Resting-state Brain Functional Magnetic Resonance Imaging Study Of Patients With Painful Neuropathy In Type 2 Diabetes

ObjectiveThe methods of fraction Amplitude of Low Frequency Fluctuation(fALFF)and Regional Homogeneity(ReHo)of resting-state functional Magnetic Resonance Imaging(rs-fMRI)were used to observe the characteristics of spontaneous brain activity of patients with pain and non pain diabetic neuropathy in resting state.Materials and MethodsEvaluate the symptoms,signs and mental conditions of 19 patients with painful diabetic neuropathy(group P)and 18 patients with non pain neuropathy(group N).Compare clinical parameters between groups.Perform the brain BOLD-fMRI scan in patients and 15 matched healthy controls.With the application of fALFF and ReHo technology,the differences of the abnormal spontaneous brain activity among the three groups were compared by one-way ANOVA.Finally,Pearson Correlation Analysis was performed between the abnormal brain activity and clinical parameters.Results1.The HOMA-IR,TCSS,SAS,HAMD,HAMA and social function scale score of group P and N were statistically different(P < 0.05).The differences in age,sex,waist to hip ratio,blood erythrocyte,HbA1 c,C peptide,blood lipid,BMI,creatinine,urine protein quantitative,eGFR,HOMA-?,electrophysiological examination and fundus examination were not statistically significant(P > 0.05).2.The fALFF values of three groups showed that there were significant differences in right cerebellum 9,left fusiform gyrus,right temporal gyrus,rightsuperior temporal gyrus,bilateral occipital gyrus,left orbital frontal gyrus,right posterior cingulate gyrus and lateral cingulate gyrus,right central posterior gyrus and right supplementary active area.In the temporal lobe,frontal lobe,occipital lobe and cerebellum,there were scattered areas with significant difference in ReHo value.(P<0.05,Alphasim correction).3.Compared with group N,the fALFF values of group P in the left temporal gyrus,the right lingual gyrus,the left middle occipital gyrus,the left occipital gyrus,the left posterior central gyrus,and the left parietal bone except the superior border gyrus and the angular gyrus were significantly higher,while the fALFF values in the left superior temporal and temporal gyrus,the inferior frontal gyrus of the left Island cover,the right superior temporal gyrus,the left Roland multi shell cover,the posterior cingulate gyrus and the lateral cingulate gyrus,the left central anterior gyrus,and bilateral supplementary areas decreased significantly.The ReHo values in the right middle frontal gyrus,the left parietal bone except the superior border gyrus and the angular gyrus were significantly higher,while ReHo value in the left lateral temporal gyrus decreased significantly(P < 0.05,Alphasim correction).4.Pearson Correlation Analysis showed that in group P,the fALFF value in the lower frontal gyrus of the left Island cover was negatively correlated with the eGFR,and HbA1 c,and fALFF value in the left occipital gyrus was negatively correlated with the HOMA-IR,and the ReHo value in right middle frontal gyrus was positively correlated with the duration of diabetes.In the group N,there was a positive correlation between the fALFF value in the lower frontal gyrus of the left Island cover and the eGFR,and the fALFF value in the left parietal bone except the superior border gyrus and the angular gyrus was positively correlated with HbA1 c,while in the left posterior central posterior gyrus,the value of fALFF was correlated with the HOMA-IR negatively.There was no significant correlation between the fALFF valueof abnormal brain area and the anxiety and depression score,the duration of diabetes and HOMA-?(P > 0.05).There was no significant correlation between the ReHo value of abnormal brain area and the anxiety and depression scores,eGFR,HbA1 c,HOMA-IR and HOMA-?(P > 0.05).Conclusions1.Compared to patients with non pain neuropathy,the patients with PDN were more severe in insulin resistance,depression and anxiety,and the quality of life was decreased.2.Multiple brain regions in patients with diabetic neuropathy showed abnormities in degree of neurons activity and synchrony.3.Patients with PDN,compared with those without pain,have several brain regions with abnormal activity(including somatosensory,cognitive,emotional and other related brain regions).4.The disease duration of diabetes,HbA1 c,HOMA-IR and eGFR are obviously related to abnormal spontaneous activity in some brain regions.