Altered Functional Connectivity Of Cerebellum Subregion In Type 2 Diabetes Mellitus Patients:a Resting-state FMRI

Objective Type 2 diabetes mellius(T2DM)not only causes systemic complications,but also increases the risk of dementia and alzhzimer’s disease.T2 DM causes extensive cognitive impirment,but the mechanism is still unclear.In this study,the functional connection between cerebellar subregion and whole brain in T2 DM patients was observed by the method of resting state functional connection.The aims to explore the function connection pattern in cognition-related cerebellar-cerebral circuits in type 2 diabetes mellitus.Methods Thirty-four T2 DM patients(male 25,female 9,the average age of56.18±5.74)and 30 age and gender matched healthy controls(HC)(male 20,female10,the average age of 54.41±5.31)were enrolled in the endocrinology department of Shaan Xi Provincial People’s Hospital between June 2018 and September 2019 in this study.All the subjects underwent neuropsychological testing and resting state fMRI(rs-fMRI)scanning.The rs-fMRI data were proceeded by dpabi3.0 toolkit on Matlab2014 b.Bilateral cerebellar Ⅸ,left and right cerebellar Crus Ⅰ/Ⅱ,and left cerebellar Ⅵ were selected as the regions of interest(ROIs).Two-sample t test was used to compare group differences in neuropsychological score and functional connectivity between each ROI and other voxels in brain.After controlling for years of education,partial correlation analysis was conducted between neuropsychological score and functional connection values from the regions with significant difference in the above comparisons.Results Compared with HC,T2 DM patients showed significantly decreased functional connection with cerebellar lobules Ⅸ and right cuneus/precuneus;right cerebellar Crus Ⅰ/Ⅱ and right middle/inferior frontal gyrus,right lingual gyrus;left cerebellar Crus Ⅰ/Ⅱ and right middle/inferior frontal gyrus,left middle/inferior temporal gyrus,bilateral supplementary motor area;left cerebellar Ⅵ and bilateral precuneus/posterior cingulate,right angular gyrus/superiormarginal gyrus/superior and middle temporal gyrus.There is no increase functional connectivity were found in brain region.Moreover,functional connection values between left cerebellar Crus Ⅰ/Ⅱ and right inferior frontal were negative correlated with Hb1Ac(r=-0.43,P=0.013),left cerebellar Ⅵ and right precunecs were negative correlated with TMT-A((r=-0.38,P=0.033)Conclusion T2 DM patients showed disrupted functional connectivity in cerebellar-cerebral DMN、ECN and VSN circuits,which suggests that altered cerebellar-cerebral circuits may be involved in the neuropathology of T2 DM,and provides a new direction for exploring the cognitive dysfunction in T2 DM.