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Chen HF, Jiang JY, Chen MH, Lin R, Jerence SWO, Chang CH, Chou CC. Gender differences in cognitive function and its associated factors among older adults with type 2 diabetes. Geriatr Nurs 2023; 52:165-171. [PMID: 37354756 DOI: 10.1016/j.gerinurse.2023.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/27/2023] [Accepted: 05/29/2023] [Indexed: 06/26/2023]
Abstract
Diabetes is widely prevalent among older people and can influence accelerated cognitive decline. Gender-based disparities may contribute to variations in cognitive decline. This study examined gender differences in cognitive function and associated factors among older adults with diabetes. A cross-sectional study was conducted involving 318 Taiwanese older adults with type 2 diabetes. Demographic, health, and diabetes-related data were collected, and cognitive neuropsychological tests were evaluated. Compared to men, women with diabetes showed significantly poorer performance in global cognitive function and executive function. Age, years of education, sleep quality, and HbA1c were correlated with domains of cognitive function in men, whereas age, years of education, depressive symptoms, HbA1c, and duration of diabetes were associated with domains of cognitive function among women. Nurses should recognize gender differences in factors associated with cognitive function in older adults with diabetes and should develop individualized interventions to improve patients' cognitive function.
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Affiliation(s)
- Hua-Fen Chen
- Division of Endocrinology & Metabolism, Far Eastern Memorial Hospital, New Taipei City, Taiwan; School of Medicine and Department of Public Health, College of Medicine, Fujen Catholic University, New Taipei City, Taiwan
| | - Ju Ying Jiang
- Division of Endocrinology & Metabolism, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Mei-Hsiu Chen
- Division of Endocrinology & Metabolism, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Biomedical Engineering, Ming Chuang University, Taoyuan, Taiwan
| | - Rong Lin
- Division of Endocrinology & Metabolism, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Seng Wei Ooi Jerence
- Division of Endocrinology & Metabolism, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chin-Huan Chang
- Division of Endocrinology & Metabolism, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Cheng-Chen Chou
- Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Gao Y, Sui C, Chen B, Xin H, Che Y, Zhang X, Wang N, Wang Y, Liang C. Voxel-based morphometry reveals the correlation between gray matter volume and serum P-tau-181 in type 2 diabetes mellitus patients with different HbA1c levels. Front Neurosci 2023; 17:1202374. [PMID: 37255749 PMCID: PMC10225590 DOI: 10.3389/fnins.2023.1202374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 04/27/2023] [Indexed: 06/01/2023] Open
Abstract
Introduction Emerging evidence suggested widespread decreased gray matter volume (GMV) and tau hyperphosphorylation were associated with type 2 diabetes mellitus (T2DM). Insulin resistance is one of the mechanisms of neuron degeneration in T2DM; it can decrease the activity of protein kinase B and increase the activity of glycogen synthesis kinase-3β, thus promoting the hyperphosphorylation of tau protein and finally leading to neuronal degeneration. However, the association between GMV and serum tau protein phosphorylated at threonine 181 (P-tau-181) in T2DM patients lacks neuroimaging evidence. We aimed to investigate the difference in brain GMV between T2DM patients with different glycated hemoglobin A1c (HbA1c) levels and healthy control (HC) subjects and the correlation between serum P-tau-181 and GMV in T2DM patients. Methods Clinical parameters, biochemical indicators, and MRI data were collected for 41 T2DM patients with high glycosylated hemoglobin level (HGL), 17 T2DM patients with normal glycosylated hemoglobin level (NGL), and 42 HC subjects. Voxel-based morphometry (VBM) method was applied to investigate GMV differences among groups, and multiple regression analysis was used to examine the correlation between serum P-tau-181 and GMV. Results Compared with HC subjects, the T2DM patients with HGL or NGL all showed significantly decreased GMV. Briefly, the GMV decreased in T2DM patients with HGL was mainly in the bilateral parahippocampal gyrus (PHG), right middle temporal gyrus (MTG), temporal pole (TPOmid), hippocampus (HIP), and left lingual gyrus. The GMV reduction in T2DM patients with NGL was in the right superior temporal gyrus (STG), and there was no significant difference in GMV between the two diabetic groups. The GMV values of bilateral PHG, right MTG, TPOmid, HIP, and STG can significantly (p < 0.0001) distinguish T2DM patients from HC subjects in ROC curve analysis. In addition, we found that serum P-tau-181 levels were positively correlated with GMV in the right superior and middle occipital gyrus and cuneus, and negatively correlated with GMV in the right inferior temporal gyrus in T2DM patients. Conclusion Our study shows that GMV atrophy can be used as a potential biological indicator of T2DM and also emphasizes the important role of P-tau-181 in diabetic brain injury, providing new insights into the neuropathological mechanism of diabetic encephalopathy.
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Affiliation(s)
- Yian Gao
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Chaofan Sui
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Boyao Chen
- College of Radiology, Shandong First Medical University (Shandong Academy of Medical Sciences), Tai’an, Shandong, China
| | - Haotian Xin
- Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yena Che
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xinyue Zhang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Na Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yuanyuan Wang
- Department of Medical Imaging, Binzhou Medical University, Yantai, Shandong, China
| | - Changhu Liang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
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Li ZY, Ma T, Yu Y, Hu B, Han Y, Xie H, Ni MH, Chen ZH, Zhang YM, Huang YX, Li WH, Wang W, Yan LF, Cui GB. Changes of brain function in patients with type 2 diabetes mellitus measured by different analysis methods: A new coordinate-based meta-analysis of neuroimaging. Front Neurol 2022; 13:923310. [PMID: 36090859 PMCID: PMC9449648 DOI: 10.3389/fneur.2022.923310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/11/2022] [Indexed: 11/22/2022] Open
Abstract
Objective Neuroimaging meta-analysis identified abnormal neural activity alterations in patients with type 2 diabetes mellitus (T2DM), but there was no consistency or heterogeneity analysis between different brain imaging processing strategies. The aim of this meta-analysis was to determine consistent changes of regional brain functions in T2DM via the indicators obtained by using different post-processing methods. Methods Since the indicators obtained using varied post-processing methods reflect different neurophysiological and pathological characteristics, we further conducted a coordinate-based meta-analysis (CBMA) of the two categories of neuroimaging literature, which were grouped according to similar data processing methods: one group included regional homogeneity (ReHo), independent component analysis (ICA), and degree centrality (DC) studies, while the other group summarized the literature on amplitude of low-frequency fluctuation (ALFF) and cerebral blood flow (CBF). Results The final meta-analysis included 23 eligible trials with 27 data sets. Compared with the healthy control group, when neuroimaging studies were combined with ReHo, ICA, and DC measurements, the brain activity of the right Rolandic operculum, right supramarginal gyrus, and right superior temporal gyrus in T2DM patients decreased significantly. When neuroimaging studies were combined with ALFF and CBF measurements, there was no clear evidence of differences in the brain function between T2DM and HCs. Conclusion T2DM patients have a series of spontaneous abnormal brain activities, mainly involving brain regions related to learning, memory, and emotion, which provide early biomarkers for clarifying the mechanism of cognitive impairment and neuropsychiatric disorders in diabetes. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=247071, PROSPERO [CRD42021247071].
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Affiliation(s)
- Ze-Yang Li
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Teng Ma
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Ying Yu
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Bo Hu
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Yu Han
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Hao Xie
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Min-Hua Ni
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
- Faculty of Medical Technology, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Zhu-Hong Chen
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Yang-Ming Zhang
- Battalion of the Second Regiment of Cadets of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Yu-Xiang Huang
- Battalion of the Second Regiment of Cadets of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Wen-Hua Li
- Battalion of the Second Regiment of Cadets of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Wen Wang
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
- *Correspondence: Guang-Bin Cui ;
| | - Lin-Feng Yan
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
- Lin-Feng Yan
| | - Guang-Bin Cui
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
- Wen Wang
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Chau ACM, Smith AE, Hordacre B, Kumar S, Cheung EYW, Mak HKF. A scoping review of resting-state brain functional alterations in Type 2 diabetes. Front Neuroendocrinol 2022; 65:100970. [PMID: 34922997 DOI: 10.1016/j.yfrne.2021.100970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 11/18/2021] [Accepted: 12/07/2021] [Indexed: 11/28/2022]
Abstract
Resting-state functional magnetic resonance imaging (rs-fMRI) has been actively used in the last decade to investigate brain functional connectivity alterations in Type 2 Diabetes Mellitus (T2DM) to understand the neuropathophysiology of T2DM in cognitive degeneration. Given the emergence of new analysis techniques, this scoping review aims to map the rs-fMRI analysis techniques that have been applied in the literature and reports the latest rs-fMRI findings that have not been covered in previous reviews. Graph theory, the contemporary rs-fMRI analysis, has been used to demonstrate altered brain topological organisations in people with T2DM, which included altered degree centrality, functional connectivity strength, the small-world architecture and network-based statistics. These alterations were correlated with T2DM patients' cognitive performances. Graph theory also contributes to identify unbiased seeds for seed-based analysis. The expanding rs-fMRI analytical approaches continue to provide new evidence that helps to understand the mechanisms of T2DM-related cognitive degeneration.
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Affiliation(s)
- Anson C M Chau
- Medical Imaging, Medical Radiation Science, Allied Health and Human Performance, University of South Australia, Adelaide, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia.
| | - Ashleigh E Smith
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia.
| | - Brenton Hordacre
- IIMPACT in Health, Allied Health and Human Performance, University of South Australia, Adelaide, Australia.
| | - Saravana Kumar
- IIMPACT in Health, Allied Health and Human Performance, University of South Australia, Adelaide, Australia; Allied Health and Human Performance, University of South Australia, Adelaide, Australia.
| | - Eva Y W Cheung
- School of Medical and Health Sciences, Tung Wah College, Hong Kong.
| | - Henry K F Mak
- Department of Diagnostic Radiology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong; Alzheimer's Disease Research Network, The University of Hong Kong, Hong Kong; State Key Laboratory for Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong.
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Zhang X, Liu J, Yang Y, Zhao S, Guo L, Han J, Hu X. Test-retest reliability of dynamic functional connectivity in naturalistic paradigm functional magnetic resonance imaging. Hum Brain Mapp 2021; 43:1463-1476. [PMID: 34870361 PMCID: PMC8837589 DOI: 10.1002/hbm.25736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 11/19/2021] [Accepted: 11/24/2021] [Indexed: 01/30/2023] Open
Abstract
Dynamic functional connectivity (dFC) has been increasingly used to characterize the brain transient temporal functional patterns and their alterations in diseased brains. Meanwhile, naturalistic neuroimaging paradigms have been an emerging approach for cognitive neuroscience with high ecological validity. However, the test–retest reliability of dFC in naturalistic paradigm neuroimaging is largely unknown. To address this issue, we examined the test–retest reliability of dFC in functional magnetic resonance imaging (fMRI) under natural viewing condition. The intraclass correlation coefficients (ICC) of four dFC statistics including standard deviation (Std), coefficient of variation (COV), amplitude of low frequency fluctuation (ALFF), and excursion (Excursion) were used to measure the test–retest reliability. The test–retest reliability of dFC in naturalistic viewing condition was then compared with that under resting state. Our experimental results showed that: (a) Global test–retest reliability of dFC was much lower than that of static functional connectivity (sFC) in both resting‐state and naturalistic viewing conditions; (b) Both global and local (including visual, limbic and default mode networks) test–retest reliability of dFC could be significantly improved in naturalistic viewing condition compared to that in resting state; (c) There existed strong negative correlation between sFC and dFC, weak negative correlation between dFC and dFC‐ICC (i.e., ICC of dFC), as well as weak positive correlation between dFC‐ICC and sFC‐ICC (i.e., ICC of sFC). The present study provides novel evidence for the promotion of naturalistic paradigm fMRI in functional brain network studies.
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Affiliation(s)
- Xin Zhang
- Institute of Medical Research, Northwestern Polytechnical University, Xi'an, Shaanxi, China
| | - Jiayue Liu
- School of Automation, Northwestern Polytechnical University, Xi'an, Shaanxi, China
| | - Yang Yang
- School of Life Sciences, Northwestern Polytechnical University, Xi'an, Shaanxi, China
| | - Shijie Zhao
- School of Automation, Northwestern Polytechnical University, Xi'an, Shaanxi, China
| | - Lei Guo
- School of Automation, Northwestern Polytechnical University, Xi'an, Shaanxi, China
| | - Junwei Han
- School of Automation, Northwestern Polytechnical University, Xi'an, Shaanxi, China
| | - Xintao Hu
- School of Automation, Northwestern Polytechnical University, Xi'an, Shaanxi, China
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