August 24, 2022Frontiers in NeurologyOpen Access

Changes of brain function in patients with type 2 diabetes mellitus measured by different analysis methods: A new coordinate-based meta-analysis of neuroimaging

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Why the study?

Neuroimaging meta-analyses identified abnormal neural activity in type 2 diabetes mellitus, but consistency and heterogeneity between different brain imaging post-processing strategies had not been analyzed.

Does type 2 diabetes mellitus alter regional brain function compared to healthy controls as measured by different neuroimaging analysis methods?

Structured PICO

Does type 2 diabetes mellitus alter regional brain function compared to healthy controls as measured by different neuroimaging analysis methods?

Population

23 eligible trials with 27 data sets including adult patients (18-65 years) with type 2 diabetes mellitus (T2DM) and healthy controls. Group 1 included 17 data sets with 553 T2DM patients; Group 2 included 11 data sets with 340 T2DM patients. Excluded patients with serious complications (diabetic nephropathy, retinopathy, microangiopathy).

Intervention

Type 2 Diabetes Mellitus (T2DM) evaluated via neuroimaging post-processing methods (Group 1: regional homogeneity [ReHo], independent component analysis [ICA], and degree centrality [DC]; Group 2: amplitude of low-frequency fluctuation [ALFF] and cerebral blood flow [CBF])

Comparator

Healthy controls (HCs) evaluated with the same neuroimaging methods

Outcome

Consistent changes of regional brain functions (abnormal neural activity alterations) measured by stereotactic three-dimensional coordinatessurrogate

Type 2 diabetes mellitus is associated with spontaneous abnormal brain activities in regions related to learning, memory, and emotion, providing potential early neuroimaging biomarkers for cognitive impairment.

Limitations

unbalanced sex distribution between T2DM and HCs in the first group
significant differences in age and MOCA scores between T2DM and HCs

Implication

Supports targeted neuroimaging for T2DM cognitive monitoring; leaves open consensus on optimal processing methods.

Abstract

Objective Neuroimaging meta-analysis identified abnormal neural activity alterations in patients with type 2 diabetes mellitus (T2DM), but there was no consistency or heterogeneity analysis between different brain imaging processing strategies. The aim of this meta-analysis was to determine consistent changes of regional brain functions in T2DM via the indicators obtained by using different post-processing methods. Methods Since the indicators obtained using varied post-processing methods reflect different neurophysiological and pathological characteristics, we further conducted a coordinate-based meta-analysis (CBMA) of the two categories of neuroimaging literature, which were grouped according to similar data processing methods: one group included regional homogeneity (ReHo), independent component analysis (ICA), and degree centrality (DC) studies, while the other group summarized the literature on amplitude of low-frequency fluctuation (ALFF) and cerebral blood flow (CBF). Results The final meta-analysis included 23 eligible trials with 27 data sets. Compared with the healthy control group, when neuroimaging studies were combined with ReHo, ICA, and DC measurements, the brain activity of the right Rolandic operculum, right supramarginal gyrus, and right superior temporal gyrus in T2DM patients decreased significantly. When neuroimaging studies were combined with ALFF and CBF measurements, there was no clear evidence of differences in the brain function between T2DM and HCs. Conclusion T2DM patients have a series of spontaneous abnormal brain activities, mainly involving brain regions related to learning, memory, and emotion, which provide early biomarkers for clarifying the mechanism of cognitive impairment and neuropsychiatric disorders in diabetes. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=247071 , PROSPERO [CRD42021247071].