| Objective:Using voxel-based degree centrality to explore the abnormalities of brain network in type 2 diabetes mellitus along with the disease progression and the correlation between them and altered cognitive tests,laboratory indexes.To provide a robust evidence into the possible pathological mechanisms of cognitive impairment by T2 DM.Materials and Methods: The study was approved by the ethics committee of the Affiliated Zhongshan Hospital of Dalian University,written informed consents were obtained from all of the subjects.25 T2 DM patients with cognitive impairment and 32 T2 DM patients treated in Affiliated Zhongshan Hospital of Dalian University,the Second Hospital of Dalian Medical University and Dalian Municipal Central Hospital Affiliated of Dalian Medical University,and 42 HC subjects were included in this study from June 2015 to January 2017.All participants were right-handed and above 40 years old,and received no less than 6 years of education.Exclusion criteria of all participants included a history of neurological and psychiatric diseases,severe cerebral white matter lesions(ARWMC score greater than 1),participants who had contraindications of MR scan,and alcohol or drug abuse.T2 DMCI and T2 DM patients who had a history of hypoglycemic episode were also excluded.HC subjects were excluded if they had the abnormal glucose metabolism.General information,medical history and medication were recorded.All of the participants received a battery of several categories of neuropsychological tests to assess general mental status(MoCA)and other cognitive domains,collected their valuable laboratorial indexes.All participants werescanned rs-fMRI.Then constructed the human functional connectome and calculated the values of DC after preprocessing of the data.One-way ANOVA was performed to investigate the DC differences of whole-brain among three groups,if statistical difference was present(p<0.05),post hoc individual tests were further conducted to detect differences between each pair of the three groups on individual DC maps.Correlation analysis was used for the correlation between DC and cognitive tests scores or laboratory tests values,the thresholds set at P<0.01 were considered to be statistically significant.Results:1.Demographic and clinical characteristics : Only TMT-A score was observed the difference in T2 DMCI and T2 DM,T2DMCI and HC,T2 DM and HC respectively(p<0.05).There were significant differences of C-peptide,weight and FPG only between T2 DMCI and T2 DM patients(p<0.05).The differences of MoCA、CDT、DST、AVLT、AVLT5min and AVLT20 min were only between T2 DMCI group and HC group.2.Between-group DC analysis : Compared with the T2 DM patients,T2 DMCI patients showed significantly decreased DC values in the left inferior parietal gyrus(IPG),while significantly increased in right lingual gyrus.Compared with the HC group,T2 DMCI patients showed significantly decreased DC values in the bilateral superior and middle temporal gyrus(STG/MTG)(P <0.05,AlphaSim corrected),T2 DM patients significantly decreased in the right postcentral gyrus but increased in partial left cerebellum areas,bilateral precuneus and left middle frontal gyrus(MFG).3.Correlation analysis : Voxel-wise correlation analysis revealed that DC values of different brain areas showed different correlations respectively,only DC values of the T2 DMCI patients in right MTG which also showed the decreased DC values compared with HC group were negatively related to TMT-A(r=-0.78975,P<0.01,AlphaSim corrected),the other brain areas DC changed mismatched with the correlation changed ones.Conclusion:1.The present study confirms that T2 DM patients have altered DC in many brain regions,which is associated with multiple poor neurocognitive performances.2.DC disturbance in right MTG may play a central role in cognitive decline associatedwith T2 DM and serve as reference for future clinical diagnosis. |
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