| PurposeIn this study,voxel-based morphometry(voxel-based morphometry,VBM),surface-based morphometry(surface-based morphometric,SBM)and trace-based spatial statistics(tract-based spatial statistics,TBSS)and seed-based correlation analysis were used to investigate the changes of brain structure and function in T2 DM patients with normal blood pressure.MethodsHigh-resolution 3DT1 WI structural phase data were collected from 30 T2 DM subjects with normal blood pressure and 20 healthy control subjects with matching age,gender and education level,MoCA(Montreal Cognitive Assessment)scale and Mini mental state exanl(MMSE)were used to evaluate the cognitive performance of each group.1.Based on voxel-based morphometry(VBM),volume segmentation was performed on 3DT1 WI structural phase data of the two groups,and the volumes of gray matter and white matter in the brain were measured,respectively,to compare whether there were significant differences in gray matter and white matter volumes between the two groups of data,and further explore the correlation between the changes of gray matter and white matter volume in T2 DM patients with clinical correlation index and neuropsychological scale.2.Based on surface-based morphometric(SBM),,cortical thickness measurements were performed on both sets of data,there was no statistical difference in corticalthickness between the two groups.3.Fractional anisotropy(FA)of DTI data description parameters was compared between groups by trace-based spatial statistics(TBSS),to further explore whether there is a statistically significant correlation between the brain areas and the clinical indicators and the neuropsychological scale.4.Based on seed-based correlation analysis,brain regions with significant differences in VBM volume measurements between the normal T2 DM group and the healthy control group were taken as seed points,and fMRI functional connections with total brain volume were analyzed respectively,and differences in functional connections between the groups were compared.Result1.Based on VBM analysis:compared with healthy controls matched for age,sex and education,the gray matter volume of left posterior central gyrus and right superior occipital gyrus in T2 DM group with normal blood pressure decreased significantly(P<0.05);and the volume of posterior left posterior central gyrus in T2 DM group with normal blood pressure was positively correlated with the attention score in the MoCA scale,there was no significant correlation between the volume of gray matter in the right superior occipital gyrus and the clinical indicators and the neuropsychological scale.There was no significant difference in white matter volume between the two groups.2.The cortical thickness(CT)analysis of 3DT1 WI structural phase data showed that compared with the healthy control group,the T2 DM group with normal blood pressure had cortical thickness decreased significantly in the fusiform?rostral middle frontal?middle temporal on the left side of the brain and decreased significantly in the supramargina?inferior parietal?paracentral lobule on the right side of the brain,the difference between groups was statistically significant(P<0.05).3.TBSS analysis of DTI data showed that compared with the healthy control group,the T2 DM group with normal blood pressure showed a number of regions with significantly reduced FA value of white matter fiber tracts.Specifically,they included left anterior thalamic radiation,inferior frontal occipital tract,right corticospinal tract,left hook tract,left cingulate gyrus,left corticospinal tract,left superior longitudinal tract,right cingulate gyrus and right anterior thalamic radiation.All the affected areas were obviously dominated by the left side and less by the right side(P<0.05).4.Brain regions with significant differences in gray matter volume measured by VBM were used as seed points,and FC analysis of fMRI data showed that subjects in the T2 DM group with normal blood pressure were significantly more functionally connected than those in the healthy control group,and the difference was statistically significant(P<0.05).With the right superior occipital gyrus as the seed point,the functional connections of the left fusiform gyrus,the triangle inferior frontal gyrus and the right Cerebelum_Crus1 in the T2 DM group with normal blood pressure were significantly enhanced compared with the healthy control group,and the differences were statistically significant(P<0.05).Conclusion1.The results show that the increase of blood glucose alone can cause a significant decrease in gray matter volume in specific brain regions,and the change of gray matter structure may have some effects on cognitive ability.At the same time,it is also found that diabetic ophthalmopathy or diabetic peripheral neuropathy are not only simple retinal or peripheral neuropathy,these complications drive the dynamic plasticity of the brain and cause potential structural changes in the brain.2.This indicates that T2 DM patients with normal blood pressure have shown abnormal changes in gray matter structure in the preclinical stage before significant cognitive decline,which may provide some reference value in the early evaluation of diabetic encephalopathy.3.The results showed that middle-aged and elderly T2 DM patients with simple blood glucose increase had shown the decrease of white matter integrity and the damage of multiple white matter fiber tracts,mainly involving the left side.To further explore the pathophysiological mechanism of diabetic brain injury and cognitive decline,to provide possible imaging markers,and to help early clinical intervention,prevent or delay the occurrence and process of diabetic encephalopathy.4.The results showed that hyperglycemia also caused significant abnormal changes in brain function,and significant functional connectivity was observed in the fusiform gyrus of the visual conduction pathway,which may be the compensatory enhancement of the attenuated visual information received by the occipital cortex in the process of visual pathway transmission. |
PDF Full Text Request