Dataset Information

Abnormal functional connectivity in the right dorsal anterior insula associated with cognitive dysfunction in patients with type 2 diabetes mellitus.

ABSTRACT:

Introduction

Type 2 diabetes mellitus (T2DM) is a chronic disease with a high incidence worldwide. T2DM can cause cognitive impairment, but its neuropathological basis is unclear. A variety of neuropsychiatric studies have found that abnormal functional connectivity (FC) in the central executive network (CEN), default-mode network (DMN), and salience network (SN) may be the neuropathological basis of cognitive dysfunction. The right dorsal anterior insula (dAI) is the core SN area. It plays an important role in regulating the CEN and the DMN. However, few studies have explored the relationship between cognitive impairment and FC among the right dAI, CEN, and DMN in patients with T2DM.

Methods

Resting-state functional magnetic resonance imaging was used to investigate FC between the right dAI and the CEN and DMN in 44 patients with T2DM and 41 sex-, age-, and education-matched healthy controls, as well as its relationship with clinical/cognitive variables.

Results

In patients with T2DM, FC between the right dAI and multiple brain regions of the CEN and DMN was generally decreased, and FC strength between the right dAI and the inferior frontal gyrus negatively correlated with trail making test A score (r = -0.421, p = 0.004).

Conclusions

Patients with T2DM exhibit abnormal FC between the right dAI and the CEN and DMN. This may be one of the neuromechanisms of cognitive impairment in patients with T2DM. In addition, reduced FC between the right dAI and the right inferior frontal gyrus may be related to abnormal attention regulation in patients with T2DM.

SUBMITTER: Wang M

PROVIDER: S-EPMC9226846 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ObjectiveDaytime cognitive impairment is an essential symptom of primary insomnia (PI). However, the underlying neural substrate remains largely unknown. Many studies have shown that the right anterior insula (rAI) as a key node of salience network (SN) plays a critical role in switching between the executive control network (ECN) and the default mode network (DMN) for better performance of cognitively demanding tasks. Aberrant effective connectivity (directional functional connectivity) of rAI with ECN or DMN may be one reason for daytime cognitive impairment in PI patients. Up to now, no effective connectivity study has been conducted on patients with PI during resting state. Our aim is to investigate the effective connectivity between the rAI and the other voxels in the whole brain in PI.Materials and methodsFifty drug-naive patients with PI and forty age- and sex-matched healthy controls were scanned using resting-state functional MRI. Seed-based Granger causality analysis was used to examine effective connectivity between the rAI, including ventral and dorsal part, and the whole brain. The effective connectivity was compared between the two groups and was correlated with clinical characteristics.ResultsCompared with controls, patients showed decreased effective connectivity from the rAI to the bilateral precuneus, the left postcentral gyrus (extending to bilateral precuneus) and the bilateral cerebellum posterior lobe, and decreased effective connectivity from the bilateral orbitofrontal cortex (OFC) to the rAI (single voxel P < 0.001, AlphaSim corrected with P < 0.01). In addition, effective connectivity from the ventral rAI to the left postcentral gyrus and from the left OFC to the ventral rAI were significantly negatively correlated with Insomnia Severity Index scores (r = -0.28/P = 0.046 and r = -0.29/P = 0.038, respectively).ConclusionThe present study is the first to reveal aberrant effective connectivity between the SN hub (rAI) and the posterior DMN hub (precuneus) as well as decision-making region (OFC) and sensori-motor region in PI. These findings suggest an aberrant salience processing system of the rAI in PI patients.