Diffusion-weighted imaging of injuries to the visual centers of the brain in patients with type 2 diabetes and retinopathy

Abstract

Abstract. The present study aimed to investigate the ability of diffusion-weighted imaging (DWI) to identify injury to the visual centers of the brain in patients with type 2 diabetes with retinopathy. The study included 84 cases (63 patients with type 2 diabetic retinopathy and 21 healthy individuals) that were assessed using DWI. Diabetic patients were equally divided into three groups: Proliferative diabetic retinopathy (PDR), non-proliferative diabetic retinopathy (NPDR) and diabetic without retinopathy. The results demonstrated that individuals in the PDR group had significantly higher disease duration and glycated hemoglobin levels than the diabetic without retinopathy group (P<0.05). Apparent diffusion coefficient (ADC) values were significantly higher in functional brain areas of the PDR group compared with the NPDR group (P<0.001), whose values were significantly higher compared with the diabetic without retinopathy and control groups (P<0.001). In addition, glycated hemoglobin levels and disease duration were positively correlated with mean ADC values in the same functional areas of the brain. In conclusion, DWI-measured ADC values may be an effective indicator of brain dysfunction in individuals with type 2 diabetic retinopathy. DWI is able to assess brain injury in individuals with early diabetic retinopathy, which may make the diagnostic technique a useful predictor of early ocular disease.

Altered Functional Connectivity Strength of Primary Visual Cortex in Subjects with Diabetic Retinopathy

“…38 A previous fMRI study revealed enhancement of FC between the left orbitofrontal gyrus and the temporal gyrus in T1DM patients, which suggested a compensatory or adaptive response to impaired functional areas in those patients. 8 Moreover, dysfunction in the OSFG has been observed in patients with DR. 11 , 39 In our study, enhanced FC between the bilateral V1 and OSFG indicated improved functional reorganization, which may relate to OSFG compensatory regulation or recruitment of visual resources from other regions.…”