Abbreviation (ISO4): Chinese Journal of Alzheimer's Disease and Related Disorders
Editor in chief: Jun WANG
Chinese Journal of Alzheimer's Disease and Related Disorders >
Executive dysfunction and altered cerebral functional network in type 2 diabetes mellitus: a study of resting-state functional MRI
Received date: 2020-03-01
Revised date: 2020-04-09
Online published: 2020-06-25
Objective: To investigate the executive dysfunction and related alteration of cerebral functional network in patients with type 2 diabetes mellitus (T2DM) with neuropsychological assessments and resting-state functional magnetic resonance imaging (rs-fMRI). Methods: Thirty-nine T2DM patients and thirty-two healthy controls (HCs) were included. The Stroop word color test, Trail making test, Phonemic Fluency, and Digital span test were used to evaluate inhibition, shifting, initiation and working memory, respectively. The default mode network (DMN), salience network (SN), dorsal attention network (DAN) and executive control network (ECN), were extracted with rs-fMRI. Results: There was no significant difference in the global cognition between two groups (MMSE: T2DM: 28.30±0.27, HC: 28.84±0.26, P=0.156; MoCA: T2DM: 25.08±0.32, HC: 26.13±0.43, P=0.050). The patients with T2DM showed impairment in inhibition and shifting (Inhibition: T2DM: -45.79±3.24, HC: -32.40±2.85, P= 0.004; Shifting: T2DM: -52.23±5.02, HC: -30.63±4.00, P=0.002). There was no significant difference in initiation and working memory (Initiation: T2DM: 6.03±0.33, HC: 6.94±0.42, P=0.089; working memory: T2DM: 6.10±0.34, HC: 6.5±0.43, P=0.421). Compared to the NC group, the T2DM group showed decreased functional connectivity (FC) in DMN and ECN, and increased FC in SN. The performance in inhibition was positively correlated with the rs-FC in DMN and ECN, while the shifting was positively correlated with the rs-FC in DMN. Conclusion: These findings suggest that the executive dysfunction could occur at the stage of normal global cognition, and correlate with alteration of rs-FC in T2DM.
ZHU Rui , ZHOU Zhi , SHAO Wen , WANG Lei , DING Xuejiao , ZHANG Shujuan , WANG Yu , PENG Dantao . Executive dysfunction and altered cerebral functional network in type 2 diabetes mellitus: a study of resting-state functional MRI[J]. Chinese Journal of Alzheimer's Disease and Related Disorders, 2020 , 3(2) : 96 -101 . DOI: 10.3969/j.issn.2096-5516.2020.02.002
表1 人口学及神经心理学结果 |
项目 | 2型糖尿病 (n=40) Type 2 diabetes mellitus | 健康对照(n=32) Healthy controls | P |
---|---|---|---|
年龄Age | 65.20±0.75 | 62.97±1.28 | 0.120 |
性别 (男性,%) Gender (Male, %) | 27, 57.5% | 14, 43.8% | 0.246 |
受教育年限 Education level | 11.68±0.54 | 11.25±0.63 | 0.610 |
MMSE | 28.30±0.27 | 28.84±0.26 | 0.156 |
MoCA | 25.08±0.32 | 26.13±0.43 | 0.050 |
表2 T2DM组和对照组患者执行功能 |
项目 | 2型糖尿病 (n=40) Type 2 diabetes mellitus | 健康对照(n=32) Healthy controls | P | |
---|---|---|---|---|
Stroop色词试验(秒) Stroop color word test | A | 21.33±0.64 | 20.31±0.65 | 0.277 |
B | 28.48±1.02 | 26.56±1.42 | 0.266 | |
C | 70.69±3.49 | 55.84±3.10 | 0.003* | |
抑制功能:(A+B)/2-C Inhibition | -45.79±3.24 | -32.40±2.85 | 0.004* | |
连线试验(秒) Trail making test | A | 45.22±3.42 | 45.59±2.7 | 0.936 |
B | 97.46±6.87 | 76.21±4.13 | 0.015* | |
定势转换:A-B Flexibility | -52.23±5.02 | -30.63±4.00 | 0.002* | |
数字广度(个)Digital span | 工作记忆:倒背 Working memory:backward | 6.10±0.34 | 6.50±0.43 | 0.421 |
语音流畅性(个) Phonemic fluency | 任务启动 Initiation | 6.03±0.33 | 6.94±0.42 | 0.089 |
Note: * P< 0.05 |
表3 脑网络组间比较显著差异的脑区 |
网络 Network | 脑区 Brain areas | BA | 团块体素数量 Voxels | t | MNI | ||
---|---|---|---|---|---|---|---|
x | y | z | |||||
对照组>2型糖尿病组 | |||||||
默认网络 Default mode network | 右侧角回,右侧颞上回,右侧颞中回 Right angular gyrus, right superior and middle temporal gyrus | 21, 22, 39 | 44 | -6.765 | 45 | -60 | 21 |
执行控制网络 Executive control network | 右侧额中回,右侧背外侧前额叶 Right middle frontal gyrus, and right dorsal lateral prefrontal cortex | 8, 9 | 41 | -5.123 | 48 | 12 | 48 |
2型糖尿病组>对照组 | |||||||
凸显网络 Salience network | 右侧额叶前部,右侧前扣带回 Right anterior frontal cortex and anterior cingulate cortex | 10, 32 | 18 | 4.716 | 12 | 51 | 12 |
注:*BA: brodmann分区;MNI:蒙特利尔神经研究所。 |
表4 2型糖尿病网络内rs-FC改变与执行功能的相关性 |
项目 | 抑制 Inhibition | 定势转换 Flexibility | 任务启动 Initiation | 工作记忆 Working memory | |
---|---|---|---|---|---|
默认网络 Default mode network | r | 0.320 | 0.178 | 0.194 | 0.148 |
P | 0.045* | 0.271 | 0.231 | 0.362 | |
执行控制网络 Executive control network | r | 0.339 | 0.402 | 0.168 | 0.298 |
P | 0.032* | 0.010* | 0.301 | 0.062 | |
凸显网络 Salience network | r | 0.153 | 0.126 | 0.088 | 0.279 |
P | 0.345 | 0.440 | 0.590 | 0.081 |
注: * P< 0.0。 |
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