 2 Diabetes exhibited significantly higher ALFF values in the superior lobe of the cerebellum, specifically in the left cerebellar crus I (Cerebellum_Crus I_L), left cerebellar lobule VI (Cerebellum_6_L), and left cerebellar lobule IV-V (Cerebellum_4_5_L). Additionally, they exhibited elevated ReHo values in the Cerebellum_Crus I_L and Cerebellum_6_L. The findings were statistically significant with a family-wise error-corrected, cluster-level p-value of less than 0.05. However, the FC analysis was not significant. AVLT scores were significantly lower in the diabetes group. The correlation analysis demonstrated a negative association between ALFF values of the Cerebellum_6_L and AVLT scores (R = 0.1375, P < 0.001). The ReHo values within the Cerebellum_6_L also exhibited a negative association with AVLT scores (R = 0.0937, P = 0.007).
Patients with Type 2 Diabetes showed abnormal neural activities in diverse cerebellar regions mainly related to cognitive functions. This provides supplementary information to deepen our insight into the neural mechanisms by which Type 2 Diabetes affects the functional activity of the brain's posterior circulation, as well as the potential association of these changes with cognitive impairment.
研究2型糖尿病患者大脑活动的变化，并探讨大脑活动改变区域与神经心理表现之间的关系。
本病例对照研究共纳入36例2型糖尿病患者和40名年龄及教育程度相匹配的健康对照者。所有参与者均接受静息态功能磁共振成像（静息态fMRI）和神经心理测试。神经心理量表包括听觉言语学习测验（AVLT）、形状轨迹测验B（STT - B）、汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）、波士顿命名测验（BNT）、符号数字模态测验（SDMT），采用局部一致性（ReHo）和低频振幅（ALFF）评估大脑自发区域活动的差异。对于功能连接（FC）分析，将组间差异显著的区域选为种子区域。然后，在2型糖尿病组和对照组之间表现出显著改变的焦点区域，具体分析神经心理量表评分（AVLT、HAMA、HAMD、STT - B、BNT和SDMT）与ALFF/ReHo值之间的相关性，详见表2和表3。
2型糖尿病患者小脑上叶的ALFF值显著升高，特别是在左小脑脚I（小脑_脚I_左）、左小脑小叶VI（小脑_6_左）和左小脑小叶IV - V（小脑_4_5_左）。此外，他们在小脑_脚I_左和小脑_6_左的ReHo值也升高。经家族性错误校正的聚类水平p值小于0.05，这些结果具有统计学意义。然而，FC分析无显著差异。糖尿病组的AVLT评分显著较低。相关性分析表明，小脑_6_左的ALFF值与AVLT评分呈负相关（R = 0.1375，P < 0.001）。小脑_6_左内的ReHo值也与AVLT评分呈负相关（R = 0.0937，P = 0.007）。
2型糖尿病患者在不同的小脑区域表现出异常的神经活动，主要与认知功能有关。这为深入了解2型糖尿病影响大脑后循环功能活动的神经机制，以及这些变化与认知障碍的潜在关联提供了补充信息。
