Large-Scale Neuronal Network Dysfunction in Diabetic Retinopathy
Large-Scale Neuronal Network Dysfunction in Diabetic Retinopathy
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糖尿病视网膜病变中的大规模神经元网络功能障碍
DOI：
10.1155/2020/6872508
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发表时间：
2020-01-22
影响因子：
3.1
通讯作者：
Shen, Yin
中科院分区：
文献类型：
--
作者：
Huang, Xin;Tong, Yan;Shen, Yin
糖尿病视网膜病变（DR）患者认知能力下降和痴呆的风险增加。越来越多的证据表明，大脑特定功能和结构的变化与 DR 患者的认知障碍有关。然而，对于 DR 患者的静息态网络 (RSN) 功能结构是否发生变化，人们知之甚少。本研究的目的是利用独立成分分析（ICA）研究 DR 患者 RSN 变化的网络内功能连接（FC）和功能网络连接（FNC）。年龄、性别和教育程度密切匹配的 34 名 DR 患者（18 名男性和 16 名女性；平均年龄为 53.53 ± 8.67 岁）和 38 名非糖尿病健康对照者 (HC)（15 名男性和 23 名女性；平均年龄为 48.63 ± 11.83 岁）接受了静息态磁共振成像扫描。应用 ICA 提取 9 个 RSN。然后，进行双样本 t 检验来调查两组之间 9 个 RSN 内的不同网络内 FC。 FNC 工具箱用于评估 RSN 之间的相互作用。采用 Pearson 相关分析来探讨 DR 组中网络内 FC 与临床变量之间的关系。绘制受试者工作特征 (ROC) 曲线来评估 RSN 的网络内 FC 区分两组的能力。与HC组相比，DR患者的基底神经节网络（BGN）、视觉网络（VN）、腹侧默认模式网络（vDMN）、右执行控制网络（rECN）、显着性网络（SN）、左执行控制网络（lECN）、听觉网络（AN）和背侧默认模式网络（dDMN）内的网络内FC显着减少。此外，FNC分析显示，相对于HC组，DR组中VN-BGN、VN-vDMN、VN-dDMN、vDMN-lECN、SN-BGN、lECN-dDMN和AN-BGN FNC增加。此外，RSN 的网络内 FC 的改变与 DR 患者的糖化血红蛋白 (HbA1c) 水平显着相关。 ROC 曲线显示，RSN 的这些特定网络内 FC 能够以高度的敏感性和特异性区分两组。我们的研究强调，DR 患者在低水平知觉和高阶认知网络中普遍存在缺陷。我们的研究结果为 DR 患者视力丧失和认知能力下降的神经机制提供了重要的见解。
Diabetic retinopathy (DR) patients are at an increased risk of cognitive decline and dementia. There is accumulating evidence that specific functional and structural architecture changes in the brain are related to cognitive impairment in DR patients. However, little is known regarding whether the functional architecture of resting-state networks (RSNs) changes in DR patients. The purpose of this study was to investigate the intranetwork functional connectivity (FC) and functional network connectivity (FNC) of RSN changes in DR patients using independent component analysis (ICA). Thirty-four DR patients (18 men and 16 women; mean age, 53.53 ± 8.67 years) and 38 nondiabetic healthy controls (HCs) (15 men and 23 women; mean age, 48.63 ± 11.83 years), closely matched for age, sex, and education, underwent resting-state magnetic resonance imaging scans. ICA was applied to extract the nine RSNs. Then, two-sample t-tests were conducted to investigate different intranetwork FCs within nine RSNs between the two groups. The FNC toolbox was used to assess interactions among RSNs. Pearson correlation analysis was conducted to explore the relationship between intranetwork FCs and clinical variables in the DR group. A receiver operating characteristic (ROC) curve was conducted to assess the ability of the intranetwork FCs of RSNs in discriminating between the two groups. Compared to the HC group, DR patients showed significant decreased intranetwork FCs within the basal ganglia network (BGN), visual network (VN), ventral default mode network (vDMN), right executive control network (rECN), salience network (SN), left executive control network (lECN), auditory network (AN), and dorsal default mode network (dDMN). In addition, FNC analysis showed increased VN-BGN, VN-vDMN, VN-dDMN, vDMN-lECN, SN-BGN, lECN-dDMN, and AN-BGN FNCs in the DR group, relative to the HC group. Furthermore, altered intranetwork FCs of RSNs were significantly correlated with the glycosylated hemoglobin (HbA1c) level in DR patients. A ROC curve showed that these specific intranetwork FCs of RSNs discriminated between the two groups with a high degree of sensitivity and specificity. Our study highlighted that DR patients had widespread deficits in both low-level perceptual and higher-order cognitive networks. Our results offer important insights into the neural mechanisms of visual loss and cognitive decline in DR patients.