Type 2 Diabetes Mellitus May Exacerbate Gray Matter Atrophy in Patients With Early-Onset Mild Cognitive Impairment

Li, Chang; Zuo, Zhiwei; Liu, Daihong; Jiang, Rui; Li, Yang; Li, Haitao; Yin, Xuntao; Lai, Yuqi; Wang, Jian; Xiong, Kunlin

doi:10.3389/fnins.2020.00856

Cited by 18 publications

(19 citation statements)

References 52 publications

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“…Accumulated evidence suggests the hippocampus plays a key role in declarative or memory function ( 46 ). Previous literature ( 47 ) demonstrated an abnormal activation in the hippocampus of patients with T2DM which was associated with memory function. Furthermore, a recent study demonstrated that a correlation between the hippocampus and olfactory memory may exist ( 48 ).…”

Section: Discussionmentioning

confidence: 83%

Altered Gray Matter Volume, Functional Connectivity, and Degree Centrality in Early-Onset Type 2 Diabetes Mellitus

Feng

Tan

et al. 2021

Front. Neurol.

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Background: Structural and functional brain alterations that underlie cognitive decline have been observed in elderly adults with type 2 diabetes mellitus (T2DM); however, whether these alterations can be observed in patients with early-onset T2DM remains unclear. Therefore, we aimed to describe the abnormalities in brain volume and functional patterns in patients with early-onset T2DM in the present study.Methods: We enrolled 20 patients with early-onset T2DM and 20 healthy controls (HCs). Changes in brain volume were assessed using voxel-based morphology (VBM), while changes in brain function were assessed using degree centrality (DC) and functional connectivity (FC).Results: Compared to HCs, patients with early-onset T2DM exhibited gray matter reductions in the left orbital superior, middle, and inferior frontal gyri as well as the right superior frontal gyrus. The gray matter reductions in the right superior frontal gyrus were negatively associated with the urine albumin to creatinine ratio. Furthermore, increased DC values were observed in the left superior temporal gyrus, left Heschl gyrus, and left hippocampus in patients with early-onset T2DM. An FC analysis of these regions revealed elevated connectivity in the right precuneus, left inferior parietal gyrus, left Heschl gyrus, bilateral post-central gyrus, bilateral insula, bilateral superior temporal gyrus, and bilateral medial and paracingulate gyrus. Furthermore, the FC of the hubs to the superior temporal gyrus, insula, and Heschl gyrus was increased and positively correlated with trail making test-B.Conclusion: Decreased local gray matter volume and increased DC and FC may represent the neurobiological mechanism underlying cognitive dysfunction in patients with early-onset T2DM.

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Section: Discussionmentioning

confidence: 83%

Altered Gray Matter Volume, Functional Connectivity, and Degree Centrality in Early-Onset Type 2 Diabetes Mellitus

Feng

Tan

et al. 2021

Front. Neurol.

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“…In the meantime, the hippocampus is a significant region which is one of the major components of the limbic system that regulates the memory function, sensation and emotion of the brain. Cognitive impairment in T2DM patients is closely related to changes in hippocampal structure and function ( 9 – 11 ). Animal models have shown that IR in the hippocampus is a potential mediator of cognitive dysfunction in T2DM ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

Altered Hippocampal Subfields Volumes Is Associated With Memory Function in Type 2 Diabetes Mellitus

Liu

et al. 2021

Front. Neurol.

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Objective: Cognitive impairment in type 2 diabetes mellitus (T2DM) patients is related to changes in hippocampal structure and function. However, the alternation of hippocampal subfields volumes and their relationship with cognitive function are unclear. This study explored morphological alterations in the hippocampus and its subfields in T2DM patients and their relationship with cognitive function.Methods: Thirty T2DM patients and 20 healthy controls (HCs) were recruited and underwent 3-dimensional, high-resolution T1-weighted sequence (3D-T1) and a battery of cognitive tests. Freesurfer 6.0 was performed to segment the hippocampus into 12 subregions automatically. Then relationships between hippocampal subfield volumes and neurocognitive scale scores in the T2DM group were evaluated.Results: Immediate memory scores on the auditory verbal learning test (AVLT) and Montreal Cognitive Assessment (MoCA) scores in T2DM patients were lower than in the HCs. T2DM patients showed that volumes of the bilateral hippocampus were significantly reduced, mainly in the bilateral molecular layer, granule cell and molecular layer of the dentate gyrus (GC-ML-DG), cornu ammonis 4 (CA4), fimbria, and left subiculum and the right hippocampus amygdala transition area (HATA) compared to HCs. In addition, T2DM patients showed the FINS was negatively correlated with volume of left GC-ML-DG (r = −0.415, P = 0.035) and left CA4 (r = −0.489, P = 0.011); the FBG was negatively correlated with volume of right fimbria (r = −0.460, P = 0.018); the HOMA-IR was negatively correlated with volume of left GC-ML-DG (r = −0.367, P = 0.046) and left CA4(r = 0.462, P = 0.010). Partial correlation analysis found that the volume of right HATA in T2DM group was positively correlated with AVLT (immediate) scores (r = 0.427, P = 0.03).Conclusion: This study showed the volumes of multiple hippocampal subfields decreased and they were correlated with FINS, FBG and HOMA-IR in T2DM patients. We hypothesized that decreased hippocampal subfields volumes in T2DM patients was related to insulin resistance and impaired vascular function. In addition, we also found that abnormal hippocampal subfields volumes were related to memory function in T2DM patients, suggesting that reduced volumes in specific hippocampal subfields may be the potential mechanism of memory dysfunction in these patients.

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“…Many neuroimaging studies have used different methods to explore the patterns of abnormal brain structure and function in T2DM patients under different cognitive states. Voxel-based morphometry (VBM) analysis has found reductions in cortical/subcortical gray matter and some overlapping brain regions in T2DM patients with and without MCI, whereas gray matter volume (GMV) atrophy is more widespread in T2DM patients with MCI (DMCI) [9,10]. Li et al suggested that subcortical atrophy may play a pivotal role in the cognitive impairment of T2DM patients [10].…”

Section: Introductionmentioning

confidence: 99%

“…Voxel-based morphometry (VBM) analysis has found reductions in cortical/subcortical gray matter and some overlapping brain regions in T2DM patients with and without MCI, whereas gray matter volume (GMV) atrophy is more widespread in T2DM patients with MCI (DMCI) [9,10]. Li et al suggested that subcortical atrophy may play a pivotal role in the cognitive impairment of T2DM patients [10]. Furthermore, several studies using different methods found no signi cant damage in white matter microstructure [11][12][13] and only slight Previous studies have used degree centrality (DC) analysis to investigate the abnormalities of hub nodes in T2DM patients, and their results suggested these abnormalities may re ect the aberrant communication of information in the brain of T2DM patients [20,21].…”

Section: Introductionmentioning

confidence: 99%

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

Huang¹,

Zhang²,

Zhang³

et al. 2022

Preprint

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Cognitive impairment in type 2 diabetes mellitus (T2DM) is associated with functional and structural abnormalities of brain networks, especially the damage to hub nodes in networks. This study explored the abnormal hub nodes of brain functional networks in T2DM patients under different cognitive states. Sixty-five T2DM patients and 34 healthy controls (HCs) underwent neuropsychological assessment. Then, degree centrality (DC) analysis and seed-based functional connectivity (FC) analysis were performed to identify the abnormal hub nodes and the FC patterns of these hubs in T2DM patients with mild cognitive impairment (MCI) (DMCI group, N = 31) and without MCI (DMCN group, N = 34). Correlation analyses examined the relationship between abnormal DC and FC and clinical/cognitive variables. Compared with HCs, both T2DM groups showed decreased DC values in the visual cortex, and the T2DM patients with MCI (DMCI) showed more extensive alterations in the right parahippocampal gyrus (PHG), posterior cingulate cortex (PCC), and left superior frontal gyrus (SFG) regions than T2DM patients with normal cognitive function. Seed-based FC analysis of PHG and PCC nodes showed that functional disconnection mainly occurred in visual pathways and the default mode network (DMN) in DMCI patients. Multiple abnormal DC values and disordered FC correlated with neuropsychological tests in the T2DM patients. In conclusion, this study found that the DMCI group displayed more extensive alterations in hub nodes and FC in visual network and the DMN, suggesting that visual network dysfunctions may be the neural basis of abnormal visuospatial functioning in DMCI patients.

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Type 2 Diabetes Mellitus May Exacerbate Gray Matter Atrophy in Patients With Early-Onset Mild Cognitive Impairment

Cited by 18 publications

References 52 publications

Altered Gray Matter Volume, Functional Connectivity, and Degree Centrality in Early-Onset Type 2 Diabetes Mellitus

Altered Gray Matter Volume, Functional Connectivity, and Degree Centrality in Early-Onset Type 2 Diabetes Mellitus

Altered Hippocampal Subfields Volumes Is Associated With Memory Function in Type 2 Diabetes Mellitus

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

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