METHODS: We investigated neuropsychological performance, and structural and functional changes in specific cerebellar subregions in 43 T2DM patients with high insulin resistance (T2DM-highIR), 72 T2DM patients with low insulin resistance (T2DM-lowIR), and 50 controls. Furthermore, the correlation and stepwise multiple linear regression analysis were performed.
RESULTS: Compared to the controls, T2DM exhibited lower cognitive scores and higher depressive/anxious scores. Furthermore, T2DM-highIR patients showed reduced gray matter volume (GMV) in the right cerebellar lobules VIIb, Crus I/II, and T2DM showed reduced GMV in left lobules I-IV compared to controls. Additionally, functional connectivity decrease was observed between the right lobules I-V and orbital part of the superior frontal gyrus in T2DM-highIR compared to both T2DM-lowIR and controls. Notably, there were negative correlations between the GMV of the lobules VIIb, Crus I/II, and updated homeostatic model assessment of insulin resistance, and positive correlation with executive/visuospatial performance in T2DM patients.
CONCLUSIONS: These results suggest that the cerebellar lobules VIIb, Crus I/II, represent vulnerable brain regions in the context of insulin resistance. Overall, this study offers new insights into the neuropathophysiological mechanisms of brain impairment in patients with T2DM.
方法:我们调查了神经心理学表现,结构,43例高胰岛素抵抗(T2DM-highIR)的T2DM患者小脑特定亚区功能改变,72名具有低胰岛素抵抗(T2DM-lowIR)的T2DM患者,50个控制此外,进行相关性和逐步多元线性回归分析.
结果:与对照组相比,T2DM表现出更低的认知评分和更高的抑郁/焦虑评分。此外,T2DM-highIR患者显示右侧小脑小叶VIIb的灰质体积(GMV)减少,CrusI/II,与对照相比,T2DM显示左小叶I-IV中GMV降低。此外,与T2DM-lowIR和对照组相比,T2DM-highIR中的右小叶I-V和额上回眶部分之间的功能连通性降低。值得注意的是,小叶VIIb的GMV之间存在负相关,CrusI/II和更新的胰岛素抵抗稳态模型评估,与T2DM患者的执行/视觉空间表现呈正相关。
结论:这些结果表明小脑小叶VIIb,CrusI/II代表胰岛素抵抗背景下的脆弱大脑区域。总的来说,这项研究为2型糖尿病患者脑损伤的神经病理生理机制提供了新的见解.