The Correlation Research Of Disrupted White Matter Network And Cognitive Decline In Type 2 Diabetes Patiens

Objective: Damage to the brain structure,such as the white matter network disorders may constitute the basis of cognitive decline.The aim of this study was to investigate the microstructure of white matter in patients with type 2 diabetes mellitus complicated with cognitive impairment by using Diffusion Tensor Imaging(DTI)technique,and to perform a complex structural network analysis of local or whole brain regions.Materials and Methods: In this study,17 patients with diabetes mellitus and 13 healthy volunteers matched with age,sex and education were selected from July 2015 to September 2016.The general clinical data of all the subjects were collected,And the MoCA and MMSE cognitive scores were performed.All subjects underwent 3.0T MR DTI imaging.Then,the topological properties of the white matter network are calculated by using the graph theory method,so as to study the network efficiency difference between groups.Independent two-sample t-test was used to assess the differences between age and education years.The chi-square test was used to compare the differences in sex and hypertension ratios between groups.The ANOVA analysis was used to test the differences between groups(age,sex,and education were classified as covariates)for neuropsychological assessment,biochemical markers,and topological organization of WMN(global brain and nodal network indicators).In addition,pearson correlation coefficients were used to calculate the correlation between network attributes(global brain and nodes)and behaviors,and to control the influence of age,gender and education duration.All statistical analyzes were performed using SPSS version 19.0 for Windows.The false discovery rate(FDR)is calculated to correct multiple comparisons.Results: (1)A large sample included 17 T2 DM patients and 13 normalcontrols,and they had no significant difference in age,sex and education(P> 0.05).There was no significant difference in MMSE score,Mo CA score and prevalence of hypertension between T2 DM patients and normal controls(PMMSE = 0.169,PMoCA = 0.413).(2)Compared with the control group,the intensity(FAw)of SPG.L and IOG.L in patients with T2 DM was statistically significant(P <0.05),and OLF.R,SFGmed.L,SFGmed.R,INS.L,SMG.L,CAU.R,STG.R The intensity of brain node(FNw)was different between groups(P <0.05).And T2 DM patients showed a significant decrease in CAL_L,CUN.R,both brain regions(P <0.05,FDR correction).(P <0.01).The results of FDR correction were still significant(P <0.05).There was no significant difference in g E between T2 DM group and non-T2 DM group.(3)In the T2 DM group,thenode intensity(FAw)of the CUN.L,CUN.R brain region was correlated with the MoCA score,and the node intensity(FAw)of the FFG.L brain region was correlated with the MMSE score(P <0.05),SPG.R The node intensity(FAw)of the brain area was significantly correlated with MMSE and MoCA scores(P <0.01).(FNw)is related to the MoCA score(P <0.05),and the nodal intensity(FNw)of the CUN region is related to the MMSE score,FFG.L,SPG.R MMSE and MoCA scores(P <0.05),and node intensity(FNw)of FFG.L brain area was significantly correlated with MMSE score(P <0.01).In the control group,the node intensity(FAw)of the ORBsup.R,MTG.R and SMA.L brain regions was correlated with the MMSE score(P <0.05),and the node intensity(FNw)of the DCG.R brain region was correlated with the MoCA score P <0.05).In the T2 DM group,only FFG.R,ITG.R was associated with MMSE and MoCA scores,and the node efficiency of LING.R,POCG.R was correlated with MoCA scores,and ITG.R,LING.R brain region l E was associated with MoCA More closely.PHG.L brain area node efficiency was significantly correlated with MMSE scores,and in the normal control group IOG.L,SMG.L node local efficiency and MMSE scores related,ROL.L,INS.R,PAL.R brain area node efficiency And MoCA scores.At the same time,there was no significant correlation between gE and MMSE and MoCA scores in T2 DM group and control group.Conclusion: T2 DM patients with cognitive impairment showed large-scale WMN integrity damage,and part of the brain brain white matter microstructure-related topological attributes of the change earlier than the cognitive evaluation changes.