Neuroimaging Study Of Cerebral Reward Circuits-Related Cortical Structure Changes In Type 2 Diabetic Sleep Disorder

Objective:This study explored whether specific morphological changes exist and their significance by analyzing cortical thickness,complexity and other brain surface morphological indicators of the brain reward circuit-related brain regions in patients with type 2 diabetes and diabetic patients with sleep disorders.It would be helpful to understand the pathogenesis of type 2 diabetes with sleep disorder,and provide the specific imaging biomarkers related to type2 diabetes in the future.Materials and Methods:General information of the subjects:This project studied from July 2017 to January 2020,recruiting 82 subjects from social recruitment,outpatient and inpatients in our hospital,and 46 patients with type 2 diabetes according to blood glucose.And 36 patients with non- type 2 diabetes.According to the Pittsburgh Sleep Quality Index Scale(PSQI),all diabetic participants were divided into two groups,including 14 diabetic patients with sleep disorder and 32 diabetic patients with normal sleep.MRI image acquisition and processing:Use a 3.0T MRI model with the skull 8-channel scan coil to collect the subjects 3D-T1TFE,T2WI,FLAIR,DWI data;use CAT12 brain structure image processing software to analyze the subject’s brain surface morphology It can calculate cortical thickness,Fractal dimension,Sulcus depth,Gyrification index.Statistical analysis:Independent sample t test was used for age,blood glucose,body mass index,duration of diabetes,and total score of PSQI using SPSS 23.0 software.Chi-square test was performed for gender,smoking history,coronary heart disease history,and hypertension history.The SPM12 software was used to perform a two-sample t-test on indicators of abnormal brain regions(reward loops,non-reward loops)between the test group.Result:General information:There was no significant difference in the age,body mass index,gender,smoking history,coronary heart disease history,and hypertension history between diabetes and normal controls.The type 2diabetes group had significantly higher blood glucose indicators than the control group(p<0.001).There were no significant differences in the age,duration of diabetes,body mass index,gender,smoking history,coronary heart disease history,and hypertension history in the diabetic sleep disorder group and the normal sleep group.The PSQI total score in the sleep disorder group was significantly higher than that in the control group(p<0.001).Compared with the normal group,the type 2 diabetic group has a reward circuit-related cortical atrophy,including bilateral orbitofrontal,bilateral medial orbitofrontal,bilateral insula,right frontal pole,right Caudal Anterior Cingulate,right Rostral Anterior Cingulate,left superior Coral and left Pars opercularis(p<0.05).Compared with the normal sleep group,the type 2 diabetic sleep disorde group has a reward circuit-related cortical atrophy,including bilateral Gyrus rectus、bilateral Orbital part of the inferior frontal gyrus、right Middle frontal sulcus、right Anterior part of the cingulate gyrus、left Transverse frontopolar gyri(p<0.05).Compared with the normal sleep group,the type 2 diabetic sleep disorder group has abnormalities in the complexity index of the brain related to the reward loop.(1)The FD of the right Opercular part of the inferior frontal gyrus,right Short insular gyri,and the left Straight gyrus were reduced(p<0.05).(2)The GI in the right lateral orbital sulcus decreased(p<0.05).(3)The SD of the right Inferior frontal sulcus and left Middle frontal sulcus decreased(p<0.05).The SD of the left Straight gyrus,right Fronto-marginal gyrus and sulcus,right Transverse frontopolar gyri and sulci,and right Superior frontal sulcus increased(p<0.05).Conclusions:Patients with type 2 diabetes have atrophy of the Prefrontal lobe,insula,and Anterior part of the cingulate gyrus cortex in the normal control group.The type 2 diabetic sleep disorder group has atrophy of the prefrontal and anterior part of the cingulate gyrus cortex compared with the normal sleep group,and the complexity of the prefrontal and insula cortex is abnormal.The atrophy of the reward loop-related cortex and the abnormality of the cortex complexity may indicate the abnormal transmission of reward loop information and brain function damage,and specific changes in the reward loop-related cortex can help improve the further understanding of diabetes-related imaging biomarkers.