| Objective:Using proton magnetic resonance spectroscopy and resting-state functional MRI to explore abnormalities of brain metabolism and spontaneous brain activity of posterior cingulate cortex in Type 2 Diabetic Patients along with the disease progression and the correlation of altered cognitive tests and laboratory indexes.To discuss possible pathological mechanism of brain damage by T2 DM.Materials and Methods:11 T2 DM patients with cognitive dysfunction and 14 T2 DM patients treated in Affiliated Zhongshan Hospital of Dalian University and 17 health controls were included in this study from March 2015 to January 2016.All participants were right-handed and none have less than 6 years education.Exclusion criteria of all participants included a history of alcohol or drug abuse,brain infarction or tumor,severe cerebral white matter lesions(ARWMC score greater than 1),neurological and psychiatric disease,unable to cooperate with exam,participants who had contraindications of MR scan.T2DM+CD and T2 DM patients treated with insulin sensitizing drugs such as thiazolidinediones were excluded.T2 DM patients who had a history of hypoglycemic episode were also excluded.Healthy controls were excluded if they had abnormal glucose metabolism or cognitive dysfunction.General infomation medical history and medication were recorded.All participants were accepted cognitive tests such as MoCA,collected their laboratorial indexes such as fasting plasma glucose.All participants were accepted ~1H-MRS of PCC and rs-fMRI scan.Read the content of metabolites included NAA,Cr,Cho,m I,Glu+Gln,PCr.Calculated the ReHo and ALFF value of PCC after preprocessing of the data.Single factor analysis of variance were used to compare differences of brain metabolism and spontaneous brain activity between three groups,LSD-t test were used for multiple comparisons.Pearson and Spearman correlation analysis were used for the correlation between brain metabolism,spontaneous brain activity indexes,cognitive tests scores and laboratory tests values.P values less than 0.05 were considered to be statistically significant.Results:1.There were significant differences of Cr,Cho,m I,PCr,Glx,Cr+PCr,mI/Cr,Glx/Cr on PCC in T2DM+CD patients,T2 DM patients and healthy controls.multiple comparisons showed there were significant differences of Glx,mI/Cr,Glx/Cr in each three groups.The differences of Cr,Cho,mI,Cr+PCr were only between T2DM+CD group and T2 DM group,T2DM+CD group and HC group.The difference of PCr was only between T2DM+CD group and HC group.2.The Cr was significant positive correlated with the score of MoCA and AVLT 5 minutes delay recall.The m I/Cr was significant negative correlated with the score of MoCA.The PCr,Glx and Cr+PCr were significant positive correlated with the C-peptide.3.There were significant differences of ReHo value on PCC in T2DM+CD patients,T2 DM patients and healthy controls.multiple comparisons showed there were significant differences only between T2DM+CD group and T2 DM group,T2DM+CD group and HC group.4.The ReHo value was significant positive correlated with the score of MoCA and the C-peptide.The ReHo value was significant negative correlated with mI/Cr.Conclusion:1.Higher mI/Cr value on PCC is sensitive for brain damage by T2 DM,it can response the progression of brain damage by T2 DM well.This index need to verify its effectiveness to the diagnosis of T2 DM brain damage and its early warning value by expand the sample size.Changes of other brain metabolics can hint the occurrance of brain damage of T2 DM,but they have insufficient evidences of early warning value and need further research by expand the sample size.2.Changes of ReHo and m I/Cr value response radiological manifestations of the early damage of default mode network by T2 DM from two different models.It provides vital biological marker for research of damage of default mode network on early stage and possible compensatory mechanism. |
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