Alterations of White Matter Integrity and Hippocampal Functional Connectivity in Type 2 Diabetes Without Mild Cognitive Impairment

Sun, Qian; Chen, Guanqun; Wang, Xibin; Yu, Ying; Hu, Yu-Chuan; Yan, Lin‐Feng; Zhang, Xin; Yang, Yang; Zhang, Jin; Liu, Bin; Wang, Congcong; Ma, Yi; Wang, Wen; Han, Ying; Cui, Guangbin

doi:10.3389/fnana.2018.00021

Cited by 51 publications

(45 citation statements)

References 45 publications

(57 reference statements)

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“…However, there were no comprehensive and sensitive assessments on cognitive function, or subjects in these studies were older. Sun et al found that functional connectivity (FC) between the hippocampus and certain brain structures had decreased significantly in T2DM subjects without MCI (12). However, results of the region of interest (ROI)-based FC analysis should be interpreted in caution, as the selected ROIs are mainly based on the prior knowledge, leading to different and unpredictable findings (13).…”

Section: Introductionmentioning

confidence: 99%

Altered Functional Hubs and Connectivity in Type 2 Diabetes Mellitus Without Mild Cognitive Impairment

Liang

Tan

et al. 2020

Front. Neurol.

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Background: Type 2 diabetes mellitus (T2DM)-related cognitive decline is associated with neuroimaging changes. However, only a few studies have focused on early functional alteration in T2DM prior to mild cognitive impairment (MCI). This study aimed to investigate the early changes of global connectivity patterns in T2DM by using a resting-state functional magnetic resonance imaging (rs-fMRI) technique. Methods: Thirty-four T2DM subjects and 38 age-, sex-, and education-matched healthy controls (HCs) underwent rs-fMRI in a 3T MRI scanner. Degree centrality (DC) was used to identify the functional hubs of the whole brain in T2DM without MCI. Then the functional connectivity (FC) between hubs and the rest of the brain was assessed by using the hub-based approach. Results: Compared with HCs, T2DM subjects showed increased DC in the right cerebellum lobules III-V. Hub-based FC analysis found that the right cerebellum lobules III-V of T2DM subjects had increased FC with the right cerebellum crus II and lobule VI, the right temporal inferior/middle gyrus, and the right hippocampus. Conclusions: Increased DC in the right cerebellum regions III-V, as well as increased FC within cerebellar regions and ipsilateral cerebrocerebellar regions, may indicate an important pathophysiological mechanism for compensation in T2DM without MCI.

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Section: Introductionmentioning

confidence: 99%

Altered Functional Hubs and Connectivity in Type 2 Diabetes Mellitus Without Mild Cognitive Impairment

Liang

Tan

et al. 2020

Front. Neurol.

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“…Some previous studies focused not only on the comparison between T2DM subjects and healthy controls, but also on the differences between those with and without cognitive impairment . Decreased hippocampal functional connectivity with the bilateral frontal cortex has been found for T2DM patients without MCI . Yang et al compared T2DM subjects with and without cognitive impairment with healthy controls, and found impaired intranetwork and internetwork connectivities, especially in those with MCI .…”

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confidence: 99%

“…A number of neuroimaging studies have emerged to investigate the abnormal brain functions of T2DM patients by measuring alterations in the spontaneous brain activities at resting state, 4 executive and memory abilities at visual n-back task, 5 and interregion functional connectivities. [6][7][8] Some previous studies focused not only on the comparison between T2DM subjects and healthy controls, but also on the differences between those with and without cognitive impairment. 8,9 Decreased hippocampal functional connectivity with the bilateral frontal cortex has been found for T2DM patients without MCI.…”

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confidence: 99%

“…8,9 Decreased hippocampal functional connectivity with the bilateral frontal cortex has been found for T2DM patients without MCI. 7 Yang et al compared T2DM subjects with and without cognitive impairment with healthy controls, and found impaired intranetwork and internetwork connectivities, especially in those with MCI. 8 The underlying brain structural changes associated with the functional abnormalities of T2DM patients with cognitive impairment have attracted increasing attention as well.…”

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confidence: 99%

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Application of neurite orientation dispersion and density imaging to characterize brain microstructural abnormalities in type‐2 diabetics with mild cognitive impairment

Xiong

Zhang

Shi

et al. 2019

Magnetic Resonance Imaging

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Background Diffusion‐tensor‐imaging (DTI) is sensitive in detecting white matter changes in type‐2 diabetes mellitus (T2DM). However, DTI indices can be affected by either neurite density or spatial variation. A novel diffusion MRI technique, termed neurite orientation dispersion and density imaging (NODDI), can provide distinct indices of fiber density and dispersion. Purpose To characterize brain microstructural alterations in T2DM patients with mild cognitive impairment (MCI) using the NODDI model. Study Type Cross‐sectional. Subjects Twenty T2DM patients with (DM‐MCI group), 18 age‐ and gender‐matched T2DM patients with normal cognition (DM‐NC group), and 28 euglycemic healthy controls (HC). Field Strength/Sequence 3T/NODDI. Assessment Diffusion data were analyzed using tract‐based‐spatial‐statistics (TBSS) analysis in white matter and voxel‐based analysis in both white and gray matter. NODDI indices, including intracellular volume fraction (Vic) and orientation dispersion index (ODI), were estimated from multiple regions and compared among these groups. Statistical Tests Differences between groups were compared by Student's t‐test, Pearson chi‐square test, or analysis of variance when appropriate. Correlation analyses were performed to investigate the relationship between NODDI variables and clinical measurements. Results Whole‐brain TBSS revealed that 2.29% and 2.02% of the white matter regions exhibited decreased fractional anisotropy and Vic, respectively, between the DM‐NC and HC, while considerably larger white matter areas showed decreased fractional anisotropy (38.38%) and Vic (34.64%) between the DM‐MCI and HC (Student's t‐test, P < 0.05). However, the angular variation of neurites, characterized by ODI, exhibited very little (0.1%, P < 0.05) or no difference (P > 0.05) between either the DM‐MCI or DM‐NC groups and HC. Decreased Vic values in the genu of the corpus callosum (R = 0.580, 0.551 and 0.586, P < 0.01) and thalamus (R = 0.570, 0.616, and 0.595, P < 0.05) correlated with glycosylated hemoglobin A1c level, disease duration, and neuropsychological scores, respectively. Data Conclusion T2DM patients with cognitive decline had reduced Vic, which indicated decreased density of axons and dendrites. NODDI might be able to help probe microstructural changes in white and gray matter and provide information on diabetic encephalopathy, including those with cognitive impairment. Level of Evidence: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:889–898.

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“…Resting-state FC can be used to evaluate interregional cooperation between different brain regions. Previous studies that examined different regions of interest (ROIs) other than the cerebellum have revealed the abnormal patterns of FC in T2DM (Musen et al, 2012;Chen et al, 2015;Sun et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Altered Cerebellar-Cerebral Circuits in Patients With Type 2 Diabetes Mellitus

Zhang

Gao

et al. 2020

Front. Neurosci.

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The role of the cerebellum in type 2 diabetes mellitus (T2DM) has been receiving increased attention. However, the functional connectivity (FC) between the cerebellar subregions and the cerebral cortex has not been investigated in T2DM. Therefore, the purpose of this study was to investigate cerebellar-cerebral FC and the relationship between FC and clinical/cognitive variables in patients with T2DM. A total of 34 patients with T2DM and 30 healthy controls were recruited for this study to receive a neuropsychological assessment and undergo resting-state FC. We selected four subregions of the cerebellum (bilateral lobules IX, right and left Crus I/II, and left lobule VI) as regions of interest (ROIs) to examine the differences in cerebellar-cerebral circuits in patients with T2DM compared to healthy controls. Correlation analysis was performed to examine the relationship between FC and clinical/cognitive variables in the patients. Compared to healthy controls, patients with T2DM showed significantly decreased cerebellar-cerebral FC in the default-mode network (DMN), executive control network (ECN), and visuospatial network (VSN). In the T2DM group, the FC between the left cerebellar lobule VI and the right precuneus was negatively correlated with the Trail Making Test A (TMT-A) score (r = −0.430, P = 0.013), after a Bonferroni correction. In conclusion, patients with T2DM have altered FC between the cerebellar subregions and the cerebral networks involved in cognitive and emotional processing. This suggests that a range of cerebellar-cerebral circuits may be involved in the neuropathology of T2DM cognitive dysfunction.

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Alterations of White Matter Integrity and Hippocampal Functional Connectivity in Type 2 Diabetes Without Mild Cognitive Impairment

Cited by 51 publications

References 45 publications

Altered Functional Hubs and Connectivity in Type 2 Diabetes Mellitus Without Mild Cognitive Impairment

Altered Functional Hubs and Connectivity in Type 2 Diabetes Mellitus Without Mild Cognitive Impairment

Application of neurite orientation dispersion and density imaging to characterize brain microstructural abnormalities in type‐2 diabetics with mild cognitive impairment

Altered Cerebellar-Cerebral Circuits in Patients With Type 2 Diabetes Mellitus

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