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鼻内胰岛素可增强2型糖尿病患者的静息态功能连接。

Intranasal insulin enhances resting-state functional connectivity in Type 2 Diabetes.

作者信息

Zhang Zongpai, Novak Vera, Novak Peter, Mantzoros Christos, Ngo Long, Lioutas Vasileios, Dai Weiying

机构信息

School of Computing, State University of New York at Binghamton, Binghamton, New York, United States of America.

Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America.

出版信息

PLoS One. 2025 May 20;20(5):e0324029. doi: 10.1371/journal.pone.0324029. eCollection 2025.

DOI:10.1371/journal.pone.0324029
PMID:40392946
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12091882/
Abstract

Type 2 diabetes mellitus (T2DM) affects cognition and resting-state functional connectivity (rsFC). Intranasal insulin (INI) has emerged as a potential treatment for T2DM-related cognitive decline. We aimed to evaluate the effect of INI treatment on rsFC with medio-prefrontal (mPFC) and left/right hippocampus (lHPC/rHPC), and their relationship with the cognition, hemoglobin A1c (HbA1c), and homeostatic model assessment of insulin resistance (HOMA-IR) and walking speed. An MRI sub-study of the MemAID trial was conducted, involving a 24-week treatment with either intranasal insulin or placebo. Blood oxygen level-dependent (BOLD) functional MRI (fMRI) images were acquired on eighteen DM subjects at baseline and eleven DM subjects (eight DM-INI patients and three DM-Placebo) at the end-of-treatment. Compared to DM-Placebo treated subjects, DM-INI patients showed increased mPFC-postcentral rsFC, lHPC-frontal rsFC, lHPC-postcentral rsFC, rHPC-frontal rsFC, and lHPC-mPFC rsFC (p < 0.05). The decreased HOMA-IR, which was observed in the MemAID trial, was associated with increased mPFC-basal ganglia rsFC (p < 0.05). This sub-study provides insights into potential mechanisms of INI effects on rsFC that require validation in a larger trial.

摘要

2型糖尿病（T2DM）会影响认知和静息态功能连接（rsFC）。鼻内胰岛素（INI）已成为治疗T2DM相关认知衰退的一种潜在疗法。我们旨在评估INI治疗对与中前额叶（mPFC）和左/右海马体（lHPC/rHPC）的rsFC的影响，以及它们与认知、糖化血红蛋白（HbA1c）、胰岛素抵抗稳态模型评估（HOMA-IR）和步行速度的关系。我们进行了MemAID试验的一项MRI子研究，包括用鼻内胰岛素或安慰剂进行为期24周的治疗。在基线时对18名糖尿病受试者以及在治疗结束时对11名糖尿病受试者（8名糖尿病-INI患者和3名糖尿病-安慰剂组患者）采集了血氧水平依赖（BOLD）功能磁共振成像（fMRI）图像。与接受糖尿病-安慰剂治疗的受试者相比，糖尿病-INI患者的mPFC-中央后回rsFC、lHPC-额叶rsFC、lHPC-中央后回rsFC、rHPC-额叶rsFC和lHPC-mPFC rsFC增加（p < 0.05）。在MemAID试验中观察到的HOMA-IR降低与mPFC-基底神经节rsFC增加有关（p < 0.05）。这项子研究为INI对rsFC影响的潜在机制提供了见解，这些机制需要在更大规模的试验中进行验证。

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