Interhemispheric Coordination And Functional Connectivity In Type 2 Diabetes Mellitus: A Resting-state Functional Magnetic Resonance Imaging Study

Objective Using resting-state functional magnetic resonance imaging(rs-f MRI)technology based on voxel-mirrored homotopic connectivity(VMHC)and seed functional connectivity(FC)analysis to investigate the interhemispheric functional connectivity in patients with type 2 diabetes mellitus(T2DM),providing imaging evidence to illuminate the neuropathological mechanism of diabetic brain damage.Methods A prospective collection of 88 of T2 DM patients,78 were finally included,61 of healthy controls(HC)were recruited by advertisement,57 were finally included as controls matching the age,sex and education level of the T2 DM group.All subjects were subjected to clinical data collection,neuropsychological scale assessment and head magnetic resonance imaging(MRI)scan.Using SPM12 and DPABAI＿V4.2 software based on MATLAB to preprocess the scanned image data.The DPARSF 4.3 software was used to calculate and analyze VMHC and FC.The two-sample t test was used to analyze the difference of VMHC and FC values between the T2 DM and the HC group.The statistical software SPSS 23.0 was used to analyze the Pearson correlation between VMHC and FC values and clinical variables and neuropsychological scale scores.Results Compared with the HC,Hamilton Anxiety Scale(HAMA),and Hamilton Depression Scale-24(HAMD-24)scores were significantly higher in the T2 DM group,Montreal Cognitive Assessment(Mo CA)scores were significantly reduced,and the differences were statistically significant(P <0.05).Compared with HC,the VMHC of supplementary motor area/cingulate gyrus in T2 DM patients was significantly increased(GRF,voxel P <0.005,cluster P <0.05).The FC between left supplementary motor area and cerebellar VI decreased significantly(GRF,voxel P <0.005,cluster P <0.05).The FC between left supplementary motor area and the left inferior parietal increased significantly(GRF,voxel P <0.005,cluster P <0.05),and it was negatively correlated with glycosylated hemoglobin(r =-0.229,P = 0.044).Conclusion Cognitive impairment,depressive and anxiety symptoms are existed in T2 DM patients.Impairment of interhemispheric coordination and abnormal FC of supplementary motor area/cingulate gyrus suggesting a disorder of information communication and integration between hemispheres,which might be important neuropathologic mechanism and potential neuroimaging biomarkers for the cerebral impairment of T2 DM.