2型糖尿病视网膜病变患者静息态功能磁共振认知控制网络研究  

Resting-state Functional Magnetic Resonance Imaging Study on Cognitive Control Network in Patients with Type 2 Diabetic Retinopathy

作　　者：张春柱 赫义兰 接传红[1] 王建伟[1] 姜颖群 吕喆 胡津赫 杨剑英[1] 杨丹[1] 高倩 那旭[2] ZHANG Chunzhu;HE Yilan;JIE Chuanhong;WANG Jianwei;JIANG Yingqun;LV Zhe;HU Jinhe;YANG Jianying;YANG Dan;GAO Qian;NA Xu(Eye Hospital,China Academy of Chinese Medical Sciences,Beijing 100040,China)

机构地区：[1]中国中医科学院眼科医院,北京100040 [2]首都医科大学附属北京潞河医院,北京101100

出　　处：《中国中医眼科杂志》2024年第4期319-324,共6页China Journal of Chinese Ophthalmology

基　　金：中国中医科学院眼科医院中央高水平中医医院项目资助(GSP5-87)。

摘　　要：目的 探讨2型糖尿病视网膜病变(T2DR)患者在静息状态下背外侧前额叶(DLPFC)的功能连接(FC)改变特征。方法 纳入2021年8月—2022年8月中国中医科学院眼科医院诊治的T2DR患者30例作为观察组,将通过广告宣传招募的30例健康受试者作为对照组。2组受试者均测定空腹状态下血糖(GLU)、糖化血红蛋白(HbA1c)、血清C肽指标,进行静息态脑功能磁共振(rs-fMRI)扫描,通过分析DLPFC与全脑的FC,比较2组受试者FC差异,将差异脑区FC值与临床量表评分进行Pearson相关分析,并完成蒙特利尔认知评估量表(MoCA)、简易智力状态检查(MMSE)的评定。结果 (1)糖尿病相关指标:观察组患者GLU、HbA1c水平高于对照组(t_(GLU)=11.601、t_(HbA1c)=13.837,均P=0.000),MoCA得分、MMSE得分低于对照组(t_(MoCA)=-12.827、t_(MMSE)=-13.395,均P=0.000),差异均有统计学意义。2组血清C肽浓度比较,差异无统计学意义(P>0.05)。(2)FC值比较:以年龄、性别、受教育程度及头动作为协变量,观察组患者以左侧DLPFC为种子点,观察组在左侧顶下小叶、右侧中央后回的FC均高于对照组(t_(左侧顶下小叶)=6.785、t_(右侧中央后回)=5.126,均P=0.000);以右侧DLPFC为种子点,观察组在左侧顶下小叶、左侧额下三角回及小脑后叶的FC均高于对照组(t_(左侧顶下小叶)=4.274,t_(左侧额下三角回)=3.991、t_(小脑后叶)=4.227,均P=0.000),阈值体素水平数值满足要求,差异均有统计学意义。(4)相关性分析:观察组以右侧DLPFC为种子点,左侧顶下小叶FC值与MoCA量表评分呈正相关(r=0.494,P=0.005),有统计学意义。结论 T2DR患者存在认知控制网络(CCN)与默认网络、感觉运动网络和小脑网络异常的FC,这可能是T2DR重要的神经病理机制。OBJECTIVE To explore the characteristics of changes in functional connectivity (FC) of the dorsolateral prefrontal cortex (DLPFC) in patients with type 2 diabetic retinopathy (T2DR) during resting state.METHODS A total of 30 patients with T2DR from August 2021 to August 2022 treated at the Eye Hospital,China Academy of Chinese Medical Sciences were included as the observation group,and 30 healthy participants recruited through advertising were included as the control group.Fasting blood glucose (GLU),glycated hemoglobin(HbA1c),and serum C-peptide levels were measured in both groups.Restingstate functional magnetic resonance imaging (rs-fMRI) scans were performed,and FC between the DLPFC and the whole brain was analyzed to compare the differences in FC between the two groups.The FC values of different brain regions were correlated with clinical scale scores using Pearson correlation analysis.Montreal Cognitive Assessment (MoCA) and Mini-mental State Examination (MMSE) were also conducted.RESULTS (1) Diabetes-related indicators:GLU and HbA1c levels in the observation group were higher than those in the control group (t_(GLU)=11.601,t_(HbA1c)=13.837,both P=0.000),while MoCA scores and MMSE scores were lower than those in the control group (t_(MoCA)=-12.827,t_(MMSE)=-13.395,both P=0.000),with statistically significant differences.There was no significant difference in serum C-peptide concentration between the two groups (P>0.05).(2) Comparison of FC values:Using age,sex,education level,and head motion as covariates,patients in the observation group showed higher FC values between the left DLPFC and the left inferior parietal lobule (LIPL) and the right posterior cingulate gyrus (RPCG) compared to the control group (t_(LIPL)=6.785,t_(RPCG)=5.126,both P=0.000).Using the right DLPFC as the seed point,patients in the observation group showed higher FC values between the LIPL,left triangular part of inferior frontal gyrus (LTPIFG),and the posterior lobe of the cerebellum (PLC) compared to the control group (t_(LIPL)=4.274

关 键 词：2型糖尿病视网膜病变 静息态 磁共振成像 功能连接 认知控制网络 

分 类 号：R774.1[医药卫生—眼科]