2型糖尿病患者岛叶功能连接异常的静息态功能磁共振研究

Abnormal functional connectivity of the insula in type 2 diabetes mellitus:a resting-state functional MRI study

目的:探讨2型糖尿病(T2DM)是否会导致岛叶与全脑功能连接异常及其在T2DM脑损伤神经机制中的作用。方法:纳入人口学资料相匹配的T2DM患者及健康被试各33例,所有被试行静息态fMRI检查及神经心理学测试,观察两组间岛叶与全脑功能连接差异,并提取显著差异脑区的功能连接平均值,将功能连接平均值与临床资料及神经心理学评分行相关性分析。结果:相比健康被试者,T2DM患者岛叶与双侧额下回、右侧颞上回、左侧角回及左侧小脑功能连接减低,未发现功能连接增强的脑区,并且T2DM患者岛叶与右侧额下回功能连接强度与糖化血红蛋白(HbA1c)呈负相关(r=-0.379,P=0.035)。结论:T2DM患者岛叶与全脑存在广泛的功能连接异常,这可能是其听觉及视觉空间功能损伤的神经基础,持续的高糖状态可能导致患者抑制性控制(IC)功能受损。

Objective: To investigate whether type 2 diabetes mellitus(T2DM) causes abnormal functional connectivity between the insula and the whole brain and its role in the neural mechanism of T2DM brain injury. Methods: A total of 33 patients with T2DM and healthy subjects(HC) matched with demographic data were included. All subjects underwent restingstate fMRI and neuropsychological tests to observe the difference in functional connectivity between the insula and the whole brain between the two groups, and the mean value of functional connections of significantly different brain regions were extracted. Then the correlation between the extracted mean value of functional connections and clinical data and neuropsycholog-ical evaluation was analyzed. Results: Compared with HC, the insula showed decreased functional connectivity between bilateral inferior frontal gyrus, right superior temporal gyrus, left angular gyrus and left cerebellum in T2DM patients, and no brain areas with enhanced functional connections were found. Moreover, the functional connectivity between the insula and the right inferior frontal gyrus in T2DM patients was negatively correlated with HbA1c(r=-0.379, P=0.035). Conclusion: There is a wide range of functional connectivity abnormalities between the insula and whole brains of T2DM patients, which may be the neurological basis of auditory and visual spatial function impairment. Continuous high glucose status may cause IC function im-pairment in T2 DM patients.