2型糖尿病患者认知障碍静息态脑功能连接分析

Analysis of resting brain functional connectivity in type 2 diabetic patients with cognitive impairment

目的利用静息态脑功能磁共振成像的f ALFF值及功能连接方法分析T2DM患者脑功能改变,探讨病情严重程度和认知障碍对于T2DM患者脑功能连接改变的影响。方法本研究基于静息态f MRI的方法,对31例T2DM患者及27例健康对照者基于比率低频振幅技术进行脑功能连接分析研究。得到病例组和对照组的所有被试者的f ALFF值并进行组间比较,获取f ALFF值有差异的脑区;以这些脑区为种子点进一步进行基于全脑体素水平的功能连接分析,最后将患者的MMSE评分与异常功能连接的脑区进行相关分析。结果结果显示多个脑区功能连接异常,T2DM患者与健康对照者相比共有7个脑区的f ALFF值出现异常增加或减低;基于这些脑区进行全脑体素水平的功能连接分析,有多个脑区出现功能连接的异常增强或减弱;患者的MMSE评分与异常功能连接的脑区存在一定的相关性。结论 T2DM患者存在多个脑区f ALFF值异常及多个功能连接异常的脑区,其中部分脑区可能是其产生认知功能及视觉功能障碍的神经病理机制,同时部分脑区存在认知及运动功能异常及代偿的神经调控机制;患者临床认知障碍与多个不同脑区的功能连接强度均有不同程度的相关。

Objective To analyze the changes of brain function in patients with T2 DM by using f ALFF value of resting state functional magnetic resonance imaging and functional connection method, and to explore the effect of severity of disease and cognitive impairment on the changes of brain function in patients with T2 DM. Methods The brain functional connectivity analysis of 31 patients with T2 DM and 27 healthy controls based on the fractional amplitude of lowfrequency fluctuation was studied, based on the resting state f MRI method. The f ALFF values of all subjects in the case group and the control group were obtained and compared between the groups to obtain the brain regions with different f ALFF values. Further, these brain regions were used as the seed points for functional connection analysis based on the whole brain voxel level. Finally, the correlation analysis of the patient＇s MMSE score and abnormally functional brain regions was performed. Results The results showed that functional connectivity was abnormal in multiple brain regions.There was an abnormal increase or decrease of f ALFF in 7 brain regions in T2 DM patients compared with healthy controls. Based on functional connectivity analysis of whole brain voxel levels in these brain regions, There was an abnormal increase or decrease of functional connectivity in multiple brain regions. There was a certain correlation between MMSE score of patients and the brain area of abnormal functional connectivity. Conclusion There are multiple brain regions with abnormal f ALFF values and multiple functional abnormalities in T2 DM patients. Among them, some brain regions may be the neuropathological mechanism of cognitive function and visual dysfunction. At the same time, some brain regions have cognitive function and visual dysfunction and compensatory neuromodulation mechanism. The clinical cognitive impairment has different degrees of correlation with functional connection strength in multiple different brain regions.