[EASD2013]大脑活动改变或可解释T2DM患者的认知功能受损
发布时间：2013-10-09 | 来源：医脉通
关键词：
2型糖尿病
认知
大脑功能
EASD2013
第49届欧洲糖尿病研究协会年会(EASD2013)于9月23-27日在西班牙巴塞罗那召开。当地时间9月24日下午，在“Neuropathy: peripheral and central mechanisms and outcomes”口头报告专场上，我国东南大学医学院孙子林教授团队介绍的一项研究表明，2型糖尿病患者大脑的很多区域低频波动幅度发生改变，导致神经认知差和代谢后果。
东南大学医学院博士研究生夏文清作为大会发言代表，在报告中提到，2型糖尿病患者大脑的低频波动幅度与神经认知能力不佳、持续严重高血糖状态和胰岛β细胞功能受损相关。
本次研究结果表明，年龄45至70岁的2型糖尿病患者（n = 28）双侧颞中回、左梭状回、左枕中回和右下枕中回的波动值显著低于健康对照组（n = 29 ）。
这些异常值可能是潜在的标志物，可识别与2型糖尿病相关的认知能力下降。
2型糖尿病患者与健康对照组相比，能力降低 [Rey-Osterrieth复杂图形检测、连线检测-B和画钟试验测试]（P <0.05）。这些变化表明，2型糖尿病患者有多层面的认知能力下降。
此外，2型糖尿病患者皮质和皮质下区域包括双侧小脑后叶、右侧小脑嘴峰和岛叶的低频率波动值幅度增加。
患者的颞中回波动值与糖化血红蛋白（P =0.026）和连线测验B评分（ P =0.016）存在负相关。然而，颞中回波动值与C -肽水平（P = 0.023）、更新的稳态模型评估法（HOMA）所估计的稳态β细胞功能（P =0.016）呈正相关。
夏文清博士表示，最重要的是， 功能性磁振造影研究(resting-state functional MRI)可能能够在2型糖尿病患者出现异常行为表现之前，跟踪到极早期脑功能改变的进展情况。
现场视频
研究摘要
| Altered baseline brain activity in type 2 diabetes: a resting-state fMRI study |
Background and aims: Type 2 diabetes mellitus (T2DM) has been associated with cognitive impairment, such as mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Our study aims to investigate whether there exists altered baseline brain activity in T2DM patients using resting-state functional magnetic resonance imaging (rs-fMRI).
Materials and methods: T2DM patients (n=28) were compared with nondiabetic age-, sex-, and education-matched control subjects (n=29) using rs-fMRI. We computed amplitude of low-frequency fluctuations (ALFF) of fMRI signal to measure the spontaneous neuronal activity, and detect the relationship between rs-fMRI information and clinical data.
Results: Compared with healthy controls, T2DM patients had significantly decreased ALFF values in bilateral middle temporal gyrus (MTG), left fusiform gyrus, left middle occipital gyrus, right inferior occipital gyrus; and increased ALFF values in both cortical and subcortical regions, including the bilateral cerebellum posterior lobe, right cerebellum culmen, and insula lobe. Moreover, we found an inverse correlation between the ALFF values in the middle temporal gyrus and both the HbA1c (r= -0.420, p= 0.026) and the score of Trail Making Test-B (TMT-B) (r= -0.451, p= 0.016) in the patient group. On the other hand, C-peptide level and HOMA2-%ß has positive correlation(r= 0.429, p= 0.023; r=0.453, p=0.016, respectively) with the ALFF value in the middle temporal gyrus.
Conclusion: The present study provides evidence that T2DM patients have altered ALFF in many brain regions, which links with poor neurocognitive performances, the severity of consistent hyperglycemic state and the impaired ß-cell function. Abnormal ALFF values in MTG may be regarded as a potential marker to identify cognitive decline associated with T2DM. Those findings may contribute to further understanding of neurological pathophysiology underlying T2DM, and present some enlightenment to clinical diagnosis in the future
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