ANALYSIS OF RS-FMRI IMAGES CLARIFIES BRAIN ALTERATIONS IN TYPE 2 DIABETES MELLITUS PATIENTS WITH COGNITIVE IMPAIRMENT

Type 2 Diabetes Mellitus (T2DM) increases the risk of cognitive impairment (CI); however, the underlying pathophysiological mechanisms are still not well understood. We propose to clarify the altered spontaneous brain activity and functional connectivity implicated in CI of T2DM by analyzing resting state functional MRI (rs-fMRI) data. Totally 22 T2DM patients with cognitive impairment (T2DM-CI) and 31 T2DM patients with normal cognition (T2DM-NC) are included in this study. The whole brain amplitude of low frequency fluctuation (ALFF) value, regional homogeneity (ReHo) value and functional connectivity (FC) analysis using posterior cingulate cortex (PCC) as a seed region are investigated through comparison between groups of T2DM-CI and T2DM-NC. It is found that, compared with T2DM-NC, T2DM-CI demonstrates the decreased ALFF in the regions of precuneus, posterior cingulate gyrus, middle occipital gyrus and left superior/middle frontal gyrus, but the increased ALFF in the left middle frontal gyrus and left superior temporal gyrus. In T2DM-CI, ReHo decreases in bilateral posterior cingulate gyrus, right precuneus, right inferior frontal gyrus, but increases in the middle frontal gyrus and right superior occipital gyrus. Higher FC between PCC and bilateral inferior parietal lobule and right middle/inferior frontal gyrus, lower FC between PCC and bilateral precuneus and right superior frontal gyrus are observed in T2DM-CI group. Compared with T2DM-NC, patients with T2DM-CI have presented altered ALFF, ReHo and FC in and between important brain regions. The observed alterations are thought to be implicated with cognitive impairment of T2DM as the potential imaging pathophysiological basis.