Intranasal Insulin Enhanced Resting-State Functional Connectivity of Hippocampal Regions in Type 2 Diabetes
Intranasal Insulin Enhanced Resting-State Functional Connectivity of Hippocampal Regions in Type 2 Diabetes
复制标题
鼻内胰岛素增强 2 型糖尿病海马区静息态功能连接
DOI：
10.2337/db14-1000
复制
发表时间：
2015-03-01
期刊：
影响因子：
7.7
通讯作者：
Novak, Vera
中科院分区：
文献类型：
--
作者：
Zhang, Hui;Hao, Ying;Novak, Vera
2型糖尿病（T2DM）改变脑功能，表现为脑萎缩。鼻内胰岛素已成为治疗认知障碍的一种有前途的干预措施。我们评估了鼻内胰岛素对老年T2DM患者静息态脑功能连接的急性影响。这项概念验证、随机、双盲、安慰剂对照研究评估了单剂40 IU胰岛素或生理盐水对14名糖尿病受试者和14名对照受试者的影响。静息状态下海马区和默认模式网络（DMN）之间的功能连接使用功能性MRI（fMRI）在3特斯拉进行定量。胰岛素给药后，糖尿病患者表现出海马区域和内侧额叶皮质（MFC）之间的静息态连接增加，与安慰剂（集群大小：右，P = 0.03）和其他DMN区域相比。在安慰剂组中，糖尿病组与对照组相比，海马区和MFC之间的连接性较低（聚类大小：右，P = 0.02），但在胰岛素组中，MFC连接性与对照组相似。静息状态连接与认知表现相关。单剂量鼻内胰岛素可增加老年T2DM患者海马区和多个DMN区之间的静息态功能连接。鼻内胰岛素给药可能会改变调节记忆和复杂认知行为的脑区之间的功能连接。
Type 2 diabetes mellitus (T2DM) alters brain function and manifests as brain atrophy. Intranasal insulin has emerged as a promising intervention for treatment of cognitive impairment. We evaluated the acute effects of intranasal insulin on resting-state brain functional connectivity in older adults with T2DM. This proof-of-concept, randomized, double-blind, placebo-controlled study evaluated the effects of a single 40 IU dose of insulin or saline in 14 diabetic and 14 control subjects. Resting-state functional connectivity between the hippocampal region and default mode network (DMN) was quantified using functional MRI (fMRI) at 3Tesla. Following insulin administration, diabetic patients demonstrated increased resting-state connectivity between the hippocampal regions and the medial frontal cortex (MFC) as compared with placebo (cluster size: right, P = 0.03) and other DMN regions. On placebo, the diabetes group had lower connectivity between the hippocampal region and the MFC as compared with control subjects (cluster size: right, P = 0.02), but on insulin, MFC connectivity was similar to control subjects. Resting-state connectivity correlated with cognitive performance. A single dose of intranasal insulin increases resting-state functional connectivity between the hippocampal regions and multiple DMN regions in older adults with T2DM. Intranasal insulin administration may modify functional connectivity among brain regions regulating memory and complex cognitive behaviors.