摘要目的 应用静息态功能磁共振采用局部一致性(ReHo)方法探讨2型糖尿病(T2DM)患者静息态脑功能随时间推移的改变.方法 分别于2012年及2015年对21例T2DM患者及12名健康对照者实施多维度认知功能测试及静息态功能磁共振(rs-fMRI)扫描.进行配对样本t检验检测前后临床变量及ReHo值的差异,并利用基于体素的Pearson相关性分析测量ReHo值改变和临床变量改变间是否具有相关性.结果 T2DM患者组2015年复杂图形测试(CFT)延迟得分(14±6)显著低于2012年(18±6)(t=-2.88,P=0.009);同时其两侧枕叶、右侧额中回ReHo值较2012年对应区域显著降低(P＜0.01,Alphasim校正).其中左枕叶ReHo值的降低和C FT延迟得分及连线试验B耗时(TMT-B)的改变显著相关(r=0.52、-0.46,均P＜0.05).健康对照组2015年较2012年认知功能测试改变无明显差异,右侧楔叶ReHo值较2012年显著降低(P＜0.01,Alphasim校正),右侧额上回ReHo值较2012年显著增高(P＜0.01,Alphasim校正),未发现脑功能改变区域与认知功能改变有明显相关性.结论 T2DM患者视觉记忆在3年内下降显著,脑功能下降区域为两侧枕叶及右侧额中回,左侧枕叶活动性下降和视觉记忆衰退、信息处理速度、注意力下降显著相关.

abstractsObjective To investigate the changes of resting brain function with time in patients with type 2 diabetes mellitus (T2DM) by using regional homogeneity (ReHo) with resting-state functional magnetic resonance imaging (rs-fMRI).Methods Multidimensional cognitive function tests and rs-fMRI scans were performed in 21 T2DM patients and 12 healthy controls in 2012 and 2015 respectively.The differences in clinical variables and the ReHo values before and after were measured by paired sample t test,and the correlation between the change of ReHo value and the change of clinical variables was measured by Pearson correlation analysis based on voxel.Results The delayed score (14 ± 6) of the T2DM patients in 2015 was significantly lower than that in 2012 (18 ±6) (t =-2.88,P =0.009);while the value of ReHo in the bilateral occipital lobe and right middle frontal gyrus was significantly lower than that in 2012 (P ＜0.01,Alphasim correction).And the decreased ReHo value in the left occipital lobe was significantly correlated with the change of complex figure test (CFF) delay score and the trail making test-B (TMT-B) (r =0.52,-0.46,both P ＜ 0.05).No significant change in cognitive function tests in the healthy control group was found between the two years,ReHo value in right cuneus decreased significantly (P ＜ 0.01,Alphasim correction),but it increased significantly in superior frontal gyrus (P ＜ 0.01,Alphasim correction) in 2015.No significant correlation between the changes of the ReHo values in the right cuneus and right superior frontal gyrus and the changes of cognitive function scores was found in the healthy controls.Conclusions The visual memory is significantly declined in T2DM patients within 3 years.The reduced neural activity areas in T2DM patients are in the bilateral occipitai lobes and the right middle frontal lobe.Decreased neural activity in the left occipital area is related to visual impairment,information processing speed and attention drops.