A multimodal meta-analysis of regional structural and functional brain alterations in type 2 diabetes

Yao, Li; Yang, Mei; Zhang, Wenjing; Li, Siyi; Li, M M Qian; Chen, Lizhou; Lui, Su; Kemp, Graham J.; Biswal, Bharat B.; Shah, N. Jon; Li, Fēi; Gong, Qiyong

doi:10.1016/j.yfrne.2021.100915

Cited by 30 publications

(42 citation statements)

References 102 publications

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“…Previous studies revealed that decreased spontaneous neural activity in the occipital lobe was relevant to impaired visual performance ( Cui et al, 2014 ). Also, T2DM subjects are prone to retinal damage ( Yao et al, 2021 ). The occipital cortex is generally deemed to dominate visual function, especially the primary visual cortex ( Wandell, 1999 ).…”

Section: Discussionmentioning

confidence: 99%

Aberrant Brain Spontaneous Activity and Synchronization in Type 2 Diabetes Mellitus Subjects Without Mild Cognitive Impairment

Feng

et al. 2021

Front. Neurosci.

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Objective: We aimed to explore whether the percent amplitude of fluctuation (PerAF) measurement could provide supplementary information for amplitude of low-frequency fluctuation (ALFF) about spontaneous activity alteration in type 2 diabetes mellitus (T2DM) subjects without mild cognitive impairment (MCI). Then we further evaluated the synchronization through the method of functional connectivity (FC) to better demonstrate brain changes in a more comprehensive manner in T2DM.Methods: Thirty T2DM subjects without MCI and thirty well-matched healthy subjects were recruited in this study. Subjects’ clinical data, neuropsychological test results, and resting-state functional magnetic resonance imaging (rs-fMRI) data were acquired. Voxel-based group difference comparisons between PerAF and ALFF were conducted. Then, seed-based FC between the recognized brain regions based on PerAF and ALFF and the rest of the whole brain was performed.Results: Compared with healthy group, T2DM group had significantly decreased PerAF in the bilateral middle occipital gyrus and the right calcarine, increased ALFF in the right orbital inferior frontal gyrus and decreased ALFF in the right calcarine. Seed-based FC analysis showed that the right middle occipital gyrus of T2DM subjects exhibited significantly decreased FC with the right caudate nucleus and right putamen. According to the partial correlation analyses, hemoglobin A1c (HbA1c) and immediate memory scores on the auditory verbal learning test (AVLT) were negatively correlated in the T2DM group. However, we found that total cholesterol was positively correlated with symbol digit test (SDT) scores.Conclusion: PerAF and ALFF may have different sensitivities in detecting the abnormal spontaneous brain activity in T2DM subjects. We suggest PerAF values may add supplementary information and indicate additional potential neuronal spontaneous activity in T2DM subjects without MCI, which may provide new insights into the neuroimaging mechanisms underlying early diabetes-associated cognitive decline.

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Section: Discussionmentioning

confidence: 99%

Aberrant Brain Spontaneous Activity and Synchronization in Type 2 Diabetes Mellitus Subjects Without Mild Cognitive Impairment

Feng

et al. 2021

Front. Neurosci.

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“…Previous studies demonstrated that the decreased perfusion in middle occipital gyrus was associated with impaired visuospatial function and visual memory (Xia et al, 2015;Cui et al, 2017). A recent metaanalysis study of functional magnetic resonance imaging (fMRI) also revealed consistent hypoactivity in the middle occipital gyrus and calcarine fissure/surrounding cortex in T2DM (Yao et al, 2021). Beside, recent studies focusing on patients with diabetic retinopathy observed decreased CBF in the bilateral calcarine fissure/surrounding cortex (Huang et al, 2021) and hypoactivity in the middle occipital gyrus (Wang et al, 2017;Qi et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

“…More importantly, no quantitative synthesizing method was used to conduct meta-analysis of voxel-based studies. As the region of interest (ROI) method has inherent bias and is more liberal in statistical threshold than voxel-based analysis (VBA) method ( Radua and Mataix-Cols, 2009 ; Yao et al, 2021 ), the quantitative meta-analysis of voxel-based studies can objectively identify regional CBF differences at whole-brain level without any priori hypothesis.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, we first systematically reviewed literatures on cerebral perfusion in T2DM using ASL and then conducted a quantitative meta-analysis on these voxel-based literatures using Seed-based d Mapping (SDM, formerly Signed Differential Mapping) as primary tool. The SDM is a well-recognized synthesizing method for voxel-based studies and has been used in meta-analysis of cerebral structural and functional alterations in T2DM ( Liu J. et al, 2017 ; Liu et al, 2021 ; Yao et al, 2021 ). This study aimed to identify consistent regional CBF alterations in T2DM and explore the potential effects of the clinical characteristics on these perfusion alterations.…”

Section: Introductionmentioning

confidence: 99%

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Cerebral Blood Flow Alterations in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Arterial Spin Labeling Studies

Liu

Yang

et al. 2022

Front. Aging Neurosci.

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ObjectiveArterial spin labeling (ASL) studies have revealed inconsistent regional cerebral blood flow (CBF) alterations in patients with type 2 diabetes mellitus (T2DM). The aim of this systematic review and meta-analysis was to identify concordant regional CBF alterations in T2DM.MethodsA systematic review was conducted to the published literatures comparing cerebral perfusion between patients with T2DM and healthy controls using ASL. The seed-based d mapping (SDM) was further used to perform quantitative meta-analysis on voxel-based literatures and to estimate the regional CBF alterations in patients with T2DM. Metaregression was performed to explore the associations between clinical characteristics and cerebral perfusion alterations.ResultsA total of 13 studies with 14 reports were included in the systematic review and 7 studies with 7 reports were included in the quantitative meta-analysis. The qualitative review found widespread CBF reduction in cerebral lobes in T2DM. The meta-analysis found increased regional CBF in right supplementary motor area and decreased regional CBF in bilateral middle occipital gyrus, left caudate nucleus, right superior parietal gyrus, and left calcarine fissure/surrounding cortex in T2DM.ConclusionThe patterns of cerebral perfusion alterations, characterized by the decreased CBF in occipital and parietal lobes, might be the neuropathology of visual impairment and cognitive aging in T2DM.

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“…They are crucially involved in learning, emotion, memory, and other processes. A recent meta-analysis, including 15 structural studies and 16 functional studies, reported decreased global and regional gray matter volume in the limbic system of patients with T2DM, which could be associated with poor cognitive performance[ 42 ]. The results from some studies indicate that the changes in limbic regions, especially in dendritic structures, inhibit the formation of the spinal cord due to the chronic hyperglycemia; moreover, they may also disrupt the processes of memory and learning[ 43 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

Large-scale functional connectivity predicts cognitive impairment related to type 2 diabetes mellitus

Shi¹,

Yu²,

Hu³

et al. 2022

WJD

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BACKGROUND Large-scale functional connectivity (LSFC) patterns in the brain have unique intrinsic characteristics. Abnormal LSFC patterns have been found in patients with dementia, as well as in those with mild cognitive impairment (MCI), and these patterns predicted their cognitive performance. It has been reported that patients with type 2 diabetes mellitus (T2DM) may develop MCI that could progress to dementia. We investigated whether we could adopt LSFC patterns as discriminative features to predict the cognitive function of patients with T2DM, using connectome-based predictive modeling (CPM) and a support vector machine. AIM To investigate the utility of LSFC for predicting cognitive impairment related to T2DM more accurately and reliably. METHODS Resting-state functional magnetic resonance images were derived from 42 patients with T2DM and 24 healthy controls. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). Patients with T2DM were divided into two groups, according to the presence (T2DM-C; n = 16) or absence (T2DM-NC; n = 26) of MCI. Brain regions were marked using Harvard Oxford (HOA-112), automated anatomical labeling (AAL-116), and 264-region functional (Power-264) atlases. LSFC biomarkers for predicting MoCA scores were identified using a new CPM technique. Subsequently, we used a support vector machine based on LSFC patterns for among-group differentiation. The area under the receiver operating characteristic curve determined the appearance of the classification. RESULTS CPM could predict the MoCA scores in patients with T2DM (Pearson’s correlation coefficient between predicted and actual MoCA scores, r = 0.32, P =0.0066 [HOA-112 atlas]; r = 0.32, P =0.0078 [AAL-116 atlas]; r = 0.42, P =0.0038 [Power-264 atlas]), indicating that LSFC patterns represent cognition-level measures in these patients. Positive (anti-correlated) LSFC networks based on the Power-264 atlas showed the best predictive performance; moreover, we observed new brain regions of interest associated with T2DM-related cognition. The area under the receiver operating characteristic curve values (T2DM-NC group vs. T2DM-C group) were 0.65-0.70, with LSFC matrices based on HOA-112 and Power-264 atlases having the highest value (0.70). Most discriminative and attractive LSFCs were related to the default mode network, limbic system, and basal ganglia. CONCLUSION LSFC provides neuroimaging-based information that may be useful in detecting MCI early and accurately in patients with T2DM.

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A multimodal meta-analysis of regional structural and functional brain alterations in type 2 diabetes

Cited by 30 publications

References 102 publications

Aberrant Brain Spontaneous Activity and Synchronization in Type 2 Diabetes Mellitus Subjects Without Mild Cognitive Impairment

Aberrant Brain Spontaneous Activity and Synchronization in Type 2 Diabetes Mellitus Subjects Without Mild Cognitive Impairment

Cerebral Blood Flow Alterations in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Arterial Spin Labeling Studies

Large-scale functional connectivity predicts cognitive impairment related to type 2 diabetes mellitus

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