White Matter Microstructural Change Contributes to Worse Cognitive Function in Patients With Type 2 Diabetes
White Matter Microstructural Change Contributes to Worse Cognitive Function in Patients With Type 2 Diabetes
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白质微观结构变化导致 2 型糖尿病患者认知功能恶化
DOI：
10.2337/db19-0233
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发表时间：
2019-11-01
期刊：
影响因子：
7.7
通讯作者：
Zhang, Zhanjun
中科院分区：
文献类型：
--
作者：
Gao, Shudan;Chen, Yaojing;Zhang, Zhanjun
2型糖尿病（T2 DM）患者发生痴呆的风险相当高，尤其是轻度认知障碍（MCI）患者。研究2型糖尿病合并遗忘型MCI（T2 DM-aMCI）和2型糖尿病认知功能正常（T2 DM-NC）患者脑内白色物质（WM）的微结构变化及其与认知功能的关系，有助于了解2型糖尿病相关性遗忘型认知功能障碍的脑内变化。在本研究中，36例T2 DM-aMCI患者、40例T2 DM-NC患者和40例健康对照（HC）个体接受了弥散张量成像和T1加权MRI扫描以及综合认知评估。所有这些认知功能在患者中表现出组间排名差异。T2 DM-NC患者和HC个体在WM完整性方面没有显示任何显著差异。与HC和T2 DM-NC相比，T2 DM-aMCI患者在多个WM束中显示出破坏的完整性。具体而言，在T2 DM患者中，右下额枕束和右下纵束的WM完整性受损与情景记忆和注意力功能受损显著相关。此外，认知功能障碍相关的WM微结构损伤与受影响的WM束连接的皮质变性有关。这些结果表明，变性广泛存在于WM束在T2 DM-aMCI，而没有脑WM损害是明显的T2 DM-NC。
Patients with type 2 diabetes mellitus (T2DM) have a considerably high risk of developing dementia, especially for those with mild cognitive impairment (MCI). The investigation of the microstructural change of white matter (WM) between T2DM with amnesic MCI (T2DM-aMCI) and T2DM with normal cognition (T2DM-NC) and their relationships to cognitive performances can help to understand the brain variations in T2DM-related amnesic cognitive impairment. In the current study, 36 T2DM-aMCI patients, 40 T2DM-NC patients, and 40 healthy control (HC) individuals underwent diffusion tensor image and T1-weighted MRI scans and comprehensive cognition assessments. All of these cognitive functions exhibited intergroup ranking differences in patients. The T2DM-NC patients and HC individuals did not reveal any significant differences in WM integrity. The T2DM-aMCI patients showed disrupted integrity in multiple WM tracts compared with HC and T2DM-NC. Specifically, the damaged WM integrity of the right inferior fronto-occipital fasciculus and the right inferior longitudinal fasciculus exhibited significant correlations with episodic memory and attention function impairment in T2DM patients. Furthermore, cognitive impairment-related WM microstructural damage was associated with the degeneration of cortex connected to the affected WM tract. These findings indicate that degeneration exists extensively in WM tracts in T2DM-aMCI, whereas no brain WM damage is evident in T2DM-NC.