Song Yaqi, Zhu Meng, Ji Weiqi, Sun Zhongru, He Liang, Chen Jinhua, Tian Weizhong, Zhang Xiaohong, Xia Jianguo
Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, Jiangsu, 225300, China.
Department of Medical Imaging, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou, Jiangsu, 225300, China.
Brain Imaging Behav. 2025 Jun 20. doi: 10.1007/s11682-025-01029-2.
The aim of this study is to investigate the disparities in volumes of hippocampal subfields and alterations in whole-brain functional connectivity among individuals diagnosed with diabetic retinopathy (DR). This study comprised a total of 32 diabetic patients with retinopathy (DR group, n = 32) and 38 healthy adults (HC group, n = 38), who underwent psychological cognitive testing along with structural and functional magnetic resonance imaging. The FreeSurfer software was utilized for the extraction and computation of hippocampal subfield volumes, as well as the overall volumes of the left and right hippocampus. The volumetric comparisons were conducted by employing independent sample t-tests in SPSS 26.0. The functional connectivity comparisons were subjected to statistical analysis using the Matlab software. Age, education level and grnder were used as control variables, and partial correlation analysis was performed to investigate the relationship between differences in volume and functional connectivity values with psychological cognitive test results and clinical indicators. The volume of the left hippocampal tail and fissure, as well as the right hippocampal C3, C4 and fissure regions in the DR patient group, exhibited significant differences compared to the HC group (P < 0.05, FDR < 0.05). Regions of interest were identified based on the segmented volume differences, and compared to the HC group, enhanced connectivity was observed between the left hippocampal tail and the left caudate nucleus (MNI: x,y, z=-6, 12, 9) and the right caudate nucleus (MNI: x,y, z = 9, 12, 12) in DR patients. Additionally, reduced connectivity was observed between the left hippocampal fissure and the right precentral gyrus (MNI: x, y, z = 57, 0, 45) and the right supplementary motor area (MNI: x, y, z = 9, 3, 60). Partial correlation analysis, with age, education level, and gender as covariates, showed no significant associations between the imaging changes and clinical indicators or cognitive scores. The alterations in hippocampal volume and function observed in patients with DR may potentially underlie their cognitive impairment and sensorimotor deficits, thus suggesting a plausible neuropathological mechanism.
本研究旨在调查糖尿病视网膜病变（DR）患者海马亚区体积差异及全脑功能连接改变情况。本研究共纳入32例糖尿病视网膜病变患者（DR组，n = 32）和38例健康成年人（HC组，n = 38），所有受试者均接受了心理认知测试以及结构和功能磁共振成像检查。使用FreeSurfer软件提取并计算海马亚区体积以及左右海马的总体积。在SPSS 26.0中采用独立样本t检验进行体积比较。使用Matlab软件对功能连接进行统计分析。将年龄、教育水平和性别作为控制变量，并进行偏相关分析以研究体积差异和功能连接值与心理认知测试结果及临床指标之间的关系。与HC组相比，DR患者组左侧海马尾部和海马裂以及右侧海马C3、C4和海马裂区域的体积存在显著差异（P < 0.05，FDR < 0.05）。基于分割后的体积差异确定感兴趣区域，与HC组相比，DR患者左侧海马尾部与左侧尾状核（MNI：x，y，z = -6，12，9）和右侧尾状核（MNI：x，y，z = 9，12，12）之间的连接增强。此外，左侧海马裂与右侧中央前回（MNI：x，y，z = 57，0，45）和右侧辅助运动区（MNI：x，y，z = 9，3，60）之间的连接减少。以年龄、教育水平和性别作为协变量的偏相关分析显示，成像变化与临床指标或认知分数之间无显著关联。DR患者海马体积和功能的改变可能是其认知障碍和感觉运动缺陷的潜在原因，从而提示了一种合理的神经病理机制。
