摘要
目的通过局部一致性(regional homogeniety,ReHo)联合基于种子点的功能连接(functional connectivity,FC)方法,探讨早期糖尿病肾病患者脑功能改变情况。材料与方法前瞻性招募了88例2型糖尿病患者,依据尿白蛋白/肌酐比值(urinary albumin-to-creatinine ratio,UACR)分为早期糖尿病肾病组(n=39)和糖尿病不伴肾病组(n=49)。收集所有受试者的临床资料并且通过蒙特利尔认知评估(Montreal Cognitive Assessment,MoCA)和简易智力状态检查量表(Mini-mental State Examination,MMSE)对他们进行认知功能测试。采集静息态功能磁共振成像数据,通过ReHo联合基于种子点的FC方法,分析两组参与者之间脑功能的差异。最后,将UACR和差异脑区的影像指标值分别与临床认知量表进行偏相关性分析。结果在认知表现方面,早期糖尿病肾病患者MoCA得分(t=-5.58,P<0.001)和MMSE得分(t=-2.68,P=0.016)相比于糖尿病不伴肾病患者显著降低。在神经影像学方面,早期糖尿病肾病患者在右侧枕中回ReHo值减低(P<0.05,FWE校正),提取此区作为感兴趣区进行全脑FC发现,其与左侧丘脑的功能连接增强(P<0.05,FWE校正)。偏相关分析结果显示,早期糖尿病肾病患者MoCA得分与右侧枕中回ReHo值呈正相关(r=0.349,P=0.043)、与左侧丘脑FC值呈负相关(r=-0.464,P=0.006);MMSE得分与右侧枕中回ReHo值呈正相关(r=0.367,P=0.033)、与左侧丘脑FC值呈负相关(r=-0.455,P=0.007);UACR与MoCA得分呈负相关(r=-0.449,P=0.008)、与MMSE得分呈负相关(r=-0.372,P=0.030)。而在糖尿病非肾病组中UACR、脑功能影像差异指标以及认知量表得分之间无显著相关性。结论结果表明早期糖尿病肾病患者在视觉信息处理相关脑区的神经活动异常,并且这些脑区功能整合的不平衡还可能加重认知能力的损害。
Objective:To explore the impact of early diabetic kidney disease on cerebral function using regional homogeneity(ReHo)and seed-based functional connectivity(FC).Materials and Methods:A total of 88 type 2 diabetes patients were prospectively recruited and divided into an early diabetic kidney disease group(n=39)and a diabetes without kidney disease group(n=49)based on the urinary albumin-to-creatinine ratio(UACR).The clinical symptoms for all participants were also collected and their cognitive scales were assessed using the Montreal Cognitive Assessment(MoCA)and the Mini-mental State Examination(MMSE).Moreover,resting state functional magnetic resonance imaging data were collected,and the cerebral functional differences between the two groups were analyzed using ReHo and seed-based FC.The partial correlation analysis was performed to identify the correlation of UACR,cognitive scores,and the brain functional imaging indices.Results:In terms of cognitive performance,the scores of MoCA(t=−5.58,P<0.001)and MMSE(t=−2.68,P=0.016)in the early diabetic kidney disease group decreased significantly compared to diabetic patients without kidney disease.Regarding neuroimaging findings,significant differences in ReHo values were found in the right middle occipital gyrus(P<0.05,FWE correction).Using this region as a seed point for whole-brain FC analysis,it was found that there was an enhanced FC with the left thalamus(P<0.05,FWE correction).Partial correlation analysis results showed that in patients with early diabetic kidney disease,MoCA scores were positively correlated with ReHo values in the right middle occipital gyrus(r=0.349,P=0.043)and negatively correlated with FC values in the left thalamus(r=−0.464,P=0.006).Similarly,MMSE scores were positively correlated with ReHo values in the right middle occipital gyrus(r=0.367,P=0.033)and negatively correlated with FC values in the left thalamus(r=−0.455,P=0.007).Additionally,UACR was negatively correlated with MoCA scores(r=−0.449,P=0.008)and MMSE scores(r=−0.372,
作者
何淼
季冰
程立庆
许昌华
王健
HE Miao;JI Bing;CHENG Liqing;XU Changhua;WANG Jian(7T Magnetic Resonance Translational Medicine Research Center,Department of Radiology,Southwest Hospital,Army Medical University(Third Military Medical University),Chongqing 400038,China;Department of Endocrinology and Metabolism,Southwest Hospital,Army Medical University(Third Military Medical University),Chongqing 400038,China)
出处
《磁共振成像》
CAS
CSCD
北大核心
2024年第10期62-68,共7页
Chinese Journal of Magnetic Resonance Imaging
基金
国家自然科学基金项目(编号:81971587)。
关键词
糖尿病肾病
认知障碍
局部一致性
功能连接
静息态功能磁共振成像
diabetic nephropathy
cognitive impairment
regional homogeniety
functional connectivity
resting-state functional magnetic resonance imaging
