2型糖尿病患者下丘脑功能连接的静息态功能磁共振研究

目的利用静息态功能磁共振技术探索2型糖尿病(T2DM)患者下丘脑与其他脑区功能连接的改变,明确T2DM是否损伤下丘脑的相关功能连接。材料与方法本研究共纳入59名T2DM患者及49名对照组志愿者,通过德国西门子MR仪采集T1WI、T2WI、T2压水序列、高分辨率3D T1WI结构像和静息态功能数据,计算下丘脑与全脑体素的功能连接值并进行组间比较,然后提取组间存在显著差异脑区的功能连接平均值并对其与临床数据进行相关性分析。结果 T2DM患者左、右侧下丘脑与右侧桥脑、左背外侧前额叶、眶额皮层、左顶下小叶、右侧枕中回间的功能连接强度均低于正常组(P0.05)。除此之外,左侧下丘脑与左侧梭状回、右侧颞下回、左侧楔前叶间的功能连接强度显著减低,左侧下丘脑与左侧岛叶间的功能连接强度显著增高(P0.05);右侧下丘脑与左侧舌回、右侧中央前回/右侧中央后回间的功能连接强度显著减低(P0.05)。相关性分析结果显示左侧下丘脑-左背外侧前额叶间功能连接强度的减低与糖化血红蛋白值存在负相关性(r=–0.24,P=0.04)。结论 T2DM损害了下丘脑与多个脑区的功能连接,其中同侧下丘脑与背外侧前额叶间功能连接减低与糖尿病严重程度相关。静息态功能磁共振能够反映2型糖尿病的严重程度。

The functional connectivity of hypothalamus in T2DM patients:a resting-state fMRI study

Objective: To investigate whether functional connection between hypothalamus and other brain regions is impaired in type 2 diabetes mellitus (T2DM), the resting-state MRI was utilized to analyze the connectivity between hypothalamus and other brain regions. Materials and Methods:This study included the T2DM patients who were diagnosed within 1-5years (T2DM, n=59), and age, sex, education-matched healthy control subjects(HC, n=49). T2WI, FLAIR, 3D-T1WI and resting-state fMRI data were collected by Siemens MR scanner. Functional connection values between bilateral hypothalamus and other voxels in the brain were calculated, the resulted values of both groups were compared using two-sample t-test to locate the regions with significant change. Then correlation analysis was conducted between clinical data and functional connection values extracted from significantly different brain regions. Results:Compared to healthy control subjects, T2DM patients showed significantly decreased functional connection values between left hypothalamus, right hypothalamus and right brainstem, left dorsolateral prefrontal cortex, orbitofrontal cortex, left Inferior parietal lobule, right middle occipital gyrus. In T2DM patients, functional connection values between left hypothalamus and inferior temporal gyrus, left precuneus, left fusiform also decreased significantly, however, the functional connection values in left insula increased;the functional connection values between right hypothalamus and left lingual gyrus, right precentral gyrus/postcentral gyrus decreased. Moreover, negative correlations were found between HbA1c and functional connection values between left hypothalamus and left dorsol ateral prefrontal cortex (r=–0.24, P=0.04) in T2DM patients group. Conclusion:The functional connection between hypothalamus and other brain regions is impaired in T2DM patients. Moreover, this study indicated that the change of functional connection values between left dorsolateral prefrontal cortex and left hypothalamus was significantly associated with diabetes mellitus severity. Resting-state MRI can reflect the severity of T2DM.