2型糖尿病患者左侧小脑Ⅵ区与全脑功能连接改变的fMRI研究

Altered functional connectivity between left cerebellumⅥregion and whole brain in T2DM patients:a resting-state fMRI study

目的:探讨2型糖尿病(T2DM)患者左侧小脑Ⅵ区与全脑功能连接的改变及其是否与视觉空间功能损伤有关。方法:纳入32例T2DM患者(T2DM组)及年龄、性别相匹配的30例健康被试(HC组)行静息态fMRI检查及神经心理学量表测试,对比左侧小脑Ⅵ区与全脑功能连接以及神经心理学量表的组间差异,提取存在显著差异脑区的功能连接平均值与行为学评分行相关性分析。结果:相对于HC组,T2DM组患者左侧小脑Ⅵ区与右侧海马旁回/梭状回,右侧颞中/上回,双侧楔前叶/右侧中、后扣带,双侧额内侧回/右侧额中、上回,右侧角回/颞中回/枕中回/缘上回/顶下小叶的功能连接减低(单个体素P<0.001,矫正后P<0.05,GRF矫正),未发现功能连接增高的脑区。T2DM组患者左侧小脑Ⅵ区和左侧楔前叶功能连接强度与连线测试A(TMT-A)评分呈负相关(r=-0.38,P=0.048)。结论:T2DM组患者左侧小脑Ⅵ区与全脑多个脑区存在异常功能连接,并与视觉空间损伤有关,为进一步了解T2DM视觉空间功能损伤的神经机制提供了新的见解。

Objective:To investigate the altered functional connections between the left cerebellarⅥregion and the whole brain in patients with type 2 diabetes mellitus(T2DM)and whether it is related to visuospatial impairment in T2DM.Methods:Resting state fMRI and neuropsychological assessment were performed on 32 T2DM patients and 30 age-and gender-matched healthy controls(HC).Neuropsychological score and functional connectivity between left cerebellarⅥregion and other voxels in the brain were compared between the two groups.Correlation analysis was conducted between neuropsychological score and mean functional connection values from the regions with significant difference in the above comparison.Results:Compared with HC,T2DM patients showed significantly decreased functional connections between left cerebellumⅥregion and right para-hippocampal/fusiform gyrus,right middle/superior temporal gyrus,bilateral precuneus/right middle&posterior cingulate,bilateral medial frontal gyrus/right superior/middle frontal gyrus,right angular/middle temporal/middle occipital/supramarginal gyrus/inferior parietal lobule(P<0.001 for individual voxel,corrected P<0.05,GRF corrected).There were no increased functional connectivity regions of the brain.Moreover,functional connection values between left cerecullarⅥand left precuneus were negative correlated with Trail Making Test A(TMT-A)in T2DM group(r=-0.38,P=0.048).Conclusion:T2DM patients have abnormal functional connections between the left cerebellumⅥregion and multiple regions of the whole brain,which was related to visuospatial impairment,providing new insights for further understanding the neural mechanism of visuospatial impairment in T2DM.