| Objective:This study aimed at using resting-state functional magnetic resonance imaging(rs-fMRI)to inspect the changes of brain function in patients with type 2 diabetes mellitus.At the same time,we were exploring the application value of amplitude of low-frequency fluctuation(ALFF),fractional ALFF(fALFF),regional homogeneity(ReHo)and the strength of functional connectivity(FC)in patients with T2 DM or diabetic encephalopathy.The resting-state functional magnetic resonance imaging might help to evaluate mild cognitive function impairment of patients with T2 DM and provide some evidence of early clinical diagnosis of diabetic encephalopathy.Materials and Methods:All type 2 diabetes mellitus patients were recruited from the Department of Endocriology of Affiliated Hospital of Taishan Medical University from Jan,2014 to Jan,2016,who were divided into two groups(T2DM group and T2 DR group).Besides,we also recruited age-and gender-matched normal controls from Outpatient Department.All the participants received MMSE score test,conventional brain MRI and rs-fMRI scans.After that,all MR images were preprocessed and analyzed by specific softwares(MatLab,Rest,Dparsf,Photoshop)in order to calculate the ALFF/fALFF/ReHo and FC value and were applied statistical analysis.We compared the differentiation of ALFF/fALFF/ReHo/FC between T2 DM and normal control,and between T2 DM and T2 DR to inspect the significantly activated brain regions.Pearson's Correlation method was utilized to analyze the correlation among MMSE scores,the functional parameters and clinical statistics.Results:One-sample t-test results showed that the ALFF/fALFF/ReHo value which were above the average base-line mainly occured in DMN areas in all three groups.Two-sample t-test results indicated that the left inferior temporal gyrus,bilateral orbital-frontal gyrus,inferior parietal cortex,right fusiform gyrus,lingual gyrus in T2 DM groups had functional changes,and the left middle temporal gyrus,left precuneus,right superior orbital-frontal gyrus,bilateral posterior cerebellum lobe and supplementary motor area in T2 DR group existed activity alterations.Correlation analysis indicated that some of the alterations in DMN areas were closely correlated with courses of disease,blood glucose level and HbA1 c.For example,the ALFF value in left medial frontal gyrus,left precuneus and PCC of T2 DM group were positively correlated with courses,while the ALFF value in the left hippocampus and right superior medial frontal gyrus were inversely correlated with blood glucose level,further more,the ReHo value in the left superior medial frontal gyrus and PCC showed negatively correlation with HbA1 c.We also found that the strength of FC mainly appeared in the left hippocampus and left PCC.An inversely correlation was found between the HbA1 c and FC in the left precuneus and right frontal gyrus,as well as between the blood glucose level and the FC in the left posterior cerebellum lobe and bilateral temporal gyrus.Besides,a negatively correlation also found between the MMSE scores and courses of disease,as well as between the MMSE scores and the FC in the left precuneus and right frontal gyrus.Conclusion:Early brain functional changes could occur in patients with type 2 diabetes mellitus which largely associated with the brain's default mode network.Most of the effected brain regions represented a disturbed spontaneous neuronal activities.Courses of disease,blood glucose and HbA1 c had an impact on DMN areas.What's more,we found that blood glucose has a great influence on the hippocampus.The combination of ALFF/fALFF/ReHo value and the strength of FC can be used to evaluate the brain function changes in patients with T2 DM,where also can be used to reflect and discover early brain dysfunction. |
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