Altered baseline brain activity in type 2 diabetes: A resting-state fMRI study

Xia, Wenqing; Wang, Shaohua; Sun, Zilin; Bai, Feng; Zhou, Yi; Yang, Yue; Wang, Pin; Huang, Yan; Yuan, Yang

doi:10.1016/j.psyneuen.2013.05.012

Cited by 116 publications

(123 citation statements)

References 51 publications

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“…These studies have revealed associations among impaired cognition, altered activation, and decreased functional connectivity (8)(9)(10)(11)(12)(13)(14). Although functional connectivity was measured by correlating signal time series of various and a priori-selected cerebral regions, aberrant connections outside these predefined regions remain undiscovered.…”

mentioning

confidence: 99%

Functional Brain Networks Are Altered in Type 2 Diabetes and Prediabetes: Signs for Compensation of Cognitive Decrements? The Maastricht Study

et al. 2016

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Type 2 diabetes is associated with cognitive decrements, accelerated cognitive decline, and increased risk for dementia. Patients with the metabolic syndrome, a major risk factor for diabetes, may display comparable cognitive decrements as seen in type 2 diabetes. Currently, the impact of diabetes and prediabetes on cognition and the underlying organization of functional brain networks still remain to be elucidated. This study investigated whether functional brain networks are affected in type 2 diabetes and prediabetes. Forty-seven participants with diabetes, 47 participants with prediabetes, and 45 control participants underwent detailed cognitive testing and 3-Tesla resting state functional MRI. Graph theoretical network analysis was performed to investigate alterations in functional cerebral networks. Participants with diabetes displayed altered network measures, characterized by a higher normalized cluster coefficient and higher local efficiency, compared with control participants. The network measures of the participants with prediabetes fell between those with diabetes and control participants. Lower processing speed was associated with shorter path length and higher global efficiency. Participants with type 2 diabetes have altered functional brain networks. This alteration is already apparent in the prediabetic stage to a somewhat lower level, hinting at functional reorganization of the cerebral networks as a compensatory mechanism for cognitive decrements.The worldwide prevalence of diabetes is increasing rapidly, with the majority of patients having type 2 diabetes (1). Along with cardiovascular risk factors, type 2 diabetes is associated with cognitive decrements, accelerated cognitive decline, and an increased risk for dementia and Alzheimer disease (2,3). A broad range of cognitive domains are affected in type 2 diabetes, and one of the most commonly affected is processing speed (4,5). However, the underlying pathological mechanism is not yet clear.The progression of normal glucose metabolism to type 2 diabetes is a gradual process in which insulin resistance plays a crucial role. Before the clinical presentation of type 2 diabetes, insulin resistance often is accompanied by other metabolic and vascular abnormalities. The cluster of these cardiovascular risk factors is referred to as the metabolic syndrome and is considered a major risk factor for diabetes (6). Patients with the metabolic syndrome have a high likelihood for diabetes and may display comparable cognitive decrements as seen in patients with type 2 diabetes (5). Furthermore, the cardiovascular risk factors are associated with an increased risk of late-life dementia (7).

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confidence: 99%

Functional Brain Networks Are Altered in Type 2 Diabetes and Prediabetes: Signs for Compensation of Cognitive Decrements? The Maastricht Study

et al. 2016

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“…13 A recent study reported distributed activity changes in T2DM patients, including the temporal gyrus, in which activity was negatively correlated with executive functioning, suggesting a joint effect of structural and functional alterations. 14 A later study, however, reported abnormal resting-state brain activity in the absence of structural differences in T2DM, which was associated with cognitive impairment. 15 The uncertainty about pathophysiological mechanisms underlying behavioral impairments and brain dysfunction remains.…”

Section: Introductionmentioning

confidence: 94%

Early Disrupted Neurovascular Coupling and Changed Event Level Hemodynamic Response Function in Type 2 Diabetes: An fMRI Study

Duarte

Pereira

Quendera

et al. 2015

J Cereb Blood Flow Metab

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Type 2 diabetes (T2DM) patients develop vascular complications and have increased risk for neurophysiological impairment. Vascular pathophysiology may alter the blood flow regulation in cerebral microvasculature, affecting neurovascular coupling. Reduced fMRI signal can result from decreased neuronal activation or disrupted neurovascular coupling. The uncertainty about pathophysiological mechanisms (neurodegenerative, vascular, or both) underlying brain function impairments remains. In this cross-sectional study, we investigated if the hemodynamic response function (HRF) in lesion-free brains of patients is altered by measuring BOLD (Blood Oxygenation Level-Dependent) response to visual motion stimuli. We used a standard block design to examine the BOLD response and an event-related deconvolution approach. Importantly, the latter allowed for the first time to directly extract the true shape of HRF without any assumption and probe neurovascular coupling, using performance-matched stimuli. We discovered a change in HRF in early stages of diabetes. T2DM patients show significantly different fMRI response profiles. Our visual paradigm therefore demonstrated impaired neurovascular coupling in intact brain tissue. This implies that functional studies in T2DM require the definition of HRF, only achievable with deconvolution in event-related experiments. Further investigation of the mechanisms underlying impaired neurovascular coupling is needed to understand and potentially prevent the progression of brain function decrements in diabetes.

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“…Using single photon emission computed tomography (SPECT) in elderly diabetic patients, it was reported that there is a reduction in cerebral perfusion of the fronto-temporal region, a region that plays an important role in memory, judgment, attention, learning ability and other functions [23]. Furthermore, a resting-state functional MRI study confirmed altered amplitude of low-frequency fluctuations (ALFF) in many brain regions of T2DM patients, which reflected poor neurocognitive performances [24]. Our study also found that MCI patients with T2DM had worse performances in memory, attention, and information processing speed.…”

Section: Comparison Of Cognitive Function Of T2dm Patients With Diffementioning

confidence: 99%

Clinical Characteristics for the Relationship between Type-2 Diabetes Mellitus and Cognitive Impairment: A Cross-Sectional Study

Zhou

Fang

Liu³

et al. 2015

Aging and disease

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ABSTRACT:We explored the potential differences in cognitive status, lipid and glucose metabolism, ApoEε4 alleles and imaging between diabetic and non-diabetic subjects. 83 subjects with normal cognitive function and 114 mild cognitive impaired patients were divided into four groups by history of diabetes. General demographics was collected from all participants followed by MRI scan, biochemical examinations and a series of neuropsychological tests. Student's t test, multiple regressions and one-way ANOVA were applied to investigate the differences between groups. Comparing diabetic patients with non-diabetic subjects in the mild cognitive impaired group, we found several decreased items in recall of three words in MMSE (p=0.020), AVLT and SCWT (p＜0.050). The multiple linear regression revealed that two-hour glucose level (B= -0.255，p＜0.001) and fasting C-peptide (B= -0.466， p=0.001) had negative effects on the score of MMSE. In addition, diabetic patients treated with insulin and other diabetes medication performed better in part of the AVLT (p＜0.050) compared to patients with insulin treatment or oral antidiabetic medication only. Patients with metformin medication had a better memory outcome compared to patients with sulphonylurea medication in the AVLT long delay free recall (p =0.010). These findings show that patients of mild cognitive impairment with diabetes mellitus have a worse outcome in attention, information processing speed and memory compared to non-diabetic patients. Higher two-hour glucose level and C-peptide level may be risk factors for severe cognitive impairment in type-2 diabetes mellitus patients. The results of this study also suggest that medication may have effects on cognitive function.Key words: Type-2 diabetes mellitus, mild cognitive impairment, C-peptide, blood glucoseThe incidence of type-2 diabetes mellitus (T2DM) in China has dramatically increased in the last decade. Besides the well-known connection between T2DM and peripheral nervous system disease, the diabetes-induced lesions in the central nervous system (CNS), such as cerebrovascular disease and cognitive dysfunction, are receiving increased attention. Several epidemiological studies have found that T2DM is an independent risk factor for both Alzheimer's disease (AD) and vascular dementia (VaD) [1,2]. In addition, further research has shown that T2DM may also exercise influence on the prevalence of mild cognitive impairment (MCI), which is considered a pre-clinical stage of dementia. In Luchsinger and colleagues' study [3], the results indicated that diabetes mellitus is related to a relatively higher risk for all causes of MCI (about 1.5 fold). In another recent metaanalysis report, diabetes was shown to have higher risk for any dementia and MCI (1.46 for AD, 2.48 for VaD and 1.21 for MCI) [4].The present studies have confirmed that T2DM is a robust risk factor for cognitive dysfunction. However, the precise mechanisms remain to be elucidated [5]. A wide range of metabolic and vascular disturbances have been proposed to e...

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Altered baseline brain activity in type 2 diabetes: A resting-state fMRI study

Cited by 116 publications

References 51 publications

Functional Brain Networks Are Altered in Type 2 Diabetes and Prediabetes: Signs for Compensation of Cognitive Decrements? The Maastricht Study

Functional Brain Networks Are Altered in Type 2 Diabetes and Prediabetes: Signs for Compensation of Cognitive Decrements? The Maastricht Study

Early Disrupted Neurovascular Coupling and Changed Event Level Hemodynamic Response Function in Type 2 Diabetes: An fMRI Study

Clinical Characteristics for the Relationship between Type-2 Diabetes Mellitus and Cognitive Impairment: A Cross-Sectional Study

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