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• Clinical Article •
Brain functional impairment in drug-free patients with type 2 diabetes: A resting-state fMRI study
WANG Han  YANG Shaoling  WANG Shihui  WANG Zexuan  YANG Shangqi  WANG Xinyu  YUAN Jiaqi  ZHANG Yanwei 

DOI:10.12015/issn.1674-8034.2026.05.008.


[Abstract] Objective To explore the alterations in spontaneous neural activity in drug-free patients with type 2 diabetes mellitus (T2DM) by combining multiple indices resting-state functional magnetic resonance imaging (rs-fMRI).Materials and Methods This study included 42 drug-free patients and 42 age, sex and education matched normal controls. Cognitive function tests, clinical biochemical examinations and rs-fMRI scans were performed. Amplitude of low frequency fluctuation (ALFF), fractional amplitude of low-frequency fluctuation (fALFF), degree centrality (DC) and regional homogeneity (ReHo) were calculated after image preprocessing. Two sample t-test was performed to explore the abnormal alterations of brain function, and the relationships among rs-fMRI indices, clinical indicators, and cognitive scores were also investigated.Results Compared to normal controls, drug-free T2DM patients exhibited decreased spontaneous neural activity in the left superior frontal gyrus, right angular gyrus, bilateral precuneus and thalamus, while increased neural activity was observed in the right superior frontal gyrus (Gaussian random field corrected, voxel P < 0.001, cluster P < 0.05). Furthermore, in the T2DM groups, the fALFF in the bilateral precuneus were positively correlated with 2-hour postprandial blood glucose (r = 0.421, P = 0.013). The ALFF in the left thalamus showed positive correlation with high-density lipoprotein (r = 0.399, P = 0.005), but negatively correlated with fasting plasma C-peptide (r = -0.345, P = 0.015). We also observed a decreased correlation between fALFF in the right angular gyrus and fasting plasma C-peptide (r = -0.432, P = 0.009).Conclusion This study demonstrates that a distinct pattern of aberrant brain function in drug-free T2DM patients is associated with clinical indicators, enhancing the understanding of diabetic brain injury mechanisms.
[Keywords] type 2 diabetes mellitus；resting-state functional magnetic resonance imaging；magnetic resonance imaging；amplitude of low frequency fluctuation；fractional amplitude of low frequency fluctuation；degree centrality；regional homogeneity

WANG Han1, 2   YANG Shaoling1   WANG Shihui1   WANG Zexuan1, 2   YANG Shangqi1, 2   WANG Xinyu1, 3   YUAN Jiaqi1, 2   ZHANG Yanwei1*  

1 Department of Radiology Diagnosis, Bethune International Peace Hospital (980th hospital of Joint Logistic Support Force), Shijiazhuang 050051, China

2 Graduate School of Hebei Medical University, Shijiazhuang 050000, China

3 Graduate School of North China University of Technology, Tangshan 063000, China

Corresponding author: ZHANG Y W, E-mail: zyw123b@qq.com

Conflicts of interest   None.

Received  2025-10-17
Accepted  2026-04-29
DOI: 10.12015/issn.1674-8034.2026.05.008
DOI:10.12015/issn.1674-8034.2026.05.008.

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