Article Figures & Data
Figures
- Fig 1.
Spatial distribution of weighted DC maps in patients with T2DM and HCs (P < .05, family-wise error–corrected). In the weighted DC map, standardized DC in the posterior cingulate, visual cortex, medial prefrontal cortex, insula, and thalamus was significantly higher than the global mean values in both groups. Color scale denotes the z score. R indicates right; L, left.
- Fig 2.
Group differences of weighted DC maps between patients with T2DM and HCs (P < .05; AlphaSim-corrected; https://afni.nimh.nih.gov/pub/dist/doc/program_help/AlphaSim.html). In the weighted DC map, patients with T2DM showed significantly decreased value (cool color) in the left lingual gyrus and increased values (warm color) in the dACC and the right anterior insula. The color scale denotes the t-value.
- Fig 3.
Spatial pattern of the network anchored in the regions with altered DC (P < .05, family-wise error–corrected). The dACC and right anterior insula (AI) exhibit similar connectivity patterns, which are largely included in the salience network. Specifically, the dACC is connected to the cingulate cortex, anterior insula, and sensorimotor cortex (first row). The AI is functionally connected to the entire insula, dACC, and adjacent frontal, temporal, and sensorimotor areas (second row). The lingual gyrus is mainly connected to the visual cortex and superior middle temporal and sensorimotor cortices (third row). The color scale denotes the t-value.
- Fig 4.
Group differences of network connectivity based on the seed regions identified in the DC comparison (P < .05, AlphaSim-corrected). Regions with significant connectivity differences in networks anchored in hubs with altered DC (ie, dACC, anterior insula [AI], and lingual gyrus). In dACC-relevant network, increased connectivity was found in the medial prefrontal cortex (first row); in the AI-relevant network, increased connectivity was mainly located in the right insula and left superior temporal gyrus (second row). In the lingual gyrus–relevant network, decreased connectivity was diffusely distributed in the visual cortex and the sensory area and superior parietal lobule (third row). Coordinates are all in Montreal Neurological Institute space. The color bar denotes the t-value.
- Fig 5.
Voxelwise correlation between network connectivity (z score) and clinical variables. Correlations in the T2DM group are represented by black diamonds, while correlations in the control group are represented by white diamonds. The T2DM group: A, CFT-delay performance was positively correlated with the occipital connectivity in the lingual gyrus–relevant network (group × performance interaction, P = .001). B, FPG was positively correlated with the connectivity of dACC-relevant network, especially in the medial frontal cortex (group × FPG interaction, P = .001). C and D, Longer time spent on TMT-B was correlated with lower connectivity in the lingual gyrus–relevant network (C, group × performance interaction, P = .87) and lower connectivity in dACC-relevant network (D, group × performance interaction, P = .04). No such correlations were observed in the control group.
Tables
Measures T2DM (n = 40) Control (n = 43) P Value Age (yr) 60.5 ± 6.9 57.6 ± 6.6 .08 Sex (male/female)a 24:21 16:30 .09 Education (yr) 10.0 ± 3.4 10.2 ± 2.3 .46 Head motion (FD) (mm) 0.09 ± 0.07 0.08 ± 0.05 .35 Diabetes duration (yr) 8.9 ± 5.0 – – Insulin treatment (No.) (%) 8 (20) – – HbA1c (%) (mmol/mol) 7.8 ± 1.6 (62 ± 17.5) 5.6 ± 0.3 (37 ± 3.3) <.001b FPG (mmol/L) 7.8 ± 2.1 5.5 ± 0.4 <.001b HOMA-IR 3.1 ± 1.9 2.4 ± 1.1 .02b BMI (kg/m2) 24.4 ± 2.7 23.8 ± 2.7 .22 Systolic BP (mm Hg) 136.6 ± 14.8 132.7 ± 14.8 .18 Diastolic BP (mm Hg) 86.0 ± 11.1 86.6 ± 11.2 .81 Hypertension (No.) (%)c 21 (53) 12 (28) Antihypertensive treatment (No.) (%)c 17 (43) 8 (19) Total cholesterol (mmol/L) 5.5 ± 1.2 5.3 ± 0.9 .46 Triglyceride (mmol/L) 1.5 ± 0.8 1.4 ± 0.8 .69 HDL cholesterol (mmol/L) 1.4 ± 0.3 1.3 ± 0.7 .57 LDL cholesterol (mmol/L) 3.3 ± 0.8 3.1 ± 0.6 .30 White matter lesions (range) 0–6 0–7 .26 Lacunar infarcts (No.) (%)a 9 5 .11 Note:—FD indicates frame-wise displacement; HOMA-IR, homeostasis model assessment of insulin resistance; BP, blood pressure; BMI, body mass index; LDL, low-density lipoprotein; HDL, high-density lipoprotein.
↵a Data are mean and number or range.
↵b P value < .05.
↵c Statistical analyses were performed by χ2 tests.
Measures T2DM (n = 40) Control (n = 43) P Value General cognitive status MMSE 28.3 ± 1.2 28.7 ± 1.2 .26 Episodic memory AVLT 5.9 ± 1.3 6.3 ± 1.8 .11 AVLT, delay 5.8 ± 2.3 6.3 ± 2.1 .31 CFT, delay 13.9 ± 5.8 17.5 ± 5.8 <.01b Working memory DST (forward) 6.8 ± 1.3 7.3 ± 1.5 .11 DST (backward) 4.1 ± 1.0 4.5 ± 1.3 .16 Attention TMT, part A 64.5 ± 19.0 63.3 ± 14.8 .76 Executive functioning TMT, part B 182.2 ± 62.8 152.0 ± 50.6 .02b Spatial processing CFT, copy 34.3 ± 1.8 34.8 ± 1.5 .16 CDT 3.3 ± 0.6 3.5 ± 0.6 .07 Language processing VFT 16.5 ± 3.6 17.6 ± 3.0 .52 - Table 3:
Brain regions with significant differences in weighted DC maps between patients with T2DM and HCsa
Brain Regions MNI Voxels Peak t-Value X Y Z RAI +42 +15 +0 51 +4.30 dACC +6 +30 +24 31 +4.03 L lingual gyrus −15 −51 −3 37 −3.51 Note:—MNI indicates Montreal Neurological Institute; RAI, right anterior insula; L, left.
↵a Comparisons were performed at P < .05, corrected by AlphaSim multiple comparisons. X, y, and z are coordinates of primary peak locations in the MNI space. Positive t values are T2DM > control subjects. Negative t values are T2DM < control subjects.
