Altered Spontaneous Brain Activity in Type 2 Diabetes: A Resting-State Functional MRI Study

Cui, Ying; Yun, Jimmy; Chen, Yu‐Chen; Wang, Kun; Gao, Bo; Su, Wen; Ju, Shenghong; Teng, Gao‐Jun

doi:10.2337/db13-0519

Cited by 179 publications

(214 citation statements)

References 40 publications

(42 reference statements)

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“…This discrepancy may have appeared due to variations in task selection and processing methods. Clinically, insulin resistance was negatively correlated with neural activity in the frontal regions in T2DM patients (38). Other abnormal levels of brain metabolites, including reduced N-acetylaspartate and increased myoinositol and choline in the frontal lobe, were found in diabetic patients compared with healthy control subjects (39), which is consistent with the report that impairments of neuronal density or viability, glial proliferation, and demyelination emerge in diabetes (40).…”

Section: Discussionsupporting

confidence: 80%

Altered Brain Activation Patterns Under Different Working Memory Loads in Patients With Type 2 Diabetes

et al. 2014

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OBJECTIVEType 2 diabetes mellitus (T2DM) has important effects on cognition and the risk for Alzheimer disease (AD). Working memory (WM) is a susceptible cognitive domain of mild cognitive impairment and AD. Thus, the identification of brain activation patterns under different WM loads can potentially enhance our understanding of the mechanisms underlying cognitive dysfunction in T2DM. RESEARCH DESIGN AND METHODSThe current study assessed the effects of T2DM on cognitive performance and explored the related neuronal damage through a visual n-back task and functional magnetic resonance imaging. RESULTSWe found that patients with T2DM exhibited worse executive and memory abilities than control subjects. Furthermore, the patterns of brain activation changed under different WM loads in the T2DM patients, who exhibited reduced activation in the left inferior frontal gyrus under low loads and reduced activation in the left middle frontal gyrus and superior frontal gyrus (SFG) under high loads. Thus, more regions of diminished activation were seen in the frontal cortex with increasing task difficulty. Furthermore, we found that lower SFG activation was associated with worse cognitive function. CONCLUSIONSThe findings demonstrate deficient WM in patients with T2DM and the relation between cognitive function and degree of neuronal activity and their relevance to AD risk. Further longitudinal studies are needed to replicate these results and to evaluate the clinical value of brain imaging methods in the prediction of disease progress in these patients.

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Section: Discussionsupporting

confidence: 80%

Altered Brain Activation Patterns Under Different Working Memory Loads in Patients With Type 2 Diabetes

et al. 2014

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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.…”

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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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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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“…The left lingual gyrus and the left middle occipital gyrus are linked with visual memory (37). Our previous study showed that the visual cortex of type 2 diabetic patients revealed disrupted resting-state amplitude of low-frequency fluctuations and regional homogeneity (38). We speculate that the decreased functional connectivity to the visual cortex lowers the performance in the CFT delayed recall test that is related to visual memory (39).…”

Section: Discussionmentioning

confidence: 79%

Aberrant Brain Functional Connectivity Related to Insulin Resistance in Type 2 Diabetes: A Resting-State fMRI Study

et al. 2014

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OBJECTIVEType 2 diabetes is characterized by insulin resistance, which is involved in the development of Alzheimer disease. This study aims to investigate the relationship between abnormal resting-state brain functional connectivity and insulin resistance in type 2 diabetes. RESEARCH DESIGN AND METHODSA total of 30 patients with type 2 diabetes and 31 healthy well-matched volunteers were prospectively examined. Resting-state brain functional connectivity analysis was used to examine the correlation between the posterior cingulate cortex (PCC) and whole-brain regions. The possible relationships between functional connectivity measures and insulin resistance were evaluated using the homeostasis model assessment of insulin resistance (HOMA-IR). RESULTSCompared with healthy controls, we observed significantly decreased functional connectivity of the PCC within some selected regions, including the right middle temporal gyrus (MTG), left lingual gyrus, left middle occipital gyrus, and left precentral gyrus; increased functional connectivity of the PCC was detected in the left cerebellum posterior lobe, right superior frontal gyrus, and right middle frontal gyrus. A significant negative correlation was found between the PCC-right MTG connectivity and HOMA-IR in type 2 diabetic patients (P = 0.014; r = 20.446). CONCLUSIONSType 2 diabetic patients develop aberrant functional connectivity of the PCC, which is associated with insulin resistance in selected brain regions. Resting-state connectivity disturbance of PCC-MTG may be a central role for evaluating the cognitive dysfunction in type 2 diabetes.Type 2 diabetes is characterized by insulin resistance, as indicated by chronically increased peripheral insulin levels and concomitantly reduced brain insulin activity (1,2). Insulin modulates numerous metabolic pathways, including those associated with brain cognitive function, such as glucose metabolism, synaptic maintenance, vascular function, tau phosphorylation, and b-amyloid regulation (3-5). Recent longitudinal studies have shown that insulin resistance is associated with an increasing risk of developing into Alzheimer disease (AD) from healthy individuals or type 2 diabetic patients (6,7). Due to the distribution of insulin receptors in

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Altered Spontaneous Brain Activity in Type 2 Diabetes: A Resting-State Functional MRI Study

Cited by 179 publications

References 40 publications

Altered Brain Activation Patterns Under Different Working Memory Loads in Patients With Type 2 Diabetes

Altered Brain Activation Patterns Under Different Working Memory Loads in Patients With Type 2 Diabetes

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

Aberrant Brain Functional Connectivity Related to Insulin Resistance in Type 2 Diabetes: A Resting-State fMRI Study

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