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• Clinical Article •
Changes of cerebral function in patients with early diabetic kidney disease based on regional homogeniety and seed-based functional connectivity
HE Miao  JI Bing  CHENG Liqing  XU Changhua  WANG Jian 

Cite this article as: HE M, JI B, CHENG L Q, et al. Changes of cerebral function in patients with early diabetic kidney disease based on regional homogeniety and seed-based functional connectivity[J]. Chin J Magn Reson Imaging, 2024, 15(10): 62-68. DOI:10.12015/issn.1674-8034.2024.10.011.


[Abstract] 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, P=0.030). In contrast, there were no significant correlations among UACR, brain functional imaging indices, and cognitive scale scores in diabetes without kidney disease group.Conclusions This study reveals that patients with early diabetic kidney disease may experience neuro-functional disorders in the visually related brain regions, and the imbalance in the functional integration of these brain regions may exacerbate cognitive impairment.
[Keywords] diabetic nephropathy；cognitive impairment；regional homogeniety；functional connectivity；resting-state functional magnetic resonance imaging

HE Miao1   JI Bing1   CHENG Liqing2   XU Changhua1   WANG Jian1*  

1 7 T Magnetic Resonance Translational Medicine Research Center, Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing 400038, China

2 Department of Endocrinology and Metabolism, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing 400038, China

Corresponding author: WANG J, E-mail: wangjian@aifmri.com

Conflicts of interest   None.

Received  2024-06-21
Accepted  2024-10-10
DOI: 10.12015/issn.1674-8034.2024.10.011
Cite this article as: HE M, JI B, CHENG L Q, et al. Changes of cerebral function in patients with early diabetic kidney disease based on regional homogeniety and seed-based functional connectivity[J]. Chin J Magn Reson Imaging, 2024, 15(10): 62-68. DOI:10.12015/issn.1674-8034.2024.10.011.

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