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Sumbul‐Sekerci B, Velioglu HA, Sekerci A. Diabetes-related clinical and microstructural white matter changes in patients with Alzheimer's disease. Brain Behav 2024; 14:e3533. [PMID: 38715429 PMCID: PMC11077244 DOI: 10.1002/brb3.3533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 04/16/2024] [Accepted: 04/17/2024] [Indexed: 05/12/2024] Open
Abstract
AIM Although there exists substantial epidemiological evidence indicating an elevated risk of dementia in individuals with diabetes, our understanding of the neuropathological underpinnings of the association between Type-2 diabetes mellitus (T2DM) and Alzheimer's disease (AD) remains unclear. This study aims to unveil the microstructural brain changes associated with T2DM in AD and identify the clinical variables contributing to these changes. METHODS In this retrospective study involving 64 patients with AD, 31 individuals had concurrent T2DM. The study involved a comparative analysis of diffusion tensor imaging (DTI) images and clinical features between patients with and without T2DM. The FSL FMRIB software library was used for comprehensive preprocessing and tractography analysis of DTI data. After eddy current correction, the "bedpost" model was utilized to model diffusion parameters. Linear regression analysis with a stepwise method was used to predict the clinical variables that could lead to microstructural white matter changes. RESULTS We observed a significant impairment in the left superior longitudinal fasciculus (SLF) among patients with AD who also had T2DM. This impairment in patients with AD and T2DM was associated with an elevation in creatine levels. CONCLUSION The white matter microstructure in the left SLF appears to be sensitive to the impairment of kidney function associated with T2DM in patients with AD. The emergence of AD in association with T2DM may be driven by mechanisms distinct from the typical AD pathology. Compromised renal function in AD could potentially contribute to impaired white matter integrity.
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Affiliation(s)
- Betul Sumbul‐Sekerci
- Department of Clinical Pharmacy, Faculty of PharmacyBezmialem Vakıf UniversityIstanbulTurkey
| | - Halil Aziz Velioglu
- Center for Psychiatric NeuroscienceFeinstein Institutes for Medical ResearchManhassetNew YorkUSA
- Department of Neuroscience, Faculty of MedicineIstanbul Medipol UniversityIstanbulTurkey
| | - Abdusselam Sekerci
- Department of Internal Medicine, Faculty of MedicineBezmialem Vakif UniversityIstanbulTurkey
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Zhang W, Fu L, Bi Y, Liu J, Li X, Zhang X, Zhang Z, Miao Y, Cheng H, Zhang B. Large-scale functional network connectivity mediates the associations between lipids metabolism and cognition in type 2 diabetes. J Cereb Blood Flow Metab 2024; 44:384-396. [PMID: 37795619 PMCID: PMC10870959 DOI: 10.1177/0271678x231204426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/06/2023] [Accepted: 09/04/2023] [Indexed: 10/06/2023]
Abstract
Type 2 diabetes (T2D) is associated with dyslipidemia and mild cognitive impairment. This study investigated the relationships between serum lipids metabolism, cognition, and functional connectivity (FC) within and between brain networks in T2D patients. The study included 102 T2D patients and 45 healthy controls who underwent functional magnetic resonance imaging, lipid profile tests, and cognitive assessments. Thirteen functional networks were identified using independent component analysis. The statistical analyses included multivariate analysis of covariance, partial correlation, canonical correlation, and mediation analyses. We found widely reduced between-network FCs in T2D, especially between the ventral sensorimotor network (SMN) and dorsal attention network (DAN) (p = 0.001) and between the ventral SMN and lateral visual network (VN) (p < 0.001). Moreover, lower between-network FCs were correlated with worse serum lipids metabolism and poorer cognitive performance (all p < 0.05). Importantly, between-network FCs mediated the relationship between lipid metabolism and cognition (β = -0.3136, 95% CI: -0.7660, -0.0186). Within-network analyses revealed altered FCs within the anterior default mode network, DAN, and lateral VN, each positively correlated with global cognition (all p < 0.01). Our results suggest the potential of improving cognitive function by regulating serum lipids in individuals with T2D.
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Affiliation(s)
- Wen Zhang
- Department of Radiology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
- Medical Imaging Center, the Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
| | - Linqing Fu
- Department of Radiology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Yan Bi
- Department of Endocrinology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Jiani Liu
- Department of Radiology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Xin Li
- Department of Radiology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Xin Zhang
- Department of Radiology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
- Medical Imaging Center, the Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
| | - Zhou Zhang
- Department of Endocrinology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Yingwen Miao
- Department of Endocrinology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Haiyan Cheng
- Department of Endocrinology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Bing Zhang
- Department of Radiology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
- Medical Imaging Center, the Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- Institute of Brain Science, Nanjing University, Nanjing, China
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3
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Zhao Q, Du X, Liu F, Zhang Y, Qin W, Zhang Q. ECHDC3 Variant Regulates the Right Hippocampal Microstructural Integrity and Verbal Memory in Type 2 Diabetes Mellitus. Neuroscience 2024; 538:30-39. [PMID: 38070593 DOI: 10.1016/j.neuroscience.2023.12.003] [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: 07/14/2023] [Revised: 11/29/2023] [Accepted: 12/02/2023] [Indexed: 12/25/2023]
Abstract
ECHDC3 is a risk gene for white matter (WM) hyperintensity and is associated with insulin resistance. This study aimed to investigate whether ECHDC3 variants selectively regulate brain WM microstructures and episodic memory in patients with type 2 diabetes mellitus (T2DM). We enrolled 106 patients with T2DM and 111 healthy controls. A voxel-wise general linear model was employed to explore the interaction effect between ECHDC3 rs11257311 polymorphism and T2DM diagnosis on fractional anisotropy (FA). A linear modulated mediation analysis was conducted to examine the potential of FA value to mediate the influence of T2DM on episodic memory in an ECHDC3-dependent manner. We observed a noteworthy interaction between genotype and diagnosis on FA in the right inferior temporal WM, right anterior limb of the internal capsule, right frontal WM, and the right hippocampus. Modulated mediation analysis revealed a significant ECHDC3 modulation on the T2DM → right hippocampal FA → short-term memory pathway, with only rs11257311 G risk homozygote demonstrating significant mediation effect. Together, our findings provide evidence of ECHDC3 modulating the effect of T2DM on right hippocampal microstructural impairment and short-term memory decline, which might be a neuro-mechanism for T2DM related episodic memory impairment.
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Affiliation(s)
- Qiyu Zhao
- Department of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Xin Du
- Department of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Feng Liu
- Department of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Yang Zhang
- Department of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Wen Qin
- Department of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China.
| | - Quan Zhang
- Department of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China.
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Li X, Zhang W, Bi Y, Chen J, Fu L, Zhang Z, Chen Q, Zhang X, Zhu Z, Zhang B. Non-alcoholic fatty liver disease is associated with brain function disruption in type 2 diabetes patients without cognitive impairment. Diabetes Obes Metab 2024; 26:650-662. [PMID: 37961040 DOI: 10.1111/dom.15354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 10/15/2023] [Accepted: 10/16/2023] [Indexed: 11/15/2023]
Abstract
AIMS To investigate the neural static and dynamic intrinsic activity of intra-/inter-network topology among patients with type 2 diabetes (T2D) with non-alcoholic fatty liver disease (NAFLD) and those without NAFLD (T2NAFLD group and T2noNAFLD group, respectively) and to assess the relationship with metabolism. METHODS Fifty-six patients with T2NAFLD, 78 with T2noNAFLD, and 55 healthy controls (HCs) were recruited to the study. Participants had normal cognition and underwent functional magnetic resonance imaging scans, clinical measurements, and global cognition evaluation. Independent component analysis was used to identify frequency spectrum parameters, static functional network connectivity, and temporal properties of dynamic functional network connectivity (P < 0.05, false discovery rate-corrected). Statistical analysis involved one-way analysis of covariance with post hoc, partial correlation and canonical correlation analyses. RESULTS Our findings showed that: (i) T2NAFLD patients had more disordered glucose and lipid metabolism, had more severe insulin resistance, and were more obese than T2noNAFLD patients; (ii) T2D patients exhibited disrupted brain function, as evidenced by alterations in intra-/inter-network topology, even without clinically measurable cognitive impairment; (iii) T2NAFLD patients had more significant reductions in the frequency spectrum parameters of cognitive executive and visual networks than those with T2noNAFLD; and (iv) altered brain function in T2D patients was correlated with postprandial glucose, high-density lipoprotein cholesterol, and waist-hip ratio. CONCLUSION This study may provide novel insights into neuroimaging correlates for underlying pathophysiological processes inducing brain damage in T2NAFLD. Thus, controlling blood glucose levels, lipid levels and abdominal obesity may reduce brain damage risk in such patients.
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Affiliation(s)
- Xin Li
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Wen Zhang
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Medical Imaging Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
| | - Yan Bi
- Department of Endocrinology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Jiu Chen
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Medical Imaging Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
| | - Linqing Fu
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Zhou Zhang
- Department of Endocrinology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Qian Chen
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Medical Imaging Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
| | - Xin Zhang
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Medical Imaging Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
| | - Zhengyang Zhu
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Bing Zhang
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Medical Imaging Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- Institute of Brain Science, Nanjing University, Nanjing, China
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de Jong JJA, Jansen JFA, Vergoossen LWM, Schram MT, Stehouwer CDA, Wildberger JE, Linden DEJ, Backes WH. Effect of Magnetic Resonance Image Quality on Structural and Functional Brain Connectivity: The Maastricht Study. Brain Sci 2024; 14:62. [PMID: 38248277 PMCID: PMC10813868 DOI: 10.3390/brainsci14010062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/27/2023] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
In population-based cohort studies, magnetic resonance imaging (MRI) is vital for examining brain structure and function. Advanced MRI techniques, such as diffusion-weighted MRI (dMRI) and resting-state functional MRI (rs-fMRI), provide insights into brain connectivity. However, biases in MRI data acquisition and processing can impact brain connectivity measures and their associations with demographic and clinical variables. This study, conducted with 5110 participants from The Maastricht Study, explored the relationship between brain connectivity and various image quality metrics (e.g., signal-to-noise ratio, head motion, and atlas-template mismatches) that were obtained from dMRI and rs-fMRI scans. Results revealed that in particular increased head motion (R2 up to 0.169, p < 0.001) and reduced signal-to-noise ratio (R2 up to 0.013, p < 0.001) negatively impacted structural and functional brain connectivity, respectively. These image quality metrics significantly affected associations of overall brain connectivity with age (up to -59%), sex (up to -25%), and body mass index (BMI) (up to +14%). Associations with diabetes status, educational level, history of cardiovascular disease, and white matter hyperintensities were generally less affected. This emphasizes the potential confounding effects of image quality in large population-based neuroimaging studies on brain connectivity and underscores the importance of accounting for it.
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Affiliation(s)
- Joost J. A. de Jong
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands
- School for Mental Health and Neurosciences (MHeNs), Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Jacobus F. A. Jansen
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands
- School for Mental Health and Neurosciences (MHeNs), Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Laura W. M. Vergoossen
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands
- School for Mental Health and Neurosciences (MHeNs), Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Miranda T. Schram
- School for Mental Health and Neurosciences (MHeNs), Maastricht University, 6200 MD Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands
- School for Cardiovascular Disease (CARIM), Maastricht University, 6200 MD Maastricht, The Netherlands
- Heart and Vascular Centre, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands
| | - Coen D. A. Stehouwer
- School for Mental Health and Neurosciences (MHeNs), Maastricht University, 6200 MD Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands
- School for Cardiovascular Disease (CARIM), Maastricht University, 6200 MD Maastricht, The Netherlands
- Heart and Vascular Centre, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands
| | - Joachim E. Wildberger
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands
- School for Cardiovascular Disease (CARIM), Maastricht University, 6200 MD Maastricht, The Netherlands
| | - David E. J. Linden
- School for Mental Health and Neurosciences (MHeNs), Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Walter H. Backes
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands
- School for Mental Health and Neurosciences (MHeNs), Maastricht University, 6200 MD Maastricht, The Netherlands
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Kanthi A, Singh D, Manjunath NK, Nagarathna R. Changes in Electrical Activities of the Brain Associated with Cognitive Functions in Type 2 Diabetes Mellitus: A Systematic Review. Clin EEG Neurosci 2024; 55:130-142. [PMID: 35343277 DOI: 10.1177/15500594221089106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: Electroencephalogram (EEG) has the potentials to decipher the neural underpinnings of cognitive processes in clinical and healthy populations. Objective: The current systematic review is intended to examine the functional brain changes underlying cognitive dysfunctions in T2DM patients. Methods: The review was conducted on studies published in the PubMed, WebofScience, Cochrane, PsycInfo database till June 2021. The keywords used were electroencephalogram, T2DM, cognitive impairment/dysfunction. We considered studies using resting-state EEG and ERP. The preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines were followed to compile the studies. Results: The search yielded a total of 2384 studies. Finally, 16 independent studies were included. There was a pattern of a shift in EEG power observed from higher to lower frequencies in T2DM patients, though to a lesser degree than Alzheimer's disease patients. P300 latency was increased in T2DM patients mainly over frontal, parietal, and posterior regions. P300 and N100 amplitudes were decreased in T2DM patients than in healthy controls. Conclusion: The results indicate that T2DM has consequences for cognitive functions, and it finds a place in the continuum of healthy cognition to dementia.
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Affiliation(s)
- Amit Kanthi
- Department of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bangalore, India
| | - Deepeshwar Singh
- Department of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bangalore, India
| | - N K Manjunath
- Department of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bangalore, India
| | - Raghuram Nagarathna
- Arogyadhama, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bangalore, India
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Li M, Li Y, Zhao K, Qin C, Chen Y, Liu Y, Qiu S, Tan X, Liang Y. Abnormal cerebral blood flow and brain function in type 2 diabetes mellitus. Endocrine 2023:10.1007/s12020-023-03342-6. [PMID: 37340286 DOI: 10.1007/s12020-023-03342-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 02/25/2023] [Indexed: 06/22/2023]
Abstract
PURPOSE Type 2 diabetes mellitus (T2DM) lead to impaired cerebral blood perfusion, which leads to changes in brain function and affects the cognitive function of patients. In this study, cerebral blood flow (CBF) was used to evaluate the effect of T2DM on cerebral perfusion, and functional connectivity (FC) analysis was further used to explore whether the FC between the abnormal CBF region and the whole brain was changed. In addition, amplitude of low-frequency fluctuation (ALFF) and degree centrality (DC) were used to investigate the changes in spontaneous activity and connectivity strength of the brain network. METHODS We recruited 40 T2DM patients and 55 healthy controls (HCs). They underwent 3D-T1WI, rs-fMRI, arterial spin labeling (ASL) sequence scans and a series of cognitive tests. Cognitive test scores and brain imaging indicators were compared between the two groups, and the relationships among laboratory indicators, cognitive test scores, and brain imaging indicators were explored in the T2DM group. RESULTS Compared to HCs, The CBF values of Calcarine_L and Precuneus_R in the T2DM group were lower. The DC value of Paracentral_Lobule_L and Precuneus_L, and the ALFF value of Hippocampus_L in the T2DM group were higher. In addition, the CBF values of Calcarine_L was negatively correlated with fasting insulin and HOMA_IR. CONCLUSION This study found that there were regions of cerebral hypoperfusion in T2DM patients, which are associated with insulin resistance. In addition, we found abnormally elevated brain activity and enhanced functional connectivity in T2DM patients, which we speculated was the compensatory mechanism of brain neural activity.
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Affiliation(s)
- Mingrui Li
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Radiology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Magnatic Resonance Imaging, Zhanjiang First Hospital of Traditional Chinese Medicine, Zhanjiang, China
| | - Yifan Li
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Radiology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Kui Zhao
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Radiology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chunhong Qin
- Department of Radiology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuna Chen
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Radiology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yujie Liu
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Radiology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shijun Qiu
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.
- Department of Radiology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
| | - Xin Tan
- Department of Radiology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
| | - Yi Liang
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.
- Department of Radiology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
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Li M, Li Y, Zhao K, Tan X, Chen Y, Qin C, Qiu S, Liang Y. Changes in the structure, perfusion, and function of the hippocampus in type 2 diabetes mellitus. Front Neurosci 2023; 16:1070911. [PMID: 36699515 PMCID: PMC9868830 DOI: 10.3389/fnins.2022.1070911] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 12/06/2022] [Indexed: 01/12/2023] Open
Abstract
Objective This study aims to explore the changes in the structure, perfusion, and function of the bilateral hippocampus in type 2 diabetes mellitus (T2DM) applying multimodal MRI methods, hoping to provide reliable neuroimaging evidence for the diagnosis of hippocampus-related brain injury in T2DM. Methods We recruited 30 T2DM patients and 45 healthy controls (HCs), on which we performed 3D T1-weighted images, resting-state functional MRI (rs-fMRI), arterial spin labeling (ASL) sequences, and a series of cognitive tests. Then, we compared the differences of two groups in the cerebral blood flow (CBF) value, amplitude of low-frequency fluctuation (ALFF) value, fractional ALFF (fALFF) value, coherence-based regional homogeneity (Cohe-ReHo) value, and degree centrality (DC) values of the bilateral hippocampus. Results In the T2DM group, the bilateral hippocampal volumes and the CBF value of the right hippocampus were lower than those in the HCs, while the ALFF value, fALFF value, and Cohe-ReHo value of the bilateral hippocampus were higher than those in the HCs. Correlation analysis showed that fasting blood glucose (FBG) was negatively correlated with the residuals of left hippocampal volume (r = -0.407, P = 0.025) and right hippocampal volume (r = -0.420, P = 0.021). The residual of the auditory-verbal learning test (AVLT) (immediate) score was positively correlated with the residual of right hippocampal volume (r = 0.369, P = 0.045). Conclusion This study indicated that the volume and perfusion of the hippocampus are decreased in T2DM patients that related to chronic hyperglycemia. Local spontaneous neural activity and coordination are increased in the hippocampus of T2DM patients, possibly as an adaptive compensation for cognitive decline.
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Affiliation(s)
- Mingrui Li
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China,Department of Magnetic Resonance Imaging, Zhanjiang First Hospital of Traditional Chinese Medicine, Zhanjiang, China
| | - Yifan Li
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Kui Zhao
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xin Tan
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuna Chen
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chunhong Qin
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China,Chunhong Qin,
| | - Shijun Qiu
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China,Shijun Qiu,
| | - Yi Liang
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China,*Correspondence: Yi Liang,
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9
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Aranyi SC, Képes Z, Nagy M, Opposits G, Garai I, Káplár M, Emri M. Topological dissimilarities of hierarchical resting networks in type 2 diabetes mellitus and obesity. J Comput Neurosci 2023; 51:71-86. [PMID: 36056275 PMCID: PMC9840595 DOI: 10.1007/s10827-022-00833-9] [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: 07/30/2021] [Revised: 07/29/2022] [Accepted: 08/23/2022] [Indexed: 01/18/2023]
Abstract
Type 2 diabetes mellitus (T2DM) is reported to cause widespread changes in brain function, leading to cognitive impairments. Research using resting-state functional magnetic resonance imaging data already aims to understand functional changes in complex brain connectivity systems. However, no previous studies with dynamic causal modelling (DCM) tried to investigate large-scale effective connectivity in diabetes. We aimed to examine the differences in large-scale resting state networks in diabetic and obese patients using combined DCM and graph theory methodologies. With the participation of 70 subjects (43 diabetics, 27 obese), we used cross-spectra DCM to estimate connectivity between 36 regions, subdivided into seven resting networks (RSN) commonly recognized in the literature. We assessed group-wise connectivity of T2DM and obesity, as well as group differences, with parametric empirical Bayes and Bayesian model reduction techniques. We analyzed network connectivity globally, between RSNs, and regionally. We found that average connection strength was higher in T2DM globally and between RSNs, as well. On the network level, the salience network shows stronger total within-network connectivity in diabetes (8.07) than in the obese group (4.02). Regionally, we measured the most significant average decrease in the right middle temporal gyrus (-0.013 Hz) and the right inferior parietal lobule (-0.01 Hz) relative to the obese group. In comparison, connectivity increased most notably in the left anterior prefrontal cortex (0.01 Hz) and the medial dorsal thalamus (0.009 Hz). In conclusion, we find the usage of complex analysis of large-scale networks suitable for diabetes instead of focusing on specific changes in brain function.
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Affiliation(s)
- Sándor Csaba Aranyi
- Division of Nuclear Medicine and Translational Imaging, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Zita Képes
- Division of Nuclear Medicine and Translational Imaging, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Marianna Nagy
- Division of Radiology and Imaging Science, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Gábor Opposits
- Division of Nuclear Medicine and Translational Imaging, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Ildikó Garai
- Division of Nuclear Medicine and Translational Imaging, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary ,Translational Research Centre, ScanoMed Ltd., Debrecen, Hungary
| | - Miklós Káplár
- Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Miklós Emri
- Division of Nuclear Medicine and Translational Imaging, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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10
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Cerebral blood flow and cardiovascular risk effects on resting brain regional homogeneity. Neuroimage 2022; 262:119555. [PMID: 35963506 PMCID: PMC10044499 DOI: 10.1016/j.neuroimage.2022.119555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/01/2022] [Accepted: 08/09/2022] [Indexed: 11/22/2022] Open
Abstract
Regional homogeneity (ReHo) is a measure of local functional brain connectivity that has been reported to be altered in a wide range of neuropsychiatric disorders. Computed from brain resting-state functional MRI time series, ReHo is also sensitive to fluctuations in cerebral blood flow (CBF) that in turn may be influenced by cerebrovascular health. We accessed cerebrovascular health with Framingham cardiovascular risk score (FCVRS). We hypothesize that ReHo signal may be influenced by regional CBF; and that these associations can be summarized as FCVRS→CBF→ReHo. We used three independent samples to test this hypothesis. A test-retest sample of N = 30 healthy volunteers was used for test-retest evaluation of CBF effects on ReHo. Amish Connectome Project (ACP) sample (N = 204, healthy individuals) was used to evaluate association between FCVRS and ReHo and testing if the association diminishes given CBF. The UKBB sample (N = 6,285, healthy participants) was used to replicate the effects of FCVRS on ReHo. We observed strong CBF→ReHo links (p<2.5 × 10-3) using a three-point longitudinal sample. In ACP sample, marginal and partial correlations analyses demonstrated that both CBF and FCVRS were significantly correlated with the whole-brain average (p<10-6) and regional ReHo values, with the strongest correlations observed in frontal, parietal, and temporal areas. Yet, the association between ReHo and FCVRS became insignificant once the effect of CBF was accounted for. In contrast, CBF→ReHo remained significantly linked after adjusting for FCVRS and demographic covariates (p<10-6). Analysis in N = 6,285 replicated the FCVRS→ReHo effect (p = 2.7 × 10-27). In summary, ReHo alterations in health and neuropsychiatric illnesses may be partially driven by region-specific variability in CBF, which is, in turn, influenced by cardiovascular factors.
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11
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Lopez-Vilaret KM, Fernandez-Alvarez M, Shokri-Kojori E, Tomasi D, Cantero JL, Atienza M. Pre-diabetes is associated with altered functional connectivity density in cortical regions of the default-mode network. Front Aging Neurosci 2022; 14:1034355. [PMID: 36438011 PMCID: PMC9686287 DOI: 10.3389/fnagi.2022.1034355] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 10/25/2022] [Indexed: 09/29/2023] Open
Abstract
Insulin resistance and glucose dysregulation are associated with patterns of regional brain hypometabolism characteristic of Alzheimer's disease (AD). As predicted by evidence linking brain glucose metabolism to brain functional connectivity, type 2 diabetes is accompanied by altered functional connectivity density (FCD) in regions highly vulnerable to AD, but whether these alterations start at earlier stages such as pre-diabetes remain to be elucidated. Here, in addition to assessing whether pre-diabetes leads to a functional reorganization of densely connected cortical areas (hubs), we will assess whether such reorganization is conditioned by sex and/or insulin resistance, and contributes to improved cognition. One hundred and forty-four cognitively unimpaired middle-aged and older adults (55-78 years, 79 females), 73 with normoglycemia and 71 with pre-diabetes, underwent resting-state fMRI scanning. We first computed FCD mapping on cortical surfaces to determine the number of short- and long-range functional connections of every vertex in the cortex, and next used hubs showing aberrant FCD as seeds for the resting-state functional connectivity (rs-FC) calculation. ANCOVAs and linear multiple regression analyses adjusted by demographic and cardiometabolic confounders using frequentist and Bayesian approaches were applied. Analyses revealed higher long-range FCD in the right precuneus of pre-diabetic females and lower short-range FCD in the left medial orbitofrontal cortex (mOFC) of pre-diabetic individuals with higher insulin resistance. Although the mOFC also showed altered rs-FC patterns with other regions of the default mode network in pre-diabetic individuals, it was FCD of the precuneus and mOFC, and not the magnitude of their rs-FC, that was associated with better planning abilities and Mini-Mental State Examination (MMSE) scores. Results suggest that being female and/or having high insulin resistance exacerbate pre-diabetes-induced alterations in the FCD of hubs of the default-mode network that are particularly vulnerable to AD pathology. These changes in brain network organization appear to be compensatory for pre-diabetic females, likely assisting them to maintain cognitive functioning at early stages of glucose dysregulation.
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Affiliation(s)
| | - Marina Fernandez-Alvarez
- Laboratory of Functional Neuroscience, Pablo de Olavide University, Seville, Spain
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, Madrid, Spain
| | - Ehsan Shokri-Kojori
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States
| | - Dardo Tomasi
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States
| | - Jose L Cantero
- Laboratory of Functional Neuroscience, Pablo de Olavide University, Seville, Spain
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, Madrid, Spain
| | - Mercedes Atienza
- Laboratory of Functional Neuroscience, Pablo de Olavide University, Seville, Spain
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, Madrid, Spain
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12
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Huang H, Ma X, Yue X, Kang S, Li Y, Rao Y, Feng Y, Wu J, Long W, Chen Y, Lyu W, Tan X, Qiu S. White Matter Characteristics of Damage Along Fiber Tracts in Patients with Type 2 Diabetes Mellitus. Clin Neuroradiol 2022; 33:327-341. [DOI: 10.1007/s00062-022-01213-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 08/06/2022] [Indexed: 11/03/2022]
Abstract
Abstract
Purpose
The white matter (WM) of the brain of type 2 diabetes mellitus (T2DM) patients is susceptible to neurodegenerative processes, but the specific types and positions of microstructural lesions along the fiber tracts remain unclear.
Methods
In this study 61 T2DM patients and 61 healthy controls were recruited and underwent diffusion spectrum imaging (DSI). The results were reconstructed with diffusion tensor imaging (DTI) and neurite orientation dispersion and density imaging (NODDI). WM microstructural abnormalities were identified using tract-based spatial statistics (TBSS). Pointwise WM tract differences were detected through automatic fiber quantification (AFQ). The relationships between WM tract abnormalities and clinical characteristics were explored with partial correlation analysis.
Results
TBSS revealed widespread WM lesions in T2DM patients with decreased fractional anisotropy and axial diffusivity and an increased orientation dispersion index (ODI). The AFQ results showed microstructural abnormalities in T2DM patients in specific portions of the right superior longitudinal fasciculus (SLF), right arcuate fasciculus (ARC), left anterior thalamic radiation (ATR), and forceps major (FMA). In the right ARC of T2DM patients, an aberrant ODI was positively correlated with fasting insulin and insulin resistance, and an abnormal intracellular volume fraction was negatively correlated with fasting blood glucose. Additionally, negative associations were found between blood pressure and microstructural abnormalities in the right ARC, left ATR, and FMA in T2DM patients.
Conclusion
Using AFQ, together with DTI and NODDI, various kinds of microstructural alterations in the right SLF, right ARC, left ATR, and FMA can be accurately identified and may be associated with insulin and glucose status and blood pressure in T2DM patients.
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13
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Hofmann SM, Beyer F, Lapuschkin S, Goltermann O, Loeffler M, Müller KR, Villringer A, Samek W, Witte AV. Towards the Interpretability of Deep Learning Models for Multi-modal Neuroimaging: Finding Structural Changes of the Ageing Brain. Neuroimage 2022; 261:119504. [PMID: 35882272 DOI: 10.1016/j.neuroimage.2022.119504] [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: 05/10/2022] [Revised: 07/15/2022] [Accepted: 07/21/2022] [Indexed: 11/17/2022] Open
Abstract
Brain-age (BA) estimates based on deep learning are increasingly used as neuroimaging biomarker for brain health; however, the underlying neural features have remained unclear. We combined ensembles of convolutional neural networks with Layer-wise Relevance Propagation (LRP) to detect which brain features contribute to BA. Trained on magnetic resonance imaging (MRI) data of a population-based study (n=2637, 18-82 years), our models estimated age accurately based on single and multiple modalities, regionally restricted and whole-brain images (mean absolute errors 3.37-3.86 years). We find that BA estimates capture aging at both small and large-scale changes, revealing gross enlargements of ventricles and subarachnoid spaces, as well as white matter lesions, and atrophies that appear throughout the brain. Divergence from expected aging reflected cardiovascular risk factors and accelerated aging was more pronounced in the frontal lobe. Applying LRP, our study demonstrates how superior deep learning models detect brain-aging in healthy and at-risk individuals throughout adulthood.
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Affiliation(s)
- Simon M Hofmann
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany; Department of Artificial Intelligence, Fraunhofer Institute Heinrich Hertz, 10587 Berlin, Germany; Clinic for Cognitive Neurology, University of Leipzig Medical Center, 04103 Leipzig, Germany.
| | - Frauke Beyer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany; Clinic for Cognitive Neurology, University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Sebastian Lapuschkin
- Department of Artificial Intelligence, Fraunhofer Institute Heinrich Hertz, 10587 Berlin, Germany
| | - Ole Goltermann
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany; Max Planck School of Cognition, 04103 Leipzig, Germany; Institute of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Germany
| | | | - Klaus-Robert Müller
- Department of Electrical Engineering and Computer Science, Technical University Berlin, 10623 Berlin, Germany; Department of Artificial Intelligence, Korea University, 02841 Seoul, Korea (the Republic of); Brain Team, Google Research, 10117 Berlin, Germany; Max Planck Institute for Informatics, 66123 Saarbrücken, Germany; BIFOLD - Berlin Institute for the Foundations of Learning and Data, 10587 Berlin, Germany
| | - Arno Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany; Clinic for Cognitive Neurology, University of Leipzig Medical Center, 04103 Leipzig, Germany; MindBrainBody Institute, Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, 10099 Berlin, Germany; Center for Stroke Research, Charité - Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Wojciech Samek
- Department of Artificial Intelligence, Fraunhofer Institute Heinrich Hertz, 10587 Berlin, Germany; Department of Electrical Engineering and Computer Science, Technical University Berlin, 10623 Berlin, Germany; BIFOLD - Berlin Institute for the Foundations of Learning and Data, 10587 Berlin, Germany
| | - A Veronica Witte
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany; Clinic for Cognitive Neurology, University of Leipzig Medical Center, 04103 Leipzig, Germany
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14
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Meng J, Liu J, Li H, Gao Y, Cao L, He Y, Guo Y, Feng L, Hu X, Li H, Zhang C, He W, Wu Y, Huang X. Impairments in intrinsic functional networks in type 2 diabetes: A meta-analysis of resting-state functional connectivity. Front Neuroendocrinol 2022; 66:100992. [PMID: 35278579 DOI: 10.1016/j.yfrne.2022.100992] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/05/2022] [Accepted: 02/28/2022] [Indexed: 12/27/2022]
Abstract
Type 2 diabetes mellitus (T2DM) is associated with abnormal communication among large-scale brain networks, revealed by resting-state functional connectivity (rsFC), with inconsistent results between studies. We performed a meta-analysis of seed-based rsFC studies to identify consistent network connectivity alterations. Thirty-three datasets from 30 studies (1014 T2DM patients and 902 healthy controls [HC]) were included. Seed coordinates and between-group effects were extracted, and the seeds were divided into networks based on their location. Compared to HC, T2DM patients showed hyperconnectivity and hypoconnectivity within the DMN, DMN hypoconnectivity with the affective network (AN), ventral attention network (VAN) and frontal parietal network, and DMN hyperconnectivity with the VAN and visual network. T2DM patients also showed AN hypoconnectivity with the somatomotor network and hyperconnectivity with the VAN. T2DM illness durations negatively correlated with within-DMN rsFC. These DMN-centered impairments in large-scale brain networks in T2DM patients may help to explain the cognitive deficits associated with T2DM.
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Affiliation(s)
- Jinli Meng
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China; Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital. C.T.), No. 20, Xi Mian Qiao Heng Jie, Wuhou District, Chengdu, Sichuan, China
| | - Jing Liu
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China; Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Hailong Li
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China; Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yingxue Gao
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China; Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Lingxiao Cao
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China; Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yuanyuan He
- Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital. C.T.), No. 20, Xi Mian Qiao Heng Jie, Wuhou District, Chengdu, Sichuan, China
| | - Yongyue Guo
- Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital. C.T.), No. 20, Xi Mian Qiao Heng Jie, Wuhou District, Chengdu, Sichuan, China
| | - Li Feng
- Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital. C.T.), No. 20, Xi Mian Qiao Heng Jie, Wuhou District, Chengdu, Sichuan, China
| | - Xin Hu
- Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital. C.T.), No. 20, Xi Mian Qiao Heng Jie, Wuhou District, Chengdu, Sichuan, China
| | - Hengyan Li
- Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital. C.T.), No. 20, Xi Mian Qiao Heng Jie, Wuhou District, Chengdu, Sichuan, China
| | - Chenghui Zhang
- Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital. C.T.), No. 20, Xi Mian Qiao Heng Jie, Wuhou District, Chengdu, Sichuan, China
| | - Wanlin He
- Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital. C.T.), No. 20, Xi Mian Qiao Heng Jie, Wuhou District, Chengdu, Sichuan, China
| | - Yunhong Wu
- Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital. C.T.), No. 20, Xi Mian Qiao Heng Jie, Wuhou District, Chengdu, Sichuan, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China; Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
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15
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Hu J, Li Y, Li Z, Chen J, Cao Y, Xu D, Zheng L, Bai R, Wang L. Abnormal brain functional and structural connectivity between the left supplementary motor area and inferior frontal gyrus in moyamoya disease. BMC Neurol 2022; 22:179. [PMID: 35578209 PMCID: PMC9108139 DOI: 10.1186/s12883-022-02705-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 05/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Disruption of brain functional connectivity has been detected after stroke, but whether it also occurs in moyamoya disease (MMD) is unknown. Impaired functional connectivity is always correlated with abnormal white matter fibers. Herein, we used multimodal imaging techniques to explore the changes in brain functional and structural connectivity in MMD patients. METHODS We collected structural images, resting-state functional magnetic resonance imaging (rs-fMRI) and diffusion tensor imaging for each subject. Cognitive functions of MMD patients were evaluated using the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Trail Making Test parts A and B (TMT-A/-B). We calculated the functional connectivity for every paired region using 90 regions of interest from the Anatomical Automatic Labeling Atlas and then determined the differences between MMD patients and HCs. We extracted the functional connectivity of paired brain regions with significant differences between the two groups. Correlation analyses were then performed between the functional connectivity and variable cognitive functions. To explore whether the impaired functional connectivity and cognitive performances were attributed to the destruction of white matter fibers, we further analyzed fiber integrity using tractography between paired regions that were correlated with cognition. RESULTS There was lower functional connectivity in MMD patients as compared to HCs between the bilateral inferior frontal gyrus, between the bilateral supramarginal gyrus, between the left supplementary motor area (SMA) and the left orbital part of the inferior frontal gyrus (IFGorb), and between the left SMA and the left middle temporal gyrus (P < 0.01, FDR corrected). The decreased functional connectivity between the left SMA and the left IFGorb was significantly correlated with the MMSE (r = 0.52, P = 0.024), MoCA (r = 0.60, P = 0.006), and TMT-B (r = -0.54, P = 0.048) in MMD patients. White matter fibers were also injured between the SMA and IFGorb in the left hemisphere and were positively correlated with reduced functional connectivity. CONCLUSIONS Brain functional and structural connectivity between the supplementary motor area and inferior frontal gyrus in the left hemisphere are damaged in MMD. These findings could be useful in the evaluation of disease progression and prognosis of MMD.
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Affiliation(s)
- Junwen Hu
- Department of Neurosurgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Jiefang Road 88th, Hangzhou, 310009, China
| | - Yin Li
- Department of Neurosurgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Jiefang Road 88th, Hangzhou, 310009, China
| | - Zhaoqing Li
- Key Laboratory of Biomedical Engineering of Education Ministry, College of Biomedical Engineering and Instrument Science, Zhejiang University, 268 Kaixuan Road, South Central Building, Room 708, Hangzhou, 310027, Zhejiang, China
| | - Jingyin Chen
- Department of Neurosurgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Jiefang Road 88th, Hangzhou, 310009, China
| | - Yang Cao
- Department of Neurosurgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Jiefang Road 88th, Hangzhou, 310009, China
| | - Duo Xu
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Leilei Zheng
- Department of Psychiatry, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ruiliang Bai
- Key Laboratory of Biomedical Engineering of Education Ministry, College of Biomedical Engineering and Instrument Science, Zhejiang University, 268 Kaixuan Road, South Central Building, Room 708, Hangzhou, 310027, Zhejiang, China. .,Department of Physical Medicine and Rehabilitation of the Affiliated Sir Run Run Shaw Hospital and Interdisciplinary Institute of Neuroscience and Technology, Zhejiang University School of Medicine, Hangzhou, China. .,MOE Frontier Science Center for Brain Science and Brain-machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou, China.
| | - Lin Wang
- Department of Neurosurgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Jiefang Road 88th, Hangzhou, 310009, China.
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16
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Wang J, Ma L, Liu G, Bai W, Ai K, Zhang P, Hu W, Zhang J. Tractography in Type 2 Diabetes Mellitus With Subjective Memory Complaints: A Diffusion Tensor Imaging Study. Front Neurosci 2022; 15:800420. [PMID: 35462734 PMCID: PMC9019711 DOI: 10.3389/fnins.2021.800420] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 12/31/2021] [Indexed: 12/12/2022] Open
Abstract
The brain white matter (WM) structural injury caused by type 2 diabetes mellitus (T2DM) has been linked to cognitive impairment. However, the focus was mainly on the mild cognitive impairment (MCI) stage in most previous studies, with little attention made to subjective memory complaints (SMC). The main purpose of the current study was to investigate the characteristics of WM injury in T2DM patients and its correlation with SMC symptoms. In a group of 66 participants (33 HC and 33 T2DM-S), pointwise differences along WM tracts were identified using the automated fiber quantification (AFQ) approach. Then we investigated the utility of DTI properties along major WM tracts as features to distinguish patients with T2DM-S from HC via the support vector machine (SVM). Based on AFQ analysis, 10 primary fiber tracts that represent the subtle alterations of WM in T2DM-S were identified. Lower fractional anisotropy (FA) in the right SLF tract (r = −0.538, p = 0.0013), higher radial diffusivity (RD) in the thalamic radiation (TR) tract (r = 0.433, p = 0.012), and higher mean diffusivity (MD) in the right inferior fronto-occipital fasciculus (IFOF) tract (r = 0.385, p = 0.0029) were significantly associated with a long period of disease. Decreased axial diffusivity (AD) in the left arcuate was associated with HbA1c (r = −0.368, p = 0.049). In addition, we found a significant negative correlation between delayed recall and abnormal MD in the left corticospinal tract (r = −0.546, p = 0.001). The FA of the right SLF tracts and bilateral arcuate can be used to differentiate the T2DM-S and the HC at a high accuracy up to 88.45 and 87.8%, respectively. In conclusion, WM microstructure injury in T2DM may be associated with SMC, and these abnormalities identified by DTI can be used as an effective biomarker.
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Affiliation(s)
- Jun Wang
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
| | - Laiyang Ma
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
| | - Guangyao Liu
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
| | - Wenjuan Bai
- Department of Endocrine, Lanzhou University Second Hospital, Lanzhou, China
| | - Kai Ai
- Department of Clinical Science, Philips Healthcare, Xi’an, China
| | - Pengfei Zhang
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
| | - Wanjun Hu
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
| | - Jing Zhang
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
- *Correspondence: Jing Zhang,
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17
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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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18
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Moran C, Than S, Callisaya M, Beare R, Srikanth V. New Horizons-Cognitive Dysfunction Associated With Type 2 Diabetes. J Clin Endocrinol Metab 2022; 107:929-942. [PMID: 34788847 DOI: 10.1210/clinem/dgab797] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Indexed: 11/19/2022]
Abstract
The prevalence of type 2 diabetes (T2D) and cognitive dysfunction increases with age. As society ages, clinicians will be increasingly tasked with managing older people who have both T2D and cognitive dysfunction. T2D is associated with an increased risk of cognitive dysfunction and hence there is increasing interest in whether T2D is a causal factor in the pathogenesis of cognitive decline and dementia. Recent advances in the use of sensitive measures of in vivo brain dysfunction in life-course studies can help understand potential mechanistic pathways and also help guide recommendations for clinical practice. In this article we will describe new horizons in the understanding of cognitive dysfunction associated with T2D. Coming from a clinical perspective, we discuss potential mechanisms and pathways linking the 2 conditions and the contribution of multimodal neuroimaging and study designs to advancing understanding in the field. We also highlight the important issues on the horizon that will need addressing in clinical identification, management, and risk reduction for people with coexistent T2D and cognitive dysfunction.
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Affiliation(s)
- Chris Moran
- Academic Unit, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, 3199 Victoria, Australia
- Department of Geriatric Medicine, Peninsula Health, Melbourne, 3199 Victoria, Australia
- Department of Geriatric Medicine, Alfred Health, Melbourne, 3004 Victoria, Australia
| | - Stephanie Than
- Academic Unit, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, 3199 Victoria, Australia
- Department of Geriatric Medicine, Peninsula Health, Melbourne, 3199 Victoria, Australia
| | - Michele Callisaya
- Academic Unit, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, 3199 Victoria, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, 7000 Tasmania, Australia
| | - Richard Beare
- Academic Unit, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, 3199 Victoria, Australia
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, 3052 Victoria, Australia
| | - Velandai Srikanth
- Academic Unit, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, 3199 Victoria, Australia
- Department of Geriatric Medicine, Peninsula Health, Melbourne, 3199 Victoria, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, 7000 Tasmania, Australia
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19
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He Y, Li L, Liu J. The whole-brain voxel-based morphometry study in early stage of T2DM patients. Brain Behav 2022; 12:e2497. [PMID: 35138040 PMCID: PMC8933776 DOI: 10.1002/brb3.2497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/26/2021] [Accepted: 01/02/2022] [Indexed: 11/11/2022] Open
Abstract
AIM This study aimed to investigate the alterations in whole-brain gray matter density in early stage type 2 diabetes mellitus (T2DM) patients with cognitive impairment using magnetic resonance imaging. METHODS Thirty-six cases of early stage T2DM patients with cognitive impairment (T2DM-CI), 34 cases of early stage T2DM patients without cognitive impairment (T2DM) and 30 cases of healthy controls (HC) were enrolled. Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) scores were used to identify the cognitive impairment. The whole-brain gray matter density was analyzed using 3D-T1 BRAVO imaging, using the voxel-based morphometry method on T1 structure imaging of two groups. RESULTS The correlation analysis of total gray matter density with MMSE and MoCA scores in the T2DM-CI group was performed. There were no significant differences in MMSE and MoCA scores between the HC and T2DM groups. However, the MMSE and MoCA scores in the T2DM-CI group were significantly reduced compared with the T2DM group. There were no significant differences in age, gender, education, body mass index (BMI) or blood pressure among the three groups. Voxel-based morphometry (VBM) results showed that the density of left triangle part of inferior frontal gyrus, orbital part of inferior frontal gyrus and opercular part of inferior frontal gyrus and left insula in the T2DM-CI group decreased compared with the T2DM group. Correlation analysis results showed that there was a significant positive correlation between total gray matter density and scores of MMSE and MoCA scores in the T2DM-CI group. CONCLUSION In conclusion, total gray matter density is positively correlated with the scores of MMSE and MoCA in T2DM patients, which may be an early sign of cognitive impairment in patients with T2DM.
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Affiliation(s)
- Yana He
- Department of Medical Imaging, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Liang Li
- Department of Medical Imaging, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jihua Liu
- Department of Medical Imaging, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
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20
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Beck D, de Lange AG, Pedersen ML, Alnæs D, Maximov II, Voldsbekk I, Richard G, Sanders A, Ulrichsen KM, Dørum ES, Kolskår KK, Høgestøl EA, Steen NE, Djurovic S, Andreassen OA, Nordvik JE, Kaufmann T, Westlye LT. Cardiometabolic risk factors associated with brain age and accelerate brain ageing. Hum Brain Mapp 2022; 43:700-720. [PMID: 34626047 PMCID: PMC8720200 DOI: 10.1002/hbm.25680] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 09/02/2021] [Accepted: 09/25/2021] [Indexed: 11/17/2022] Open
Abstract
The structure and integrity of the ageing brain is interchangeably linked to physical health, and cardiometabolic risk factors (CMRs) are associated with dementia and other brain disorders. In this mixed cross-sectional and longitudinal study (interval mean = 19.7 months), including 790 healthy individuals (mean age = 46.7 years, 53% women), we investigated CMRs and health indicators including anthropometric measures, lifestyle factors, and blood biomarkers in relation to brain structure using MRI-based morphometry and diffusion tensor imaging (DTI). We performed tissue specific brain age prediction using machine learning and performed Bayesian multilevel modeling to assess changes in each CMR over time, their respective association with brain age gap (BAG), and their interaction effects with time and age on the tissue-specific BAGs. The results showed credible associations between DTI-based BAG and blood levels of phosphate and mean cell volume (MCV), and between T1-based BAG and systolic blood pressure, smoking, pulse, and C-reactive protein (CRP), indicating older-appearing brains in people with higher cardiometabolic risk (smoking, higher blood pressure and pulse, low-grade inflammation). Longitudinal evidence supported interactions between both BAGs and waist-to-hip ratio (WHR), and between DTI-based BAG and systolic blood pressure and smoking, indicating accelerated ageing in people with higher cardiometabolic risk (smoking, higher blood pressure, and WHR). The results demonstrate that cardiometabolic risk factors are associated with brain ageing. While randomized controlled trials are needed to establish causality, our results indicate that public health initiatives and treatment strategies targeting modifiable cardiometabolic risk factors may also improve risk trajectories and delay brain ageing.
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Affiliation(s)
- Dani Beck
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- Sunnaas Rehabilitation Hospital HTNesodden
| | - Ann‐Marie G. de Lange
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- LREN, Centre for Research in Neurosciences‐Department of Clinical NeurosciencesCHUV and University of LausanneLausanneSwitzerland
- Department of PsychiatryUniversity of OxfordOxfordUK
| | - Mads L. Pedersen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
| | - Dag Alnæs
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Bjørknes CollegeOsloNorway
| | - Ivan I. Maximov
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- Department of Health and FunctioningWestern Norway University of Applied SciencesBergenNorway
| | - Irene Voldsbekk
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
| | - Geneviève Richard
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
| | - Anne‐Marthe Sanders
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- Sunnaas Rehabilitation Hospital HTNesodden
| | - Kristine M. Ulrichsen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- Sunnaas Rehabilitation Hospital HTNesodden
| | - Erlend S. Dørum
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- Sunnaas Rehabilitation Hospital HTNesodden
| | - Knut K. Kolskår
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- Sunnaas Rehabilitation Hospital HTNesodden
| | - Einar A. Høgestøl
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
| | - Nils Eiel Steen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
| | - Srdjan Djurovic
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
| | - Ole A. Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- KG Jebsen Centre for Neurodevelopmental DisordersUniversity of OsloOsloNorway
| | | | - Tobias Kaufmann
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of Psychiatry and PsychotherapyUniversity of TübingenTubingenGermany
| | - Lars T. Westlye
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical MedicineUniversity of OsloOslo
- Department of PsychologyUniversity of OsloOslo
- KG Jebsen Centre for Neurodevelopmental DisordersUniversity of OsloOsloNorway
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21
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Lei H, Hu R, Luo G, Yang T, Shen H, Deng H, Chen C, Zhao H, Liu J. Altered Structural and Functional MRI Connectivity in Type 2 Diabetes Mellitus Related Cognitive Impairment: A Review. Front Hum Neurosci 2022; 15:755017. [PMID: 35069149 PMCID: PMC8770326 DOI: 10.3389/fnhum.2021.755017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 12/13/2021] [Indexed: 12/16/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is associated with cognitive impairment in many domains. There are several pieces of evidence that changes in neuronal neuropathies and metabolism have been observed in T2DM. Structural and functional MRI shows that abnormal connections and synchronization occur in T2DM brain circuits and related networks. Neuroplasticity and energy metabolism appear to be principal effector systems, which may be related to amyloid beta (Aβ) deposition, although there is no unified explanation that includes the complex etiology of T2DM with cognitive impairment. Herein, we assume that cognitive impairment in diabetes may lead to abnormalities in neuroplasticity and energy metabolism in the brain, and those reflected to MRI structural connectivity and functional connectivity, respectively.
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22
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Li Y, Li M, Feng Y, Ma X, Tan X, Chen Y, Qin C, Huang H, Liang Y, Qiu S. Aberrant Brain Spontaneous Activity and Synchronization in Type 2 Diabetes Mellitus Subjects Without Mild Cognitive Impairment. Front Neurosci 2022; 15:749730. [PMID: 34975372 PMCID: PMC8716545 DOI: 10.3389/fnins.2021.749730] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/19/2021] [Indexed: 01/21/2023] Open
Abstract
Objective: We aimed to explore whether the percent amplitude of fluctuation (PerAF) measurement could provide supplementary information for amplitude of low-frequency fluctuation (ALFF) about spontaneous activity alteration in type 2 diabetes mellitus (T2DM) subjects without mild cognitive impairment (MCI). Then we further evaluated the synchronization through the method of functional connectivity (FC) to better demonstrate brain changes in a more comprehensive manner in T2DM. Methods: Thirty T2DM subjects without MCI and thirty well-matched healthy subjects were recruited in this study. Subjects' clinical data, neuropsychological test results, and resting-state functional magnetic resonance imaging (rs-fMRI) data were acquired. Voxel-based group difference comparisons between PerAF and ALFF were conducted. Then, seed-based FC between the recognized brain regions based on PerAF and ALFF and the rest of the whole brain was performed. Results: Compared with healthy group, T2DM group had significantly decreased PerAF in the bilateral middle occipital gyrus and the right calcarine, increased ALFF in the right orbital inferior frontal gyrus and decreased ALFF in the right calcarine. Seed-based FC analysis showed that the right middle occipital gyrus of T2DM subjects exhibited significantly decreased FC with the right caudate nucleus and right putamen. According to the partial correlation analyses, hemoglobin A1c (HbA1c) and immediate memory scores on the auditory verbal learning test (AVLT) were negatively correlated in the T2DM group. However, we found that total cholesterol was positively correlated with symbol digit test (SDT) scores. Conclusion: PerAF and ALFF may have different sensitivities in detecting the abnormal spontaneous brain activity in T2DM subjects. We suggest PerAF values may add supplementary information and indicate additional potential neuronal spontaneous activity in T2DM subjects without MCI, which may provide new insights into the neuroimaging mechanisms underlying early diabetes-associated cognitive decline.
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Affiliation(s)
- Yifan Li
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Mingrui Li
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yue Feng
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaomeng Ma
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xin Tan
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuna Chen
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chunhong Qin
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Haoming Huang
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yi Liang
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shijun Qiu
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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23
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Fang F, Gong YJ, Luo Q, Ge RB, Kang M, Ma MM, Zhang L, Mu D, Yin DZ, Wang YF. Cognitive Dysfunction in Type 2 Diabetes Is Not a One-Way Process: Evidence From a Longitudinal Brain Connectivity Study. Front Endocrinol (Lausanne) 2022; 13:874538. [PMID: 35573998 PMCID: PMC9095898 DOI: 10.3389/fendo.2022.874538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 03/29/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cognitive dysfunction is an important comorbidity of diabetes characterized by brain functional hypo-connectivity. However, our recent study demonstrated an adaptive hyper-connectivity in young type 2 diabetes with cognitive decrements. This longitudinal study aimed to further explore the changes in functional connectivity and cognitive outcomes after regular glycemic control. METHODS At 18 months after recruitment, participants underwent a second cognitive assessment and magnetic resonance imaging. Three enhanced functional connectivities previously identified at baseline were followed up. Linear mixed-effects models were performed to compare the longitudinal changes of cognition and functional connectivity in patients with type 2 diabetes and non-diabetic controls. A linear regression model was used to investigate the association between changes in functional connectivity and changes in cognitive performance. RESULTS Improvements in multiple cognitive domains were observed in diabetes; however, the enhanced functional connectivity at baseline decreased significantly. Moreover, the decrease in hippocampal connectivity was correlated with an increase in the accuracy of Stroop task and the decrease in posterior cingulate cortex connectivity was correlated with an increase in Montreal Cognitive Assessment in diabetes. CONCLUSION This study suggests diabetes-related cognitive dysfunction is not a one-way process and the early-stage enhancement of brain connectivity was a potential "window period" for cognitive reversal.
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Affiliation(s)
- Fang Fang
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yu-Jia Gong
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Qian Luo
- Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Ren-Bin Ge
- Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Mei Kang
- Clinical Research Center, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Ming-Ming Ma
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Lei Zhang
- Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Di Mu
- Department of Anesthesiology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Da-Zhi Yin
- Shanghai Key Laboratory of Brain Functional Genomics (Ministry of Education), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
- Shanghai Changning Mental Health Center, Shanghai, China
- *Correspondence: Yu-Fan Wang, ; Da-Zhi Yin,
| | - Yu-Fan Wang
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Yu-Fan Wang, ; Da-Zhi Yin,
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24
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Li M, Li Y, Liu Y, Huang H, Leng X, Chen Y, Feng Y, Ma X, Tan X, Liang Y, Qiu S. Altered Hippocampal Subfields Volumes Is Associated With Memory Function in Type 2 Diabetes Mellitus. Front Neurol 2021; 12:756500. [PMID: 34899576 PMCID: PMC8657943 DOI: 10.3389/fneur.2021.756500] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 11/03/2021] [Indexed: 01/10/2023] Open
Abstract
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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Affiliation(s)
- Mingrui Li
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yifan Li
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yujie Liu
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Haoming Huang
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xi Leng
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuna Chen
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yue Feng
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaomeng Ma
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xin Tan
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yi Liang
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shijun Qiu
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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25
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Accinelli RA, Arias KB, Leon-Abarca JA, López LM, Saavedra JE. Frequency of depression and quality of life in patients with diabetes mellitus in public health facilities in Metropolitan Lima. ACTA ACUST UNITED AC 2021; 50:243-251. [PMID: 34742694 DOI: 10.1016/j.rcpeng.2021.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 01/30/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Diabetes is one of the main pandemics in recent years. Its association with depression increases the risk of mortality and morbidity. The coexistence of both diseases leads to poor management of diabetes, which leads to a worse quality of life. OBJECTIVE To determine the frequency of depression in patients with diabetes mellitus and the effect of both pathologies on the quality of life in patients who attend outpatient appointments at public health facilities in Lima and Callao. METHODOLOGY Secondary analysis of the Epidemiological Study of Mental Health of depression in diabetic adults. The instrument used to determine the depressive episode was the MINI (Mini-International Neuropsychiatric Interview) while quality of life was measured using the Mezzich Quality of Life Index. Diagnosis information of type 1 or 2 diabetes was obtained from the daily medical record (HIS) of care. RESULTS The frequency of depression in the 471 patients with diabetes was 5.8% in the last two weeks. While the annual frequency was 8.6% and 31.8% at some point in life. Being a woman was associated with a greater frequency of depression. Quality of life was lower in patients with diabetes and depression (p < 0.005). CONCLUSIONS The frequency of depression in patients with diabetes who are treated on an outpatient basis in public health centres is higher than the general population and their quality of life is significantly reduced, which raises the need for considering depression as an additional factor to the burden of morbidity of this condition.
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Affiliation(s)
- Roberto A Accinelli
- Hospital Cayetano Heredia, Lima, Peru; Instituto de Investigaciones de la Altura, Universidad Peruana Cayetano Heredia, Lima, Peru; Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru; Médico Neumólogo, Magister en Salud Pública.
| | - Kevin Brian Arias
- Instituto de Investigaciones de la Altura, Universidad Peruana Cayetano Heredia, Lima, Peru; Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru; Médico Cirujano
| | - Juan Alonso Leon-Abarca
- Instituto de Investigaciones de la Altura, Universidad Peruana Cayetano Heredia, Lima, Peru; Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru; Estudiante de Medicina
| | - Lidia M López
- Instituto de Investigaciones de la Altura, Universidad Peruana Cayetano Heredia, Lima, Peru; Médico Cirujano
| | - Javier E Saavedra
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto Nacional de Salud Mental "Honorio Delgado - Hideyo Noguchi", Lima, Peru; Médico Psiquiatra, Doctor en Medicina
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26
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Yao L, Yang C, Zhang W, Li S, Li Q, Chen L, Lui S, Kemp GJ, Biswal BB, Shah NJ, Li F, Gong Q. A multimodal meta-analysis of regional structural and functional brain alterations in type 2 diabetes. Front Neuroendocrinol 2021; 62:100915. [PMID: 33862036 DOI: 10.1016/j.yfrne.2021.100915] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/30/2021] [Accepted: 04/11/2021] [Indexed: 02/04/2023]
Abstract
Neuroimaging studies have identified brain structural and functional alterations of type 2 diabetes mellitus (T2DM) patients; however, there is no systematic information on the relations between abnormalities in these two domains. We conducted a multimodal meta-analysis of voxel-based morphometry and regional resting-state functional MRI studies in T2DM, including fifteen structural datasets (693 patients and 684 controls) and sixteen functional datasets (378 patients and 358 controls). We found, in patients with T2DM compared to controls, conjoint decreased regional gray matter volume (GMV) and altered intrinsic activity mainly in the default mode network including bilateral superior temporal gyrus/Rolandic operculum, left middle and inferior temporal gyrus, and left supramarginal gyrus; decreased GMV alone in the limbic system; and functional abnormalities alone in the cerebellum, insula, and visual cortex. This meta-analysis identified complicated patterns of conjoint and dissociated brain alterations in T2DM patients, which may help provide new insight into the neuropathology of T2DM.
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Affiliation(s)
- Li Yao
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, NO. 37 Guoxue Xiang, Chengdu 610041, China; Functional and Molecular Imaging Key Laboratory of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China
| | - Chengmin Yang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, NO. 37 Guoxue Xiang, Chengdu 610041, China; Functional and Molecular Imaging Key Laboratory of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China
| | - Wenjing Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, NO. 37 Guoxue Xiang, Chengdu 610041, China; Functional and Molecular Imaging Key Laboratory of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China
| | - Siyi Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, NO. 37 Guoxue Xiang, Chengdu 610041, China; Functional and Molecular Imaging Key Laboratory of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China
| | - Qian Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, NO. 37 Guoxue Xiang, Chengdu 610041, China; Functional and Molecular Imaging Key Laboratory of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China
| | - Lizhou Chen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, NO. 37 Guoxue Xiang, Chengdu 610041, China; Functional and Molecular Imaging Key Laboratory of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, NO. 37 Guoxue Xiang, Chengdu 610041, China; Functional and Molecular Imaging Key Laboratory of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China
| | - Graham J Kemp
- Liverpool Magnetic Resonance Imaging Centre (LiMRIC) and Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L69 3BX, L3 5TR, United Kingdom
| | - Bharat B Biswal
- Department of Biomedical Engineering, New Jersey Institute of Technology, 323 Dr Martin Luther King Jr Blvd, Newark, NJ 07102, USA; The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, No.4, Section 2, North Jianshe Road, Chengdu 610054, China
| | - Nadim J Shah
- Institute of Neuroscience and Medicine (INM-4), Medical Imaging Physics, Forschungszentrum Jülich GmbH, 52425 Jülich, Germany
| | - Fei Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, NO. 37 Guoxue Xiang, Chengdu 610041, China; Functional and Molecular Imaging Key Laboratory of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China; Institute of Neuroscience and Medicine (INM-4), Medical Imaging Physics, Forschungszentrum Jülich GmbH, 52425 Jülich, Germany.
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, NO. 37 Guoxue Xiang, Chengdu 610041, China; Functional and Molecular Imaging Key Laboratory of Sichuan University, NO. 37 Guoxue Xiang, Chengdu 610041, China.
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27
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Yu KKK, Cheing GLY, Cheung C, Kranz GS, Cheung AKK. Gray Matter Abnormalities in Type 1 and Type 2 Diabetes: A Dual Disorder ALE Quantification. Front Neurosci 2021; 15:638861. [PMID: 34163319 PMCID: PMC8215122 DOI: 10.3389/fnins.2021.638861] [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: 12/07/2020] [Accepted: 05/07/2021] [Indexed: 12/06/2022] Open
Abstract
Aims/hypothesis: Diabetes mellitus (DM) is associated with comorbid brain disorders. Neuroimaging studies in DM revealed neuronal degeneration in several cortical and subcortical brain regions. Previous studies indicate more pronounced brain alterations in type 2 diabetes mellitus (T2DM) than in type 1 diabetes mellitus (T1DM). However, a comparison of both types of DM in a single analysis has not been done so far. The aim of this meta-analysis was to conduct an unbiased objective investigation of neuroanatomical differences in DM by combining voxel-based morphometry (VBM) studies of T1DM and T2DM using dual disorder anatomical likelihood estimation (ALE) quantification. Methods: PubMed, Web of Science and Medline were systematically searched for publications until June 15, 2020. VBM studies comparing gray matter volume (GMV) differences between DM patients and controls at the whole-brain level were included. Study coordinates were entered into the ALE meta-analysis to investigate the extent to which T1DM, T2DM, or both conditions contribute to gray matter volume differences compared to controls. Results: Twenty studies (comprising of 1,175 patients matched with 1,013 controls) were included, with seven studies on GMV alterations in T1DM and 13 studies on GMV alterations in T2DM. ALE analysis revealed seven clusters of significantly lower GMV in T1DM and T2DM patients relative to controls across studies. Both DM subtypes showed GMV reductions in the left caudate, right superior temporal lobe, and left cuneus. Conversely, GMV reductions associated exclusively with T2DM (>99% contribution) were found in the left cingulate, right posterior lobe, right caudate and left occipital lobe. Meta-regression revealed no significant influence of study size, disease duration, and HbA1c values. Conclusions/interpretation: Our findings suggest a more pronounced gray matter atrophy in T2DM compared to T1DM. The increased risk of microvascular or macrovascular complications, as well as the disease-specific pathology of T2DM may contribute to observed GMV reductions. Systematic Review Registration: [PROSPERO], identifier [CRD42020142525].
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Affiliation(s)
- Kevin K K Yu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong.,University Research Facility in Behavioral and Systems Neuroscience (UBSN), The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Gladys L Y Cheing
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong.,University Research Facility in Behavioral and Systems Neuroscience (UBSN), The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Charlton Cheung
- Department of Psychiatry, The University of Hong Kong, Pokfulam, Hong Kong
| | - Georg S Kranz
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong.,The State Key Laboratory for Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong.,Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Alex Kwok-Kuen Cheung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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28
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Zhang X, Yu Y, Shi ZS, Xu K, Feng JH, Li ZY, Zhang XN, Shen SN, Yang Y, Yan LF, Zhang J, Sun Q, Hu B, Cui GB, Wang W. Increased resting state functional irregularity of T2DM brains with high HbA1c: sign for impaired verbal memory function? Brain Imaging Behav 2021; 15:772-781. [PMID: 32712796 DOI: 10.1007/s11682-020-00285-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Glycosylated hemoglobin A1c (HbA1c) has been considered as a key contributor to impaired cognition in type 2 diabetes mellitus (T2DM) brains. However, how does it affect the brain and whether the glucose controlling can slow down the process are still unknown. In the current study, T2DM patients with high glycosylated hemoglobin level (HGL) and controls with normal glycosylated hemoglobin level (NGL) were enrolled to investigate the relationships between HbA1c, brain imaging characteristics and cognitive function. First, a series of cognitive tests including California Verbal Learning Test (CVLT) were conducted. Then, the functional irregularity based on resting state functional magnetic resonance imaging data was evaluated via a new data-driven brain entropy (BEN) mapping analysis method. We found that the HGLs exhibited significantly increased BEN in the right precentral gyrus (PreCG.R), the right middle frontal gyrus (MFG.R), the triangular and opercular parts of the right inferior frontal gyrus (IFGtriang.R and IFGoperc.R). The strengths of the functional connections of PreCG.R with the brainstem/cerebellum were decreased. Partial correlation analysis showed that HbA1c had a strong positive correlation to regional BEN and negatively correlated with some CVLT scores. Negative correlations also existed between the BEN of PreCG.R/IFGoperc.R and some CVLT scores, suggesting the correspondence between higher HbA1c, increased BEN and decreased verbal memory function. This study demonstrated the potential of BEN in exploring the functional alterations affected by HbA1c and interpreting the verbal memory function decline. It will help understanding the neurophysiological mechanism of T2DM-induced cognitive decline and taking effective prevention or treatment measures.
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Affiliation(s)
- Xin Zhang
- Functional and Molecular Imaging Key Lab of Shaanxi Province, Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, China
- Institute of Medical Research, Northwestern Polytechnical University, Xi'an, 710072, Shaanxi, China
| | - Ying Yu
- Functional and Molecular Imaging Key Lab of Shaanxi Province, Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, China
| | - Zhe-Sheng Shi
- Student Brigade, Fourth Military Medical University, 169 Changle Road, Xi'an, 710032, Shaanxi, China
| | - Ke Xu
- Student Brigade, Fourth Military Medical University, 169 Changle Road, Xi'an, 710032, Shaanxi, China
| | - Jia-Hao Feng
- Student Brigade, Fourth Military Medical University, 169 Changle Road, Xi'an, 710032, Shaanxi, China
| | - Ze-Yang Li
- Student Brigade, Fourth Military Medical University, 169 Changle Road, Xi'an, 710032, Shaanxi, China
| | - Xiang-Nan Zhang
- Department of Science and Technology Affairs, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, China
| | - Shu-Ning Shen
- Department of Stomatology, PLA 984 Hospital, Beijing, 100094, China
| | - Yang Yang
- Functional and Molecular Imaging Key Lab of Shaanxi Province, Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, China
| | - Lin-Feng Yan
- Functional and Molecular Imaging Key Lab of Shaanxi Province, Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, China
| | - Jin Zhang
- Functional and Molecular Imaging Key Lab of Shaanxi Province, Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, China
| | - Qian Sun
- Functional and Molecular Imaging Key Lab of Shaanxi Province, Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, China
| | - Bo Hu
- Functional and Molecular Imaging Key Lab of Shaanxi Province, Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, China
| | - Guang-Bin Cui
- Functional and Molecular Imaging Key Lab of Shaanxi Province, Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, China.
| | - Wen Wang
- Functional and Molecular Imaging Key Lab of Shaanxi Province, Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, China.
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29
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Shinohara M, Kikuchi M, Onishi-Takeya M, Tashiro Y, Suzuki K, Noda Y, Takeda S, Mukouzono M, Nagano S, Fukumori A, Morishita R, Nakaya A, Sato N. Upregulated expression of a subset of genes in APP; ob/ ob mice: Evidence of an interaction between diabetes-linked obesity and Alzheimer's disease. FASEB Bioadv 2021; 3:323-333. [PMID: 33977233 PMCID: PMC8103720 DOI: 10.1096/fba.2020-00151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/17/2021] [Accepted: 01/29/2021] [Indexed: 12/26/2022] Open
Abstract
Clinical studies have indicated that obesity and diabetes are associated with Alzheimer's disease (AD) and neurodegeneration. However, the mechanism by which obesity/diabetes and AD interact with each other and contribute to dementia remains elusive. To obtain insights into their interaction at molecular levels, we performed gene expression analysis of APP;ob/ob mice, which were generated by crossing transgenic AD model mice (APP23 mice) with ob/ob mice, which are obese and mildly diabetic. The Aβ level in these mice was reduced compared with that in pure APP mice. However, we identified a cluster of genes (cluster 10) upregulated in APP;ob/ob mice but not in either APP or ob/ob mice. Interestingly, genes upregulated in the human AD brain were enriched in cluster 10. Moreover, genes in cluster 10 formed a network and shared upregulated genes with a cell model of neurodegeneration and other models of neurological disorders such as ischemia and epilepsy. In silico analyses showed that serum response factor (SRF), recently identified in a single-cell analysis of human brains as a transcription factor that can control the conversion from healthy cells to AD cells, might be a common transcriptional regulator for a subset of cluster 10 genes. These data suggest that upregulation of genes uniquely associated with APP;ob/ob mice is an evidence of the interaction between obesity/diabetes and AD.
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Affiliation(s)
- Mitsuru Shinohara
- Department of Aging Neurobiology Center for Development of Advanced Medicine for Dementia National Center for Geriatrics and Gerontology Obu Aichi Japan.,Department of Aging Neurobiology Graduate School of Medicine Osaka University Osaka Japan
| | - Masataka Kikuchi
- Department of Genome Informatics Graduate School of Medicine Osaka University Osaka Japan
| | - Miyuki Onishi-Takeya
- Department of Geriatric Medicine Graduate School of Medicine Osaka University Osaka Japan
| | - Yoshitaka Tashiro
- Department of Aging Neurobiology Center for Development of Advanced Medicine for Dementia National Center for Geriatrics and Gerontology Obu Aichi Japan
| | - Kaoru Suzuki
- Department of Aging Neurobiology Center for Development of Advanced Medicine for Dementia National Center for Geriatrics and Gerontology Obu Aichi Japan
| | - Yasuhiro Noda
- Department of Aging Neurobiology Center for Development of Advanced Medicine for Dementia National Center for Geriatrics and Gerontology Obu Aichi Japan
| | - Shuko Takeda
- Department of Clinical Gene Therapy Graduate School of Medicine Osaka University Osaka Japan
| | - Masahiro Mukouzono
- Department of Clinical Gene Therapy Graduate School of Medicine Osaka University Osaka Japan
| | - Seiichi Nagano
- Department of Neurology Graduate School of Medicine Osaka University Osaka Japan
| | - Akio Fukumori
- Department of Aging Neurobiology Center for Development of Advanced Medicine for Dementia National Center for Geriatrics and Gerontology Obu Aichi Japan.,Department of Aging Neurobiology Graduate School of Medicine Osaka University Osaka Japan
| | - Ryuichi Morishita
- Department of Clinical Gene Therapy Graduate School of Medicine Osaka University Osaka Japan
| | - Akihiro Nakaya
- Department of Genome Informatics Graduate School of Medicine Osaka University Osaka Japan
| | - Naoyuki Sato
- Department of Aging Neurobiology Center for Development of Advanced Medicine for Dementia National Center for Geriatrics and Gerontology Obu Aichi Japan.,Department of Aging Neurobiology Graduate School of Medicine Osaka University Osaka Japan
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30
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Breton JM, Long KLP, Barraza MK, Perloff OS, Kaufer D. Hormonal Regulation of Oligodendrogenesis II: Implications for Myelin Repair. Biomolecules 2021; 11:290. [PMID: 33669242 PMCID: PMC7919830 DOI: 10.3390/biom11020290] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/10/2021] [Accepted: 02/13/2021] [Indexed: 02/07/2023] Open
Abstract
Alterations in myelin, the protective and insulating sheath surrounding axons, affect brain function, as is evident in demyelinating diseases where the loss of myelin leads to cognitive and motor dysfunction. Recent evidence suggests that changes in myelination, including both hyper- and hypo-myelination, may also play a role in numerous neurological and psychiatric diseases. Protecting myelin and promoting remyelination is thus crucial for a wide range of disorders. Oligodendrocytes (OLs) are the cells that generate myelin, and oligodendrogenesis, the creation of new OLs, continues throughout life and is necessary for myelin plasticity and remyelination. Understanding the regulation of oligodendrogenesis and myelin plasticity within disease contexts is, therefore, critical for the development of novel therapeutic targets. In our companion manuscript, we review literature demonstrating that multiple hormone classes are involved in the regulation of oligodendrogenesis under physiological conditions. The majority of hormones enhance oligodendrogenesis, increasing oligodendrocyte precursor cell differentiation and inducing maturation and myelin production in OLs. Thus, hormonal treatments present a promising route to promote remyelination. Here, we review the literature on hormonal regulation of oligodendrogenesis within the context of disorders. We focus on steroid hormones, including glucocorticoids and sex hormones, peptide hormones such as insulin-like growth factor 1, and thyroid hormones. For each hormone, we describe whether they aid in OL survival, differentiation, or remyelination, and we discuss their mechanisms of action, if known. Several of these hormones have yielded promising results in both animal models and in human conditions; however, a better understanding of hormonal effects, interactions, and their mechanisms will ultimately lead to more targeted therapeutics for myelin repair.
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Affiliation(s)
- Jocelyn M Breton
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA 94720, USA
| | - Kimberly L P Long
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA 94720, USA
| | - Matthew K Barraza
- Molecular and Cellular Biology, University of California Berkeley, Berkeley, CA 94720, USA
| | - Olga S Perloff
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, CA 94143, USA
| | - Daniela Kaufer
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA 94720, USA
- Integrative Biology, University of California Berkeley, Berkeley, CA 94720, USA
- Canadian Institute for Advanced Research, Toronto, ON M5G1M1, Canada
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31
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Köbe T, Binette AP, Vogel JW, Meyer PF, Breitner JCS, Poirier J, Villeneuve S. Vascular risk factors are associated with a decline in resting-state functional connectivity in cognitively unimpaired individuals at risk for Alzheimer's disease: Vascular risk factors and functional connectivity changes. Neuroimage 2021; 231:117832. [PMID: 33549747 DOI: 10.1016/j.neuroimage.2021.117832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/25/2021] [Accepted: 01/27/2021] [Indexed: 12/12/2022] Open
Abstract
Resting-state functional connectivity is suggested to be cross-sectionally associated with both vascular burden and Alzheimer's disease (AD) pathology. However, evidence is lacking regarding longitudinal changes in functional connectivity. This study includes 247 cognitively unimpaired individuals with a family history of sporadic AD (185 women/ 62 men; mean [SD] age of 63 [5.3] years). Plasma total-, HDL-, and LDL-cholesterol and systolic and diastolic blood pressure were measured at baseline. Global (whole-brain) brain functional connectivity and connectivity from canonical functional networks were computed from resting-state functional MRI obtained at baseline and ~3.5 years of annual follow-ups, using a predefined functional parcellation. A subsample underwent Aβ- and tau-PET (n=91). Linear mixed-effects models demonstrated that global functional connectivity increased over time across the entire sample. In contrast, higher total-cholesterol and LDL-cholesterol levels were associated with greater reduction of functional connectivity in the default-mode network over time. In addition, higher diastolic blood pressure was associated with global functional connectivity reduction. The associations were similar when the analyses were repeated using two other functional brain parcellations. Aβ and tau deposition in the brain were not associated with changes in functional connectivity over time in the subsample. These findings provide evidence that vascular burden is associated with a decrease in functional connectivity over time in older adults with elevated risk for AD. Future studies are needed to determine if the impact of vascular risk factors on functional brain changes precede the impact of AD pathology on functional brain changes.
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Affiliation(s)
- Theresa Köbe
- Department of Psychiatry, McGill University, H3A 1A1, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StoP-AD) Centre, H4H 1R3, Montreal, Quebec, Canada; German Center for Neurodegenerative Diseases (DZNE), 01307, Dresden, Germany.
| | - Alexa Pichet Binette
- Department of Psychiatry, McGill University, H3A 1A1, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StoP-AD) Centre, H4H 1R3, Montreal, Quebec, Canada
| | - Jacob W Vogel
- Montreal Neurological Institute, McGill University, H3A 2B4, Montreal, QC, Canada
| | - Pierre-François Meyer
- Department of Psychiatry, McGill University, H3A 1A1, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StoP-AD) Centre, H4H 1R3, Montreal, Quebec, Canada
| | - John C S Breitner
- Department of Psychiatry, McGill University, H3A 1A1, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StoP-AD) Centre, H4H 1R3, Montreal, Quebec, Canada
| | - Judes Poirier
- Department of Psychiatry, McGill University, H3A 1A1, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StoP-AD) Centre, H4H 1R3, Montreal, Quebec, Canada
| | - Sylvia Villeneuve
- Department of Psychiatry, McGill University, H3A 1A1, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StoP-AD) Centre, H4H 1R3, Montreal, Quebec, Canada; Department of Neurology and Neurosurgery, McGill University, H3A 2B4, Montreal, Quebec, Canada.
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32
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Li C, Zhang J, Qiu M, Liu K, Li Y, Zuo Z, Yin X, Lai Y, Fang J, Tong H, Guo Y, Wang J, Chen X, Xiong K. Alterations of Brain Structural Network Connectivity in Type 2 Diabetes Mellitus Patients With Mild Cognitive Impairment. Front Aging Neurosci 2021; 12:615048. [PMID: 33613263 PMCID: PMC7891182 DOI: 10.3389/fnagi.2020.615048] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 12/30/2020] [Indexed: 12/31/2022] Open
Abstract
Patients with type 2 diabetes mellitus (T2DM) are highly susceptible to developing dementia, especially for those with mild cognitive impairment (MCI), but its underlying cause is still unclear. This study aims to investigate the early detection of white matter structural network changes in T2DM patients with MCI and assess the relationship between cognitive impairment and structural network alterations in T2DM patients. In this study, we performed a battery of neuropsychological tests and diffusion tensor MRI in 30 T2MD-MCI patients, 30 T2DM patients with normal cognition (T2DM-NC) and 30 age-, sex-, and education-matched healthy control (HC) individuals. Cognitive performance exhibited obvious differences among the three groups. The structural network was significantly disrupted in both global and regional levels in T2DM patients. The T2DM-MCI group showed more severe impairment of global network efficiency, and lower nodal efficiency and fewer connections within multiple regions like the limbic system, basal ganglia, and several cortical structures. Moreover, a subnetwork impaired in T2DM-MCI patients was characterized by cortical-limbic fibers, and commissural fibers and pathways within the frontal, temporal, and occipital lobes. These altered global and nodal parameters were significantly correlated with cognitive function in T2DM-MCI patients. In particular, executive dysfunction and working memory impairment in T2DM-MCI patients correlated with nodal efficiency in the right opercular part and triangular part of the inferior frontal gyrus, which indicated that white matter disruption in these regions may act as potential biomarkers for T2DM-associated MCI detection. Our investigation provides a novel insight into the neuropathological effects of white matter network disruption on cognition impairments induced by T2DM.
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Affiliation(s)
- Chang Li
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China.,Department of Radiology, Southwest Hospital, Army Medical University, Chongqing, China
| | - Jingna Zhang
- Department of Medical Imaging, College of Biomedical Engineering, Army Medical University, Chongqing, China
| | - Mingguo Qiu
- Department of Medical Imaging, College of Biomedical Engineering, Army Medical University, Chongqing, China
| | - Kaijun Liu
- Department of Gastroenterology, Daping Hospital, Army Medical University, Chongqing, China
| | - Yang Li
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China
| | - Zhiwei Zuo
- Department of Radiology, General Hospital of Western Theater Command, Chengdu, China
| | - Xuntao Yin
- Department of Medical Imaging, Guizhou Provincial People's Hospital, Guiyang, China
| | - Yuqi Lai
- School of Foreign Languages and Cultures, Chongqing University, Chongqing, China
| | - Jingqin Fang
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China.,Chongqing Clinical Research Center for Imaging and Nuclear Medicine, Chongqing, China
| | - Haipeng Tong
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China
| | - Yu Guo
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China
| | - Jian Wang
- Department of Radiology, Southwest Hospital, Army Medical University, Chongqing, China
| | - Xiao Chen
- Chongqing Clinical Research Center for Imaging and Nuclear Medicine, Chongqing, China.,Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, China
| | - Kunlin Xiong
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China.,Chongqing Clinical Research Center for Imaging and Nuclear Medicine, Chongqing, China
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33
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Alotaibi A, Tench C, Stevenson R, Felmban G, Altokhis A, Aldhebaib A, Dineen RA, Constantinescu CS. Investigating Brain Microstructural Alterations in Type 1 and Type 2 Diabetes Using Diffusion Tensor Imaging: A Systematic Review. Brain Sci 2021; 11:brainsci11020140. [PMID: 33499073 PMCID: PMC7911883 DOI: 10.3390/brainsci11020140] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/15/2021] [Accepted: 01/17/2021] [Indexed: 12/13/2022] Open
Abstract
Type 1 and type 2 diabetes mellitus have an impact on the microstructural environment and cognitive functions of the brain due to its microvascular/macrovascular complications. Conventional Magnetic Resonance Imaging (MRI) techniques can allow detection of brain volume reduction in people with diabetes. However, conventional MRI is insufficiently sensitive to quantify microstructural changes. Diffusion Tensor Imaging (DTI) has been used as a sensitive MRI-based technique for quantifying and assessing brain microstructural abnormalities in patients with diabetes. This systematic review aims to summarise the original research literature using DTI to quantify microstructural alterations in diabetes and the relation of such changes to cognitive status and metabolic profile. A total of thirty-eight published studies that demonstrate the impact of diabetes mellitus on brain microstructure using DTI are included, and these demonstrate that both type 1 diabetes mellitus and type 2 diabetes mellitus may affect cognitive abilities due to the alterations in brain microstructures.
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Affiliation(s)
- Abdulmajeed Alotaibi
- Division of Clinical Neuroscience, Nottingham University Hospitals NHS Trust, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (C.T.); (R.S.); (G.F.); (A.A.); (R.A.D.); (C.S.C.)
- School of Applied Medical Sciences, King Saud bin Abdul-Aziz University for Health Sciences, Riyadh 14611, Saudi Arabia;
- Correspondence: ; Tel.: +44-115-823-1443; Fax: +44-115-9709738
| | - Christopher Tench
- Division of Clinical Neuroscience, Nottingham University Hospitals NHS Trust, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (C.T.); (R.S.); (G.F.); (A.A.); (R.A.D.); (C.S.C.)
| | - Rebecca Stevenson
- Division of Clinical Neuroscience, Nottingham University Hospitals NHS Trust, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (C.T.); (R.S.); (G.F.); (A.A.); (R.A.D.); (C.S.C.)
| | - Ghadah Felmban
- Division of Clinical Neuroscience, Nottingham University Hospitals NHS Trust, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (C.T.); (R.S.); (G.F.); (A.A.); (R.A.D.); (C.S.C.)
- School of Applied Medical Sciences, King Saud bin Abdul-Aziz University for Health Sciences, Riyadh 14611, Saudi Arabia;
| | - Amjad Altokhis
- Division of Clinical Neuroscience, Nottingham University Hospitals NHS Trust, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (C.T.); (R.S.); (G.F.); (A.A.); (R.A.D.); (C.S.C.)
- School of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh 11564, Saudi Arabia
| | - Ali Aldhebaib
- School of Applied Medical Sciences, King Saud bin Abdul-Aziz University for Health Sciences, Riyadh 14611, Saudi Arabia;
| | - Rob A. Dineen
- Division of Clinical Neuroscience, Nottingham University Hospitals NHS Trust, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (C.T.); (R.S.); (G.F.); (A.A.); (R.A.D.); (C.S.C.)
- NIHR Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK
| | - Cris S. Constantinescu
- Division of Clinical Neuroscience, Nottingham University Hospitals NHS Trust, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (C.T.); (R.S.); (G.F.); (A.A.); (R.A.D.); (C.S.C.)
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Li C, Jin R, Liu K, Li Y, Zuo Z, Tong H, Zhang J, Zhang J, Guo Y, Lai Y, Sun J, Wang J, Xiong K, Chen X. White Matter Atrophy in Type 2 Diabetes Mellitus Patients With Mild Cognitive Impairment. Front Neurosci 2021; 14:602501. [PMID: 33536867 PMCID: PMC7848149 DOI: 10.3389/fnins.2020.602501] [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: 09/03/2020] [Accepted: 12/21/2020] [Indexed: 01/21/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) patients are highly susceptible to developing dementia, especially for those with mild cognitive impairment (MCI), but its underlying cause is still unclear. In this study, we performed a battery of neuropsychological tests and high-resolution sagittal T1-weighted structural imaging to explore how T2DM affects white matter volume (WMV) and cognition in 30 T2DM-MCI patients, 30 T2DM with normal cognition (T2DM-NC) patients, and 30 age-, sex-, and education-matched healthy control (HC) individuals. The WMV of the whole brain was obtained with automated segmentation methods. Correlations between the WMV of each brain region and neuropsychological tests were analyzed in the T2DM patients. The T2DM-NC patients and HC individuals did not reveal any significant differences in WMV. Compared with the T2DM-NC group, the T2DM-MCI group showed statistically significant reduction in the WMV of seven brain regions, mainly located in the frontotemporal lobe and limbic system, five of which significantly correlated with Montreal Cognitive Assessment (MoCA) scores. Subsequently, we evaluated the discriminative ability of these five regions for MCI in T2DM patients. The WMV of four regions, including left posterior cingulate, precuneus, insula, and right rostral middle frontal gyrus had high diagnostic value for MCI detection in T2DM patients (AUC > 0.7). Among these four regions, left precuneus WMV presented the best diagnostic value (AUC: 0.736; sensitivity: 70.00%; specificity: 73.33%; Youden index: 0.4333), but with no significant difference relative to the minimum AUC. In conclusion, T2DM could give rise to the white matter atrophy of several brain regions. Each WMV of left posterior cingulate, precuneus, insula, and right rostral middle frontal gyrus could be an independent imaging biomarker to detect cognitive impairment at the early stage in T2DM patients and play an important role in its pathophysiological mechanism.
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Affiliation(s)
- Chang Li
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China.,Department of Radiology, Southwest Hospital, Army Medical University, Chongqing, China
| | - Rongbing Jin
- Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, China.,Chongqing Clinical Research Center for Imaging and Nuclear Medicine, Chongqing, China
| | - Kaijun Liu
- Department of Gastroenterology, Daping Hospital, Army Medical University, Chongqing, China
| | - Yang Li
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China
| | - Zhiwei Zuo
- Department of Radiology, General Hospital of Western Theater Command, Chengdu, China
| | - Haipeng Tong
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China.,Chongqing Clinical Research Center for Imaging and Nuclear Medicine, Chongqing, China
| | - Jingna Zhang
- Department of Medical Imaging, College of Biomedical Engineering, Army Medical University, Chongqing, China
| | - Junfeng Zhang
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China.,Chongqing Clinical Research Center for Imaging and Nuclear Medicine, Chongqing, China
| | - Yu Guo
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China
| | - Yuqi Lai
- School of Foreign Languages and Cultures, Chongqing University, Chongqing, China
| | - Jinju Sun
- Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, China
| | - Jian Wang
- Department of Radiology, Southwest Hospital, Army Medical University, Chongqing, China
| | - Kunlin Xiong
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China.,Chongqing Clinical Research Center for Imaging and Nuclear Medicine, Chongqing, China
| | - Xiao Chen
- Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, China.,Chongqing Clinical Research Center for Imaging and Nuclear Medicine, Chongqing, China
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Cheng P, Song S, Li Y, Zhang Y, Yi J, Xu X, Zhou H, Zuo Z. Aberrant Functional Connectivity of the Posterior Cingulate Cortex in Type 2 Diabetes Without Cognitive Impairment and Microvascular Complications. Front Endocrinol (Lausanne) 2021; 12:722861. [PMID: 34759889 PMCID: PMC8573207 DOI: 10.3389/fendo.2021.722861] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 10/04/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE We aimed to investigate the alterations of brain functional connectivity (FC) in type 2 diabetes mellitus (T2DM) patients without clinical evidence of cognitive impairment and microvascular complications (woCIMC-T2DM) using resting-state functional MRI (rs-fMRI) and to determine whether its value was correlated with clinical indicators. METHODS A total of 27 T2DM and 26 healthy controls (HCs) were prospectively examined. Cognitive impairment was excluded using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) scales, and microvascular complications were excluded by fundus photography, microalbuminuria, and other indicators. The correlation maps, derived from rs-fMRI with posterior cingulate cortex (PCC) as the seed, were compared between T2DM patients and HCs. Pearson's correlation analysis was performed to determine the relationship between the FC of PCC and the clinical indicators. RESULTS Compared with HC, woCIMC-T2DM patients showed significantly decreased FCs with PCC (PCC-FCs) in the anterior cingulate cortex (ACC), right superior frontal gyrus, right medial frontal gyrus, and right angular gyrus. Meanwhile, increased PCC-FCs was observed in the right superior temporal gyrus and calcarine fissure (CAL). The FC of PCC-ACC was negatively correlated with glycosylated hemoglobin (HbA1c) and diabetes duration, and the FC of PCC-CAL was significantly positively correlated with HbA1c and diabetes duration. CONCLUSION The FC, especially of the PCC with cognitive and visual brain regions, was altered before clinically measurable cognitive impairment and microvascular complications occurred in T2DM patients. In addition, the FC of the PCC with cognitive and visual brain regions was correlated with HbA1c and diabetes duration. This indicates that clinicians should pay attention not only to blood glucose control but also to brain function changes before the occurrence of adverse complications, which is of great significance for the prevention of cognitive dysfunction and visual impairment.
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Affiliation(s)
- Panpan Cheng
- Department of Radiology, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shuyan Song
- College of Electrics and Information Engineering, South-Central University for Nationalities, Wuhan, China
| | - Yumin Li
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yao Zhang
- Department of Endocrinology, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Yi
- Department of Psychiatry, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiangyang Xu
- Department of Radiology, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongmei Zhou
- Department of Radiology, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Hongmei Zhou, ; Zhentao Zuo,
| | - Zhentao Zuo
- State Key Laboratory of Brain and Cognitive Science, Beijing MRI Center for Brain Research, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
- Sino-Danish College, University of Chinese Academy of Sciences, Beijing, China
- CAS Center for Excellence in Brain and Science and Intelligence Technology, Chinese Academy of Sciences, Beijing, China
- *Correspondence: Hongmei Zhou, ; Zhentao Zuo,
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Zhou C, Li J, Dong M, Ping L, Lin H, Wang Y, Wang S, Gao S, Yu G, Cheng Y, Xu X. Altered White Matter Microstructures in Type 2 Diabetes Mellitus: A Coordinate-Based Meta-Analysis of Diffusion Tensor Imaging Studies. Front Endocrinol (Lausanne) 2021; 12:658198. [PMID: 34012420 PMCID: PMC8127836 DOI: 10.3389/fendo.2021.658198] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/07/2021] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE Type 2 diabetes mellitus (T2DM) is often accompanied by cognitive decline and depressive symptoms. Numerous diffusion tensor imaging (DTI) studies revealed microstructural white matter (WM) abnormalities in T2DM but the findings were inconsistent. The present study aimed to conduct a coordinate-based meta-analysis (CBMA) to identify statistical consensus of DTI studies in T2DM. METHODS We performed a systematic search on relevant studies that reported fractional anisotropy (FA) differences between T2DM patients and healthy controls (HC). The anisotropic effect size seed-based d mapping (AES-SDM) approach was used to explore WM alterations in T2DM. A meta-regression was then used to analyze potential influences of sample characteristics on regional FA changes. RESULTS A total of eight studies that comprised 245 patients and 200 HC, along with 52 coordinates were extracted. The meta-analysis identified FA reductions in three clusters including the left inferior network, the corpus callosum (CC), and the left olfactory cortex. Besides, FA in the CC was negatively correlated with body mass index (BMI) in the patients group. CONCLUSIONS T2DM could lead to subtle WM microstructural alterations, which might be associated with cognitive deficits or emotional distress symptoms. This provides a better understanding of the pathophysiology of neurodegeneration and complications in T2DM. SYSTEMATIC REVIEW REGISTRATION Registered at PROSPERO (http://www.crd.york.ac.uk/PROSPERO), registration number: CRD42020218737.
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Affiliation(s)
- Cong Zhou
- School of Mental Health, Jining Medical University, Jining, China
- *Correspondence: Cong Zhou,
| | - Jie Li
- Department of Psychiatry, Jining Psychiatric Hospital, Jining, China
| | - Man Dong
- School of Mental Health, Jining Medical University, Jining, China
| | - Liangliang Ping
- Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen, China
| | - Hao Lin
- School of Mental Health, Jining Medical University, Jining, China
| | - Yuxin Wang
- School of Mental Health, Jining Medical University, Jining, China
| | - Shuting Wang
- School of Mental Health, Jining Medical University, Jining, China
| | - Shuo Gao
- School of Mental Health, Jining Medical University, Jining, China
| | - Ge Yu
- School of Mental Health, Jining Medical University, Jining, China
| | - Yuqi Cheng
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xiufeng Xu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China
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Common Brain Structural Alterations Associated with Cardiovascular Disease Risk Factors and Alzheimer's Dementia: Future Directions and Implications. Neuropsychol Rev 2020; 30:546-557. [PMID: 33011894 DOI: 10.1007/s11065-020-09460-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 09/24/2020] [Indexed: 01/18/2023]
Abstract
Recent reports suggest declines in the age-specific risk of Alzheimer's dementia in higher income Western countries. At the same time, investigators believe that worldwide trends of increasing mid-life modifiable risk factors [e.g., cardiovascular disease (CVD) risk factors] coupled with the growth of the world's oldest age groups may nonetheless lead to an increase in Alzheimer's dementia. Thus, understanding the overlap in neuroanatomical profiles associated with CVD risk factors and AD may offer more relevant targets for investigating ways to reduce the growing dementia epidemic than current targets specific to isolated AD-related neuropathology. We hypothesized that a core group of common brain structural alterations exist between CVD risk factors and Alzheimer's dementia. Two co-authors conducted independent literature reviews in PubMed using search terms for CVD risk factor burden (separate searches for 'cardiovascular disease risk factors', 'hypertension', and 'Type 2 diabetes') and 'aging' or 'Alzheimer's dementia' with either 'grey matter volumes' or 'white matter'. Of studies that reported regionally localized results, we found support for our hypothesis, determining 23 regions commonly associated with both CVD risk factors and Alzheimer's dementia. Within this context, we outline future directions for research as well as larger cerebrovascular implications for these commonalities. Overall, this review supports previous as well as more recent calls for the consideration that both vascular and neurodegenerative factors contribute to the pathogenesis of dementia.
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38
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Li Y, Liang Y, Tan X, Chen Y, Yang J, Zeng H, Qin C, Feng Y, Ma X, Qiu S. Altered Functional Hubs and Connectivity in Type 2 Diabetes Mellitus Without Mild Cognitive Impairment. Front Neurol 2020; 11:1016. [PMID: 33071928 PMCID: PMC7533640 DOI: 10.3389/fneur.2020.01016] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/03/2020] [Indexed: 01/06/2023] Open
Abstract
Background: Type 2 diabetes mellitus (T2DM)-related cognitive decline is associated with neuroimaging changes. However, only a few studies have focused on early functional alteration in T2DM prior to mild cognitive impairment (MCI). This study aimed to investigate the early changes of global connectivity patterns in T2DM by using a resting-state functional magnetic resonance imaging (rs-fMRI) technique. Methods: Thirty-four T2DM subjects and 38 age-, sex-, and education-matched healthy controls (HCs) underwent rs-fMRI in a 3T MRI scanner. Degree centrality (DC) was used to identify the functional hubs of the whole brain in T2DM without MCI. Then the functional connectivity (FC) between hubs and the rest of the brain was assessed by using the hub-based approach. Results: Compared with HCs, T2DM subjects showed increased DC in the right cerebellum lobules III-V. Hub-based FC analysis found that the right cerebellum lobules III-V of T2DM subjects had increased FC with the right cerebellum crus II and lobule VI, the right temporal inferior/middle gyrus, and the right hippocampus. Conclusions: Increased DC in the right cerebellum regions III-V, as well as increased FC within cerebellar regions and ipsilateral cerebrocerebellar regions, may indicate an important pathophysiological mechanism for compensation in T2DM without MCI.
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Affiliation(s)
- Yifan Li
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yi Liang
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xin Tan
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuna Chen
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jinquan Yang
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hui Zeng
- Department of Radiology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
| | - Chunhong Qin
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yue Feng
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaomeng Ma
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shijun Qiu
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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Strong J, Fonda JR, Grande L, Milberg W, McGlinchey R, Leritz E. The role of cognitive reserve in the relationship between metabolic syndrome and cognitive functioning. AGING NEUROPSYCHOLOGY AND COGNITION 2020; 28:717-732. [PMID: 32893722 DOI: 10.1080/13825585.2020.1817304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Metabolic syndrome (MetS) is a cluster of vascular risk factors that can impact cognition. Cognitive reserve (CR), specifically early operators of reserve (e.g., education), have not been explored in the relationship between MetS and cognition. Adults 45-90 years old (n = 149) underwent neuropsychological testing and evaluation for MetS. Exploratory and confirmatory factor analyses defined neuropsychological domains and created a CR score based on early operators of CR. Regression analyses examined the association among MetS, CR, and neuropsychological performance. CFA revealed two neuropsychological factors: Episodic Memory and Executive Functioning. Controlling for age and physical ability, MetS and CR were significant predictors of the Factors. With CR in the model, MetS became a non-significant predictor of Executive Functioning; CR and physical ability were the most significant predictors. CR and MetS significantly predicted Episodic Memory . The results are discussed in the context of neuroprotective factors and cognitive aging.
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Affiliation(s)
- Jessica Strong
- VA Boston Healthcare System; Boston, Massachusetts, USA.,New England Geriatric Research Education and Clinical Center; Boston, Massachusetts, USA.,Harvard Medical School, Department of Psychiatry; Boston, Massachusetts, USA
| | - Jennifer R Fonda
- VA Boston Healthcare System; Boston, Massachusetts, USA.,Translational Research Center for Traumatic Brain Injury and Stress Disorders; Boston, Massachusetts, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, USA
| | - Laura Grande
- VA Boston Healthcare System; Boston, Massachusetts, USA.,Harvard Medical School, Department of Psychiatry; Boston, Massachusetts, USA
| | - William Milberg
- VA Boston Healthcare System; Boston, Massachusetts, USA.,Harvard Medical School, Department of Psychiatry; Boston, Massachusetts, USA.,Translational Research Center for Traumatic Brain Injury and Stress Disorders; Boston, Massachusetts, USA
| | - Regina McGlinchey
- VA Boston Healthcare System; Boston, Massachusetts, USA.,Harvard Medical School, Department of Psychiatry; Boston, Massachusetts, USA.,Translational Research Center for Traumatic Brain Injury and Stress Disorders; Boston, Massachusetts, USA
| | - Elizabeth Leritz
- VA Boston Healthcare System; Boston, Massachusetts, USA.,New England Geriatric Research Education and Clinical Center; Boston, Massachusetts, USA.,Harvard Medical School, Department of Psychiatry; Boston, Massachusetts, USA
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40
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Karvani M, Kapoukranidou D. Implementation of Imaging Methods in Evaluation of T2DM-Correlated Brain Alterations and Cognitive Dysfunction. ACTA INFORMATICA MEDICA : AIM : JOURNAL OF THE SOCIETY FOR MEDICAL INFORMATICS OF BOSNIA & HERZEGOVINA : CASOPIS DRUSTVA ZA MEDICINSKU INFORMATIKU BIH 2020; 28:138-143. [PMID: 32742067 PMCID: PMC7382768 DOI: 10.5455/aim.2020.28.138-143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Introduction: There has been mounting evidence that type 2 diabetes mellitus (T2DM) populations are prone to aberrant brain functionality and cognitive deficits. Hyperglycemic status and insulin resistance, among other factors, have been associated with compromised brain neural congruity, leading to lower cognitive performance. Aim: The aim of the present paper is to provide a comprehensive review of imaging techniques and their applicability in detection of brain changes in the setting of T2DM. Methods: A search of PubMed electronic database was followed. Primary search terms included “imaging methods”, “type 2 diabetes” and “cognitive impairment”. Results: A range of imaging modalities that can be of value in depiction of diabetes-mediated structural and functional brain aberrations. Conclusion: An increasingly body of research points to the adverse effect T2DM exerts on brain integrity and higher cognitive skills. Findings support the role of imaging techniques in delineation of brain divergence in middle-aged and older diabetic populations.
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Affiliation(s)
- Marianna Karvani
- Physiology Department, Health Science School, Medical School, Aristotle University of Thessaloniki, Greece
| | - Dorothea Kapoukranidou
- Physiology Department, Health Science School, Medical School, Aristotle University of Thessaloniki, Greece
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41
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Tian Q, Pilling LC, Atkins JL, Melzer D, Ferrucci L. The relationship of parental longevity with the aging brain-results from UK Biobank. GeroScience 2020; 42:1377-1385. [PMID: 32671621 DOI: 10.1007/s11357-020-00227-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/06/2020] [Indexed: 01/23/2023] Open
Abstract
A few studies report that parental longevity is associated with preserved cognition and physical function and lower risk of Alzheimer's disease. However, data on structural neuroimaging correlates of parental longevity and its spatial distribution are limited. This study aims to examine relationships of parental longevity with regional brain structure and to explore sex differences. We identified 12,970 UK Biobank participants (mean age = 64.4, 51.5%women) with data on parental longevity, regional gray matter volumes, and white matter microstructure. Participants were categorized based on whether at least one parent lived to age 85 or older or neither parent survived to age 85. Associations of parental longevity, maternal, and paternal longevity with each neuroimaging marker of interest were examined using linear regression, adjusted for demographics, APOE e4 status, lifestyle, and cardiometabolic conditions. Compared to participants whose both parents died before 85 (43%), those with at least one parent surviving to 85 (57%) had greater volumes in hippocampus, parahippocampal gyrus, middle temporal lobe, and primary sensorimotor cortex and had lower mean diffusivity in posterior thalamic radiation and uncinate fasciculus. Associations were prominent with maternal longevity. Adjustment for cardiometabolic conditions did not affect observed associations except mean diffusivity in posterior thalamic radiation. There were no structural differences in other areas. Parental longevity is associated with preserved brain structure localized in primary sensorimotor cortex and temporal areas including hippocampus. These relationships are prominent with maternal longevity. Longitudinal studies are needed to determine whether changes in these brain structures account for the association between parental longevity and dementia.
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Affiliation(s)
- Qu Tian
- Translational Gerontology Branch Longitudinal Studies Section, National Institute on Aging, 251 Bayview Blvd., Suite 100, RM 04B316, Baltimore, MD, USA.
| | - Luke C Pilling
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Janice L Atkins
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - David Melzer
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Luigi Ferrucci
- Translational Gerontology Branch Longitudinal Studies Section, National Institute on Aging, 251 Bayview Blvd., Suite 100, RM 04B316, Baltimore, MD, USA
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Accinelli RA, Arias KB, Leon-Abarca JA, López LM, Saavedra JE. Frequency of Depression and Quality of Life in Patients with Diabetes Mellitus in Public Health Facilities in Metropolitan Lima. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2020; 50:S0034-7450(20)30028-7. [PMID: 33734990 DOI: 10.1016/j.rcp.2020.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 11/29/2019] [Accepted: 01/30/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Diabetes is one of the main pandemics in recent years. Its association with depression increases the risk of mortality and morbidity. The coexistence of both diseases leads to poor management of diabetes, which leads to a worse quality of life. OBJECTIVE To determine the frequency of depression in patients with diabetes mellitus and the effect of both pathologies on the quality of life in patients who attend outpatient appointments at public health facilities in Lima and Callao. METHODOLOGY Secondary analysis of the Epidemiological Study of Mental Health of depression in diabetic adults. The instrument used to determine the depressive episode was the MINI (Mini-International Neuropsychiatric Interview) while quality of life was measured using the Mezzich Quality of Life Index. Diagnosis information of type 1 or 2 diabetes was obtained from the daily medical record (HIS) of care. RESULTS The frequency of depression in the 471 patients with diabetes was 5.8% in the last two weeks. While the annual frequency was 8.6% and 31.8% at some point in life. Being a woman was associated with a greater frequency of depression. Quality of life was lower in patients with diabetes and depression (p <0.005). CONCLUSIONS The frequency of depression in patients with diabetes who are treated on an outpatient basis in public health centres is higher than the general population and their quality of life is significantly reduced, which raises the need for considering depression as an additional factor to the burden of morbidity of this condition.
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Affiliation(s)
- Roberto A Accinelli
- Hospital Cayetano Heredia, Lima, Perú; Instituto de Investigaciones de la Altura, Universidad Peruana Cayetano Heredia, Lima, Perú; Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Perú; Médico Neumólogo, Magister en Salud Pública.
| | - Kevin Brian Arias
- Instituto de Investigaciones de la Altura, Universidad Peruana Cayetano Heredia, Lima, Perú; Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Perú; Médico Cirujano
| | - Juan Alonso Leon-Abarca
- Instituto de Investigaciones de la Altura, Universidad Peruana Cayetano Heredia, Lima, Perú; Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Perú; Estudiante de Medicina
| | - Lidia M López
- Instituto de Investigaciones de la Altura, Universidad Peruana Cayetano Heredia, Lima, Perú; Médico Cirujano
| | - Javier E Saavedra
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Perú; Instituto Nacional de Salud Mental «Honorio Delgado - Hideyo Noguchi», Lima, Perú; Médico Psiquiatra, Doctor en Medicina
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43
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Cui Y, Tang TY, Lu CQ, Cai Y, Lu T, Wang YC, Teng GJ, Ju S. Abnormal Cingulum Bundle Induced by Type 2 Diabetes Mellitus: A Diffusion Tensor Tractography Study. Front Aging Neurosci 2020; 12:594198. [PMID: 33384593 PMCID: PMC7771529 DOI: 10.3389/fnagi.2020.594198] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 11/16/2020] [Indexed: 01/29/2023] Open
Abstract
Purpose: In Type 2 diabetes (T2DM), white matter (WM) pathology has been suggested to play an important role in the etiology of T2DM-related cognitive impairment. This study aims to investigate the integrity of the cingulum bundle (CB), a major WM tract, in T2DM patients using diffusion tensor tractography. Methods: Thirty-seven T2DM patients and 34 age-, sex- and education matched healthy controls were included and underwent diffusion tensor imaging. Tractography of bilateral CB tracts was performed and diffusion measurements were compared between the two groups. Next, brain regions with significant group differences on fractional anisotropy (FA) values were set as the region of interest (ROI), and the CB fibers that passed through were identified. Diffusion measures were extracted from these fibers to investigate their correlations with the cognitive performances and endocrine parameters. Results: T2DM patients exhibited decreased FA in bilateral CB, increased mean diffusion (MD) in the right CB, and decreased length in the left CB. Through voxel-wise comparison, the most prominent FA difference was identified in the posterior segment of the CB and the reconstructed tract was part of the retrosplenial component. Importantly, the diffusion measurements of the tract were significantly correlated with the impaired performance in executive functioning and elevated insulin resistance (IR) in the T2DM group, instead of the control group. Conclusions: The diffusion measurements in bilateral CB were altered in T2DM patients, which might reflect important neuropathologic changes in the fibers. Our study adds to knowledge about how the cingulum changes structurally along its entire length in T2DM and highlights the relationship between WM and cognitive performance. Besides, IR might be an important risk factor that warrants further exploration.
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Affiliation(s)
- Ying Cui
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Tian-Yu Tang
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Chun-Qiang Lu
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yu Cai
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Tong Lu
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yuan-Cheng Wang
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Gao-Jun Teng
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Shenghong Ju
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
- *Correspondence: Shenghong Ju
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Li J, Guo Y, Li Q, Miao K, Wang C, Zhang D, Tian C, Zhang S. Presence of White Matter Lesions Associated with Diabetes-Associated Cognitive Decline in Male Rat Models of Pre-Type 2 Diabetes. Med Sci Monit 2019; 25:9679-9689. [PMID: 31848329 PMCID: PMC6930701 DOI: 10.12659/msm.918557] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The aim of this study was to determine the association between white matter lesions (WML) and diabetes-associated cognitive decline (DACD) in rat models of type 2 diabetes (T2DM). MATERIAL AND METHODS Sixty Sprague-Dawley male rats were divided into 4 groups: control, control+metformin, T2DM, and T2DM+metformin groups. The T2DM groups were fed a diet high in fat and glucose to induce impaired glucose tolerance (IGT) and then were injected with streptozotocin to induce T2DM. The Morris water maze test was used to evaluate cognitive function. Brain diffusion tensor imaging scans were performed for WML. The expression of myelin basic protein (MBP), oligodendrocyte transcription factor 1 (OLIG1), and OLIG2 (markers of brain damage and repair) was determined using immunofluorescence. After IGT, the fractional anisotropy (FA) values of the right thalamus area were significantly lower in both T2DM groups compared with controls. RESULTS Eight weeks after streptozotocin injection, the FA values of the thalamus were lower in the T2DM (bilateral thalamus) group and T2DM+metformin (left thalamus) group than in controls, while the FA values in the left thalamus area were lower in the T2DM+metformin group than in the control and control+metformin groups. The maze escape latency was longer and the number of rats passing through the platform was smaller in the T2DM and T2DM+metformin groups than in the control group. MBP levels were lower and OLIG1 and OLIG2 levels were higher in both T2DM groups than in controls. CONCLUSIONS WML is associated with DACD and appears before the onset of T2DM and signs of DACD and plays a role in diabetes-associated cognitive decline. Metformin reduces WMLs but does not rescue cognitive dysfunction.
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Affiliation(s)
- Jun Li
- Department of Endocrinology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China (mainland)
| | - Yafei Guo
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China (mainland)
| | - Qingju Li
- Department of Endocrinology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China (mainland)
| | - Keke Miao
- Department of Breast Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China (mainland)
| | - Chongxian Wang
- Department of Endocrinology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China (mainland)
| | - Dongming Zhang
- Department of Endocrinology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China (mainland)
| | - Chenguang Tian
- Department of Endocrinology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China (mainland)
| | - Suhe Zhang
- Department of Endocrinology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China (mainland)
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45
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Rashid B, Dev SI, Esterman M, Schwarz NF, Ferland T, Fortenbaugh FC, Milberg WP, McGlinchey RE, Salat DH, Leritz EC. Aberrant patterns of default-mode network functional connectivity associated with metabolic syndrome: A resting-state study. Brain Behav 2019; 9:e01333. [PMID: 31568716 PMCID: PMC6908882 DOI: 10.1002/brb3.1333] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 03/13/2019] [Accepted: 03/29/2019] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Metabolic syndrome (MetS) is a clustering of three or more cardiovascular risk factors (RF), including hypertension, obesity, high cholesterol, or hyperglycemia. MetS and its component RFs are more prevalent in older age, and can be accompanied by alterations in brain structure. Studies have shown altered functional connectivity (FC) in samples with individual RFs as well as in clinical populations that are at higher risk to develop MetS. These studies have indicated that the default mode network (DMN) may be particularly vulnerable, yet little is known about the overall impact of MetS on FC in this network. METHODS In this study, we evaluated the integrity of FC to the DMN in participants with MetS relative to non-MetS individuals. Using a seed-based connectivity analysis approach, resting-state functional MRI (fMRI) data were analyzed, and the FC measures among the DMN seed (isthmus of the cingulate) and rest of the brain voxels were estimated. RESULTS Participants with MetS demonstrated reduced positive connectivity between the DMN seed and left superior frontal regions, and reduced negative connectivity between the DMN seed and left superior parietal, left postcentral, right precentral, right superior temporal and right superior parietal regions, after accounting for age- and sex-effects. CONCLUSIONS Our results suggest that MetS is associated with alterations in FC between the DMN and other regions of the brain. Furthermore, these results indicate that the overall burden of vascular RFs associated with MetS may, in part, contribute to the pathophysiology underlying aberrant FC in the DMN.
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Affiliation(s)
- Barnaly Rashid
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Sheena I Dev
- Harvard Medical School, Boston, Massachusetts.,SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, California
| | - Michael Esterman
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts.,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
| | - Nicolette F Schwarz
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,McLean Imaging Center, McLean Hospital, Belmont, Massachusetts
| | - Tori Ferland
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Francesca C Fortenbaugh
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - William P Milberg
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Regina E McGlinchey
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - David H Salat
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,The Athinoula A. Martinos Center for Biomedical Imaging, Boston, Massachusetts
| | - Elizabeth C Leritz
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
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46
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Gao S, Chen Y, Sang F, Yang Y, Xia J, Li X, Zhang J, Chen K, Zhang Z. White Matter Microstructural Change Contributes to Worse Cognitive Function in Patients With Type 2 Diabetes. Diabetes 2019; 68:2085-2094. [PMID: 31439643 PMCID: PMC6804632 DOI: 10.2337/db19-0233] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 08/15/2019] [Indexed: 01/20/2023]
Abstract
Patients with type 2 diabetes mellitus (T2DM) have a considerably high risk of developing dementia, especially for those with mild cognitive impairment (MCI). The investigation of the microstructural change of white matter (WM) between T2DM with amnesic MCI (T2DM-aMCI) and T2DM with normal cognition (T2DM-NC) and their relationships to cognitive performances can help to understand the brain variations in T2DM-related amnesic cognitive impairment. In the current study, 36 T2DM-aMCI patients, 40 T2DM-NC patients, and 40 healthy control (HC) individuals underwent diffusion tensor image and T1-weighted MRI scans and comprehensive cognition assessments. All of these cognitive functions exhibited intergroup ranking differences in patients. The T2DM-NC patients and HC individuals did not reveal any significant differences in WM integrity. The T2DM-aMCI patients showed disrupted integrity in multiple WM tracts compared with HC and T2DM-NC. Specifically, the damaged WM integrity of the right inferior fronto-occipital fasciculus and the right inferior longitudinal fasciculus exhibited significant correlations with episodic memory and attention function impairment in T2DM patients. Furthermore, cognitive impairment-related WM microstructural damage was associated with the degeneration of cortex connected to the affected WM tract. These findings indicate that degeneration exists extensively in WM tracts in T2DM-aMCI, whereas no brain WM damage is evident in T2DM-NC.
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Affiliation(s)
- Shudan Gao
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, People's Republic of China
- Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing, People's Republic of China
| | - Yaojing Chen
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, People's Republic of China
- Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing, People's Republic of China
| | - Feng Sang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, People's Republic of China
- Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing, People's Republic of China
| | - Yiru Yang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, People's Republic of China
- Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing, People's Republic of China
| | - Jianan Xia
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, People's Republic of China
- Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing, People's Republic of China
| | - Xin Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, People's Republic of China
- Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing, People's Republic of China
| | - Junying Zhang
- Institute of Basic Research in Clinical Medicine, China Academy of Traditional Chinese Medicine, Beijing, People's Republic of China
| | - Kewei Chen
- Banner Alzheimer's Institute, Phoenix, AZ
| | - Zhanjun Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, People's Republic of China
- Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing, People's Republic of China
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47
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Sanjari Moghaddam H, Ghazi Sherbaf F, Aarabi MH. Brain microstructural abnormalities in type 2 diabetes mellitus: A systematic review of diffusion tensor imaging studies. Front Neuroendocrinol 2019; 55:100782. [PMID: 31401292 DOI: 10.1016/j.yfrne.2019.100782] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 07/27/2019] [Accepted: 08/07/2019] [Indexed: 12/13/2022]
Abstract
Type 2 diabetes mellitus (T2DM) is associated with deficits in the structure and function of the brain. Diffusion tensor imaging (DTI) is a highly sensitive method for characterizing cerebral tissue microstructure. Using PRISMA guidelines, we identified 29 studies which have demonstrated widespread brain microstructural impairment and topological network disorganization in patients with T2DM. Most consistently reported structures with microstructural abnormalities were frontal, temporal, and parietal lobes in the lobar cluster; corpus callosum, cingulum, uncinate fasciculus, corona radiata, and internal and external capsules in the white matter cluster; thalamus in the subcortical cluster; and cerebellum. Microstructural abnormalities were correlated with pathological derangements in the endocrine profile as well as deficits in cognitive performance in the domains of memory, information-processing speed, executive function, and attention. Altogether, the findings suggest that the detrimental effects of T2DM on cognitive functions might be due to microstructural disruptions in the central neural structures.
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Affiliation(s)
| | - Farzaneh Ghazi Sherbaf
- Neuroradiology Division, Tehran University of Medical Sciences, School of Medicine, Tehran, Iran
| | - Mohammad Hadi Aarabi
- Neuroradiology Division, Tehran University of Medical Sciences, School of Medicine, Tehran, Iran.
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48
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Zhuo Y, Fang F, Lu L, Li T, Lian J, Xiong Y, Kong D, Li K. White matter impairment in type 2 diabetes mellitus with and without microvascular disease. NEUROIMAGE-CLINICAL 2019; 24:101945. [PMID: 31374399 PMCID: PMC6676007 DOI: 10.1016/j.nicl.2019.101945] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 05/09/2019] [Accepted: 07/17/2019] [Indexed: 12/12/2022]
Abstract
Background and objective Type 2 diabetes mellitus (T2DM) is a serious public health problem, and the phenomenon of T2DM occurring in younger people has directed more attention to functional changes in the brain. In this study, the microstructural integrity of white matter (WM) was evaluated in three groups of middle-aged subjects: healthy controls (HCs) and T2DM patients with and without peripheral microvascular complications (T2DM-C and T2DM-NC patients, respectively). Methods Diffusion tensor imaging (DTI) and related clinical examinations were performed in 66 subjects, including 20 T2DM-C patients, 20 T2DM-NC patients, 26 age- and sex-matched HCs. Magnetic resonance imaging (MRI) at 3 T was used to perform DTI; then, FSL and tract-based spatial statistics (TBSS) software were used to assess differences in the fractional anisotropy (FA) and mean diffusivity (MD) among the groups. The use of the FA and MD as parameters was evaluated by receiver operating characteristic (ROC) curve analysis. Results There were no significant differences in sex or age among the groups, and the clinical data of the groups met the experimental requirements. There was no significant difference in the FA values between the HCs and T2DM-NC groups. Compared with the HCs, the T2DM-C patients showed decreased FA values and increased MD values in the corpus callosum, bilateral anterior limb of the internal capsule, right retrolenticular part of the internal capsule, bilateral posterior thalamic radiation, right superior longitudinal fasciculus, bilateral superior corona radiata and left middle frontal gyrus (P < .01). Compared with the T2DM-NC patients, the T2DM-C patients showed decreased FA values and increased MD values in the corpus callosum, bilateral fornix, right retrolenticular part of the internal capsule, middle cerebral peduncle, right superior longitudinal fasciculus, right posterior thalamic radiation, and left middle frontal gyrus (P < .01). Conclusions This study indicates that WM impairment is present in T2DM patients and may be related to microvascular complications. More importantly, this study also shows that such impairment may be diagnosed using the DTI mode of functional MRI before it can be diagnosed clinically. White matter impairment in middle-aged type 2 diabetes mellitus patients Grouping type 2 diabetes mellitus patients according to the presence or absence of microvascular complications Significant differences in the fractional anisotropy (FA) and mean diffusivity (MD) among the groups
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Affiliation(s)
- Yaoyao Zhuo
- Department of Radiology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200080, PR China; Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 200000, PR China
| | - Fang Fang
- Department of Endocrinology and Metabolic Diseases, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200020, PR China
| | - Lunbo Lu
- Department of Radiology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200080, PR China
| | - Ting Li
- Department of Radiology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200080, PR China
| | - Jingge Lian
- Department of Radiology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200080, PR China
| | - Yun Xiong
- School of Computer Science and Technology, Fudan University, Shanghai Key Laboratory of Data Science, Shanghai, PR China
| | - Dexing Kong
- School of Mathematical Sciences, Zhejiang University, Zhejiang 310027, PR China
| | - Kangan Li
- Department of Radiology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200080, PR China.
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Fang F, Lai MY, Huang JJ, Kang M, Ma MM, Li KA, Lian JG, Wang Z, Yin DZ, Wang YF. Compensatory Hippocampal Connectivity in Young Adults With Early-Stage Type 2 Diabetes. J Clin Endocrinol Metab 2019; 104:3025-3038. [PMID: 30817818 DOI: 10.1210/jc.2018-02319] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 02/25/2019] [Indexed: 01/15/2023]
Abstract
CONTEXT Middle-aged to elderly patients with type 2 diabetes mellitus (T2DM) exhibit reduced functional connectivity and brain atrophy underlying cognitive decrements; however, little is known about brain abnormalities in young patients. OBJECTIVE To detect brain anatomical and functional changes in young patients with T2DM during the early disease stage. DESIGN Case-control study. SETTING Tertiary referral hospital. PARTICIPANTS Thirty-five young patients with T2DM (<40 years of age) with no detectable microangiopathy and 32 nondiabetic control subjects. INTERVENTION None. MAIN OUTCOME MEASURES Subjects underwent neuropsychological assessments and structural and resting-state functional MRI. Both voxel-based morphometry and resting-state functional connectivity analyses were performed. RESULTS No significant differences in brain volume were observed between the patients with T2DM and the controls after controlling for age, sex, education, and body mass index. Compared with the controls, the patients showed greater connectivity of the left hippocampus with the left inferior frontal gyrus and the left inferior parietal lobule. Moreover, the enhanced functional connectivity of left hippocampus with the left inferior frontal gyrus significantly correlated with disease severity (urinary albumin-to-creatinine ratio) (r = 0.613, P < 0.001) and executive function (completion time of Stroop Color and Word Test) (r = -0.461, P = 0.005) after false discovery rate correction. CONCLUSIONS Our findings suggest an adaptive compensation of brain function to counteract the insidious cognitive decrements during the early stage of T2DM. Additionally, the functional alterations occurring before changes in brain structure and peripheral microangiopathy might serve as early biomarkers related to cognitive decrements.
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Affiliation(s)
- Fang Fang
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Meng-Yu Lai
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jing-Jing Huang
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Mei Kang
- Clinical Research Center, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Ming-Ming Ma
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Kang-An Li
- Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jing-Ge Lian
- Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Zheng Wang
- Institute of Neuroscience, State Key Laboratory of Neuroscience, Chinese Academy of Sciences Center for Excellence in Brain Science and Intelligence Technology, Shanghai Institute for Biological Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Da-Zhi Yin
- Institute of Neuroscience, State Key Laboratory of Neuroscience, Chinese Academy of Sciences Center for Excellence in Brain Science and Intelligence Technology, Shanghai Institute for Biological Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Yu-Fan Wang
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
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50
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Zhang X, Huang-Fu Z, Lang XY, Chun P, Chi YY, Yuan XY, Wang XG. Pathological and cognitive changes in patients with type 2 diabetes mellitus and comorbid MCI and protective hypoglycemic therapies: a narrative review. Rev Neurosci 2019; 30:757-770. [PMID: 31199776 DOI: 10.1515/revneuro-2018-0083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 01/30/2019] [Indexed: 01/04/2023]
Abstract
Type 2 diabetes mellitus (T2DM) is becoming a significant health issue worldwide. Many studies support the hypothesis that patients with T2DM have a higher-than-expected incidence of mild cognitive impairment (MCI) than individuals without diabetes. Based on the results from recent studies, MCI might be associated with the effects of T2DM on glucose metabolism and brain atrophy. As a narrative review, we will illuminate pathological and cognitive changes in patients with T2DM and comorbid MCI and protective hypoglycemic therapies. The early abnormal signs of cognition must be elucidated, and extensive investigations are needed to develop improved therapies for use in the clinic.
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Affiliation(s)
- Xiao Zhang
- The First Affiliated Hospital of Dalian Medical University, Dalian 116000, P.R. China
| | - Zhao Huang-Fu
- The Second Affiliated Hospital of Dalian Medical University, Dalian 116027, P.R. China
| | - Xing-Ying Lang
- Dalian Center for Disease Control and Prevention, Dalian 116021, P.R. China
| | - Pu Chun
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian 16044, P.R. China
| | - Yan-Yan Chi
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian 16044, P.R. China
| | - Xiao-Ying Yuan
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian 16044, P.R. China
| | - Xu-Gang Wang
- Department of Neurology, The Second Affiliated Hospital of Dalian Medical University, Dalian 116027, P.R. China
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