2型糖尿病患者执行控制网络及额顶网络的功能磁共振研究
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摘要
目的 :采用静息态功能磁共振(f MRI)技术联合运用独立成分分析(Independent component analysis,ICA)方法 ,研究2型糖尿病(Type 2 diabetes mellitus,T2DM)患者认知障碍的特点及大脑执行控制网络(Executive control network,ECN)、额顶网络(Frontoparietal network,FPN)的完整性。方法:对23名T2DM患者及25名健康对照者进行临床资料采集、多维度认知功能测试及静息态f MRI扫描。使用双样本t检验分析两组生化指标、认知功能、静息态脑网络同步性活动的组间差异,并采用Pearson相关分析脑网络差异与生化指标、认知功能测试的相关性。结果 :T2DM患者蒙特利尔认知评估北京版(Mo CA)、连线测试B(TMT-B)、复杂图形测试(CFT)、CFT-延迟、数字广度测验(DST)的得分低于健康对照组(均P<0.05)。T2DM患者ECN中的左顶叶深部白质、扣带回、右侧前额叶功能连接减弱(P<0.05,Alpha Sim校正)。T2DM患者右侧FPN中的右侧额下回、额中回功能连接增强,右中央后回功能连接减低(P<0.05,Alpha Sim校正)。T2DM患者左侧FPN中的左顶叶功能连接减低(P<0.05,Alpha Sim校正)。另外,ECN中的右侧前额叶功能连接减低与胰岛素抵抗水平显著相关。结论 :T2DM患者存在执行功能、注意功能、信息处理速度及空间情景记忆功能障碍,并且存在ECN、右侧FPN和左侧FPN选择性受损,T2DM患者ECN功能连接受损与胰岛素抵抗水平相关。
Objective: To investigate the integrity of executive control network(ECN), frontoparietal network(FPN) in type 2 diabetic patients by using independent component analysis(ICA), and to explore the relationship between network abnormalities,neurocognitive performance and glycaemic indices. Methods: Multidimensional cognitive function tests and rs-f MRI scans were performed in 23 T2 DM patients and 25 healthy controls. Statistical analysis was conducted using REST-statistical analysis and the SPSS software. Results: Patients performed significantly worse on the Mo CA, TMT-B, CFT, CFT-delayed recall and DST tests, which mainly involved cognitive domains of executive function, processing speed and spatial episodic memory. Compared with the healthy controls, patients showed decreased FC in the left parietal lobe, cingulate gyrus, right frontal lobe of ECN;increased FC in the right inferior frontal gyrus and middle frontal gyrus, decreased FC in the right postcentral gyrus of r-FPN; decreased FC in the left parietal lobe of l-FPN. Correlation analysis showed decreased connectivity in the right frontal lobe was significantly correlated with the insulin resistance level(P=0.046, r=-0.420). FC strength in the ECN and FPN was negative correlated with the neurocognitive performance. Conclusion: T2 DM group manifests cognitive impairments of executive function, processing speed and spatial episodic memory and have a slective defects of ECN, FPN on right and FPN on left.The disrupted pattern of resting-state ECN was associated with IR in T2 DM patients.
Objective: To investigate the integrity of executive control network(ECN), frontoparietal network(FPN) in type 2 diabetic patients by using independent component analysis(ICA), and to explore the relationship between network abnormalities,neurocognitive performance and glycaemic indices. Methods: Multidimensional cognitive function tests and rs-f MRI scans were performed in 23 T2 DM patients and 25 healthy controls. Statistical analysis was conducted using REST-statistical analysis and the SPSS software. Results: Patients performed significantly worse on the Mo CA, TMT-B, CFT, CFT-delayed recall and DST tests, which mainly involved cognitive domains of executive function, processing speed and spatial episodic memory. Compared with the healthy controls, patients showed decreased FC in the left parietal lobe, cingulate gyrus, right frontal lobe of ECN;increased FC in the right inferior frontal gyrus and middle frontal gyrus, decreased FC in the right postcentral gyrus of r-FPN; decreased FC in the left parietal lobe of l-FPN. Correlation analysis showed decreased connectivity in the right frontal lobe was significantly correlated with the insulin resistance level(P=0.046, r=-0.420). FC strength in the ECN and FPN was negative correlated with the neurocognitive performance. Conclusion: T2 DM group manifests cognitive impairments of executive function, processing speed and spatial episodic memory and have a slective defects of ECN, FPN on right and FPN on left.The disrupted pattern of resting-state ECN was associated with IR in T2 DM patients.
引文
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[14]Gispen WH,Biessels GJ.Cognition and synaptic plasticity in diabetes mellitus[J].Trends Neurosci,2000,23(11):542-549.
[2]Mccrimmon RJ,Ryan CM,Frier BM.Diabetes and cognitive dysfunction[J].Lancet,2012,379(9833):2291-2299.
[3]van den Berg E,Reijmer YD,de Bresser J,et al.A 4 year follow-up study of cognitive functioning in patients with type 2 diabetes mellitus[J].Diabetologia,2010,53(1):58-65.
[4]Bowie CR,Harvey PD.Administration and interpretation of the Trail Making Test[J].Nat Protoc,2006,1(5):2277-2281.
[5]Shin MS,Park SY,Park SR,et al.Clinical and empirical applications of the Rey-Osterrieth Complex Figure Test[J].Nat Protoc,2006,1(2):892-899.
[6]Manschot SM,Brands AM,van der Grond J,et al.Brain magnetic resonance imaging correlates of impaired cognition in patients with type 2 diabetes[J].Diabetes,2006,55(4):1106-1113.
[7]Cui Y,Jiao Y,Chen YC,et al.Altered spontaneous brain activity in type 2 diabetes:a resting-state functional MRI study[J].Diabetes,2014,63(2):749-760.
[8]Chen YC,Xia W,Qian C,et al.Thalamic resting-state functional connectivity:disruption in patients with type 2 diabetes[J].Metab Brain Dis,2015,30(5):1227-1236.
[9]Bruehl H,Wolf OT,Sweat V,et al.Modifiers of cognitive function and brain structure in middle-aged and elderly individuals with type 2 diabetes mellitus[J].Brain Res,2009,1280:186-194.
[10]Yau PL,Javier D,Tsui W,et al.Emotional and neutral declarative memory impairments and associated white matter microstructural abnormalities in adults with type 2 diabetes[J].Psychiatry Res,2009,174(3):223-230.
[11]Koechlin E,Summerfield C.An information theoretical approach to prefrontal executive function[J].Trends Cogn Sci,2007,11(6):229-235.
[12]Seeley WW,Menon V,Schatzberg AF,et al.Dissociable intrinsic connectivity networks for salience processing and executive control[J].J Neurosci,2007,27(9):2349-2356.
[13]Vincent JL,Kahn I,Snyder AZ,et al.Evidence for a frontoparietal control system revealed by intrinsic functional connectivity[J].J Neurophysiol,2008,100(6):3328-3342.
[14]Gispen WH,Biessels GJ.Cognition and synaptic plasticity in diabetes mellitus[J].Trends Neurosci,2000,23(11):542-549.