2型糖尿病患者早期认知功能障碍弥散峰度成像研究

目的:采用弥散峰度成像技术分析2型糖尿病(T2DM)患者早期认知功能障碍的全脑弥散结构改变,并分析其与认知行为学及临床实验室指标的相关性,为T2DM患者早期认知功能障碍的诊断与治疗提供有力的影像学依据.方法:对18例早期无其它并发症的T2DM患者组及19例种族、性别、年龄、受教育年限相匹配的正常对照组(HC)进行DKI...

DKI study of early cognitive impairment in patients with type 2 diabetes mellitus

Objective:To investigate the alterations of whole brain diffusion structures of early cognitive impairment in type 2 diabetes mellitus(T2DM)patients by using diffusion kurtosis imaging(DKI),and to analyze its correlations with cognitive behavior and clinical laboratory indicators,so as to provide powerful imaging basis for diagnosis and treatment of early cognitive impairment in T2DM patients.Methods:DKI data were collected from 18 T2DM patients without other complications and 19 normal controls(HC)matched with race,gender,age and education years.The differences of DKI kurtosis and diffusion parameter values of whole-brain voxels between the two groups were automatically analyzed by voxel-based analysis(VBA)method,as well as the correlations with clinical variables and cognitive function scores were evaluated.Results:Compared with HC group,MK values of T2DM group in the left limbic lobe,lingual gyrus,precuneus,splenium of corpus callosum,parahippocampal gyrus and the hippocampus,the left fusiform gyrus,left inferior occipital gyrus,middle occipital gyrus,inferior temporal gyrus,right fusiform gyrus,left cerebellum posterior lobe,left cerebellum crus area significantly increased(P<0.01),these results were attributed to an increase in AK and/or RK values.The results of kurtosis parameters values were more than those of diffusion parameters values.The results of correlation analysis showed that the AD values of the right lentiform nucleus in the T2DM group were significantly positively correlated with the MMSE scores(r=0.53,P=0.02),the MD values of the right limbic lobe and the parahippocampal gyrus were negatively correlated with the MMSE scores(r=-0.41,P=0.09),and the RK values of the right precuneus were significantly negatively correlated with the HbA1c values(r=-0.47,P=0.04).Conclusion:The diffusion structural abnormalities of limbic system and other cognitive-related brain areas are the underlying mechanisms of early cognitive impairment in T2DM patients,abnormal AD values in the right lentiform nucleus and MD values in the right limbic lobe and parahippocampa gyrus are associated with cognitive impairment,increased RK values in the right precuneus suggest that the patients are in the compensatory stage of cognitive impairment,the level of HbA1c can influence whole brain micro-structure.