2型糖尿病患者工作记忆相关脑区的无效率激活  

Inefficient activity in working memory related brain regions in patients with type 2 diabetes mellitus

作　　者：张会美 李威[1] 张扬[1] 卢山[2] 李楠[1] 倪长林[2] 张权[1] 

机构地区：[1]天津医科大学总医院放射科天津市功能影像重点实验室,天津300052 [2]天津医科大学代谢病医院,天津300060

出　　处：《中国临床医学影像杂志》2015年第5期313-316,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨2型糖尿病(T2DM)患者工作记忆相关脑区的激活改变,及其可能的神经机制。方法:对21例T2DM患者及21名正常对照受试者进行数字1-back任务下的f MRI实验。采用SPM8软件进行数据预处理和统计分析,组内分析采用单样本t检验,组间比较采用双样本t检验,统计阈值均设定为P<0.01(Alpha Sim校正)。将组间差异区的BOLD信号变化百分比与工作记忆任务的反应时间及糖化血红蛋白之间进行相关分析。结果:T2DM组的空腹血糖和糖化血红蛋白明显高于对照组(P<0.001),1-back任务的正确率明显低于对照组(P<0.05)。在1-back任务下,T2DM组的双侧前额叶腹外侧及背外侧、右侧后顶叶皮层的激活强度明显高于对照组(P<0.01),左侧顶下小叶和右侧额上回的负激活程度明显低于对照组(P<0.01)。双侧前额皮层背外侧的激活强度与1-back任务的反应时间明显负相关(P<0.05)。结论:T2DM患者存在工作记忆能力损害,工作记忆相关脑区以过度激活的模式对工作记忆能力进行有限的代偿。Objective： To investigate the altered activity of working memory related brain regions in patients with type 2 diabetes mellitus （T2DM）, and the possible neural mechanisms. Methods： Twenty-one T2DM patients and 21 normal subjects received functional MRI（fMRI） scanning with a 1-back working memory（WM） task in this study. The fMRI data were prepro- cessed using SPMS. One-sample t-test and two-sample t-test were used to analyze the WM related brain activity within and between groups, respectively. Statistical thresholds were set at P〈0.01 （AlphaSim correction）. BOLD percent signal change（PSC） of regions with intergroup difference was calculated and the correlation analyses were performed between the PSC and the re- sponse time （RT） of 1-back task and glycosylated hemoglobin level. Results： The fasting plasma glucose and glycosylated hemoglobin level were significantly higher in T2DM patients than controls （P〈0.001）, and accuracy of 1-back task was signifi- candy lower than that of controls （P〈0.05）. Compared to, the controls, T2DM patients showed significantly higher activation in the bilateral dorsolateral and ventrolateral prefrontal cortex and the right posterior parietal cortex （P〈0.01）, and significantly lower deactivation in the left inferior parietal lobule and the right superior frontal gyrus （P〈0.01）. Significant negative correla- tions were found between the PSC of the bilateral dorsolateral prefrontal cortex and the RT in T2DM group（P〈0.05）. Conclu- sion： Hyperactivation of the WM related brain regions may have a limited compensation for the decreased WM behavior in T2DM patients.

关 键 词：糖尿病 2型 认知障碍 磁共振成像 

分 类 号：R587.1[医药卫生—内分泌] R749.2[医药卫生—内科学]