Association of diffusion tensor imaging along the perivascular space index with cognitive impairment in type 2 diabetes mellitus
Notice bibliographique
Résumé
Background: Type 2 diabetes mellitus (T2DM) often coexists with cognitive impairment, but the exact mechanisms underlying this relationship remain unclear. Glymphatic dysfunction may be a significant factor contributing to cognitive impairment. This study aimed to assess the changes in diffusion tensor imaging along the perivascular space (DTI-ALPS) index in patients with T2DM and to determine its association with cognitive impairment and whole-brain white-matter damage. Methods: We prospectively recruited patients with T2DM and healthy controls (HCs) for a case-control study in which all participants underwent cognitive assessments and underwent magnetic resonance imaging (MRI) scans. We calculated the DTI-ALPS index of HCs and patients with T2DM based on the DTI. Furthermore, we calculated whole-brain fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD), and structural connectivity parameters, including the average clustering coefficient (Cp), characteristic path length (Lp), global efficiency (Eglob), and small-world index (Sigma) to assess brain white-matter damage. A general linear model was used to analyze the differences between the groups, which was followed by multiple linear regression analysis to examine the relationship among the DTI-ALPS index, MRI parameters, and cognitive function. Results: This study enrolled 70 patients with T2DM (age 66.37±9.85 years; 48 males) and 35 HCs (age 64.03±11.26 years; 21 males). There were 35 patients with T2DM with mild cognitive impairment (T2DM-MCI). The DTI-ALPS index and whole-brain FA of patients with T2DM were reduced, while the whole-brain MD, AD, and RD were increased, especially in patients with T2DM-MCI. The Eglob of structural connectivity was decreased and Lp increased in patients with T2DM. No significant differences were found in the Cp or the Sigma between the T2DM group and HCs. We found that in the patients with T2DM, the DTI-ALPS index was associated with Montreal Cognitive Assessment [β =0.577; 95% confidence interval (CI): 0.360 to 0.793; P false discovery rate (PFDR)<0.001], FA (β =0.340; 95% CI: 0.069 to 0.611; PFDR=0.043), MD (β =−0.338; 95% CI: −0.610 to −0.065; PFDR=0.043), AD (β =−0.440; 95% CI: −0.712 to −0.168; PFDR=0.016), and RD values (β =−0.313; 95% CI: −0.581 to −0.044; PFDR=0.046). No association was found between the DTI-ALPS index and the structural connectivity parameters. In addition, mediation analysis showed that FA partially mediated the association of decreased DTI-ALPS index with cognitive impairment in patients with T2DM (β =0.086; mediation effect 14.86%). Conclusions: Our study demonstrated that the DTI-ALPS index is decreased in patients with T2DM, especially in those with T2DM-MCI. A decrease in DTI-ALPS index is associated with cognitive impairment and whole-brain white-matter damage in patients with T2DM.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».