2型糖尿病患者大脑灰质结构和神经活动协同性的磁共振成像研究

Regional Neural Activity Homogeneity and Anatomical Brain Alterations in Type 2 Diabetes

目的利用磁共振成像技术结合基于体素的形态学(voxel-based morphology,VBM)及静息态局部一致性(regional homogeneity,ReHo)的分析方法探索2型糖尿病(type 2 diabetes mellitus,T2DM)患者大脑神经结构的微观变化及神经活动协同性的改变。方法研究共纳入26例T2DM患者及24名健康自愿者对照,采集所有被试大脑结构像及静息态功能数据。计算全脑体素的灰质体积(gray matter volume,GMV)及ReHo值并进行组间统计分析,提取存在显著差异脑区的GMV/ReHo值与临床数据做相关分析。结果 VBM结果显示与正常对照组相比T2DM患者双侧纹状体、双侧丘脑、左侧岛叶及左侧小脑的部分区域灰质体积明显降低(P<0.05,FDR校正)。ReHo减低的脑区(P<0.05,FDR校正)主要位于双侧舌回/距状裂周围皮层、楔叶、左侧枕上回/枕中回。ReHo升高的脑区主要位于颞叶、双侧纹状体、两侧丘脑、右侧额中回。患者双侧丘脑、右侧纹状体灰质体积与糖化血红蛋白值呈负相关。结论 T2DM患者纹状体、丘脑等灰质核团存在广泛的结构萎缩,并且这种结构的缺损与长期的血糖控制密切相关。局部脑区神经功能紊乱可能是患者认知功能损伤的基础,纹状体、丘脑等灰质核团体积萎缩而功能活动一致性增强可能是糖尿病脑病中枢系统损伤的早期代偿性表现。

Objective To investigate the brain structurally and functional alteration in patients with type 2 diabetes mellitus using T1 WI and resting state functional magnetic resonance imaging（ f MRI）. Methods A total of 26 T2 DM patients and 24 healthy controls were enrolled. Changes in gray matter volume（ GMV） and regional neural activity homogeneity were assessed using voxel-based morphology（ VBM） and regional homogeneity（ ReHo） analysis. Results T2 DM patients showed decreased GMV in the bilateral thalamus,striatum,left insular and left cerebellum. Decreased ReHo values were found mainly in lingual gyrus,cuneus,inferior and superior occipital gyrus and increased ReHo values in the temporal lobe,bilateral thalamus / striatum and frontal gyrus. Conclusion T2 DM patients distributed morphological and functional abnormalities across the brain,structure defects were correlated with long-term glycemic control. The regional neural activity dysfunction could associate with cognitive impairment in T2 DM. Structural-functional dissociation pattern in thalamus /striatum could be a trait related feature of diabetic encephalopathy.