Connecting Peripheral to Central Neuropathy: Examination of Nerve Conduction Combined with Olfactory Tests in Patients with Type 2 Diabetes.
Connecting Peripheral to Central Neuropathy: Examination of Nerve Conduction Combined with Olfactory Tests in Patients with Type 2 Diabetes.
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DOI：
10.2147/dmso.s312021
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Bi Y
中科院分区：
文献类型：
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作者：
Ni W;Zhang Z;Zhang B;Zhang W;Cheng H;Miao Y;Chen W;Liu J;Zhu D;Bi Y
很少有研究调查糖尿病周围神经病变（DPN）与认知能力下降之间的关联。嗅觉障碍与神经退行性疾病和 2 型糖尿病 (T2DM) 有关；然而，DPN 患者的认知改变以及嗅觉功能在 DPN 中的作用尚不清楚。我们探讨了 DPN 认知的改变以及神经病变参数与认知和嗅觉的关联。健康对照 (HC) 和 T2DM 患者接受了神经传导测试、详细的认知评估、嗅觉行为测试和气味诱导的功能磁共振成像 (fMRI)。 T2DM 患者分为两组（非 DPN [NDPN] 和 DPN）。选择两组之间显示不同激活的嗅觉大脑区域进行功能连接（FC）分析。还生成了结构方程模型（SEM）来证明认知、嗅觉和神经病变参数之间的关联。一百名个体（36 名 HC、36 名 NDPN 和 28 名 DPN）在年龄、性别和教育水平上进行了匹配。与NDPN组相比，DPN组的记忆和处理速度得分显着较低，嗅觉识别和记忆得分也较低，左额叶激活减少，右侧岛叶基于种子的功能连接减少。 T2DM 患者的神经传导速度与认知功能相关。神经传导和执行功能之间的关联是由嗅觉行为介导的。 DPN患者在记忆和处理速度方面的认知能力比NDPN患者差。认知功能障碍可以通过嗅觉行为测试和电生理检查来预测。
Few studies have investigated the associations between diabetic peripheral neuropathy (DPN) and cognitive decline. Olfactory impairment is related to neurodegenerative diseases and type 2 diabetes mellitus (T2DM); however, the cognitive alterations of patients with DPN and the role of olfactory function in DPN are not known. We explored alterations in cognition with DPN and the associations of neuropathy parameters with cognition and olfaction. Healthy controls (HCs) and patients with T2DM underwent nerve-conduction tests, detailed cognitive assessment, olfactory-behavior tests, and odor-induced functional magnetic resonance imaging (fMRI). T2DM patients were divided into two groups (non-DPN [NDPN] and DPN). Olfactory brain regions showing different activation between the two groups were selected for functional connectivity (FC) analyses. A structural equation model (SEM) was also generated to demonstrate the association among cognition, olfactory, and neuropathy parameters. One hundred individuals (36 HCs, 36 NDPN, and 28 DPN) were matched for age, sex, and educational level. Compared with the NDPN group, the DPN group had significantly lower scores for memory and processing speed, as well as lower olfactory identification and memory scores, decreased activation of the left frontal lobe, and reduced seed-based functional connectivity in the right insula. The nerve conduction velocity in patients with T2DM was associated with cognitive functions. The association between nerve conduction and executive function was mediated by olfactory behavior. Patients with DPN had worse cognition than the NDPN patients in the domains of memory and processing speed. Cognitive dysfunction could be predicted by olfactory-behavior tests and electrophysiological examination.