The Brain White Matter Topological Microstructural Network Changes In Type 2 Diabetes Mellitus Patients

Objective:In this study,diffusion tensor imaging(DTI)was used to explore the changes in the global and local network topological structure of the white matter microstructure in patients with T2DM patients,and then we try to explore the possible mechanism of T2DM causing changes in neurological and mental functions,so as to provide anatomical basis of neural function for predicting the occurrence and development of neurological and mental diseases and other complications in T2DM patients.Materials and Methods:In this study,30 cases of T2DM patients with complete clinical data,and 25 cases of healthy controls(HCs)group volunteers considering with age,gender and years of education,and necessary clinical data were collected.All subjects were tested by skull DTI imaging examination in a GE 3.0 750W MRI scanner.The number of white matter fiber bundles(FN)in the brain was taken as the research object.AAL map partition was used as the network Node and the network connection of the brain region was used as the Edge of the network.The graph theory was used to estimate the difference between the global and local network characteristic parameters of the network Node in the brain structural network of T2DM patients and the HCs group,and NBS method was used to estimate the network connection(Edge)in the structural network.In addition,we used Pearson partial correlation coefficient to calculate a group of patients with type 2 diabetes mellitus(T2DM)abnormal brain structure of the network of global and local network characteristic indexes related to clinical indexes(including the course of the disease,body mass index(BMI),fasting plasma glucose(FPG),glycosylated hemoglobin(HBAlc),total cholesterol(TC),triglyceride(TG)).All statistical analyses were performed using SPSS version 22.0 software with FDR correction to correct false positives caused by multiple comparisons.Results:1.The "small worldness" of T2DM patients has statistically difference compared with the HCs group(FDR correction,p=0.0153<0.05,t=2.253).2.The parameters of global and local brain structure network in T2DM were statistically different from those inHCs.(p<0.05,FDR correction)3.Compared with the HCs group,there were statistically difference in abnormal network connections including the bilateral orbital superior frontal gyrus(ORBsup.L,ORBsup.R);the bilateral dorsolateral superior frontal gyrus(SFGdor.L,SFGdor.R);the left medial superior frontal gyrus(SFGMed.L),left medial frontal gyrus(MFG.L);the left central anterior gyrus(PreCG.L)(p<0.05,FDR correction)for T2DM patients.4.The T2DM group,compared with the HCs group,showed a statistically difference in the regional--the left olfactory(OLF.L),left caudatus(CAU.L),and left insula(INS.L)(p<0.05,FDR correction).5.Compared with HCs group,the local efficiency of nodes(Enodal)of T2DM patients in two brain regions(MFG.R and OLF.R)had significant statistical difference(p<0.01,FDR correction),ten brain regions(ORBsup.L?ORBsup.R?ORBsupmed.L?ORBsupmed.R and HIP.L,etc.)had statistical difference(p<0.05,FDR correction).6.In this study,the Eloc in the left middle frontal gyrus(MFG.L)was negatively correlated with HBA1c in T2DM patients.Conclusion:1.The brain structure network in T2DM patients with "small-worldness"still had the ability of "separation" and "integration",and got balanced,but this"balance" ability had changed,which may have impact on the brain structure network information transmission efficiency and processing.2.In the T2DM patients group,extensive damage and changes in brain structural networks,including the default mode network(DMN),may be one of the mechanisms for the occurrence and development of neuropsychiatric diseases caused by T2DM.,such as AD,MCI,PD and depression.3.The damage of the brain structure network in the left frontal area and may be one of possible causes of the disorder of blood glucose metabolism in T2DM patients.