Aberrant Brain Network Integration and Segregation in Diabetic Peripheral Neuropathy Revealed by Structural Connectomics

Abstract

Diabetic peripheral neuropathy (DPN) is one of the most common forms of peripheral neuropathy, and its incidence has been increasing. Mounting evidence has shown that patients with DPN have been associated with widespread alterations in the structure, function and connectivity of the brain, suggesting possible alterations in large-scale brain networks. Using structural covariance networks as well as advanced graph-theory-based computational approaches, we investigated the topological abnormalities of large-scale brain networks for a relatively large sample of patients with DPN (N = 67) compared to matched healthy controls (HCs; N = 88). Compared with HCs, the structural covariance networks of patients with DPN showed an increased characteristic path length, clustering coefficient, sigma, transitivity, and modularity, suggestive of inefficient global integration and increased local segregation. These findings may improve our understanding of the pathophysiological mechanisms underlying alterations in the central nervous system of patients with DPN from the perspective of large-scale structural brain networks.

Changes in the central nervous system in diabetic neuropathy

“…And the site of cortical damage in DPN patients suggests us that pain perception and pain modulation-related pathways may be abnormal in PDN patients. Meanwhile, in the same study population [ 38 ], discovered a significant decrease in cortical thickness in DPN patients based on a human brain connectomics study, mainly in some brain regions related to sensorimotor function and pain, which is consistent with a previous study by Zhang. In addition, they found differences between the number and distribution of hubs in the networks of DPN patients and healthy controls, with DPN patients not only having new hubs (mainly in the prefrontal gyrus, superior temporal sulcus, insula cortex, and sphenoid gyrus) but also missing some of the hubs that were previously present, such as the left pars orbitalis and left rostral anterior cingulate cortex.…”

Cognition and motion dysfunction‐associated brain functional network disruption in diabetic peripheral neuropathy

“…A recent graph theory analysis showed that the increase in nodal parameters of the anterior cingulate gyrus and orbitofrontal lobe could be employed as biomarkers of cognitive deficits in T2DM patients and used to make an early diagnosis (Zhou et al, 2022). Another study based on the gray matter structural covariance network demonstrated that the clustering coefficient and characteristic path length of DPN patients increased compared with those of healthy controls (HCs), suggesting that the global integration efficiency decreased and that local separation was enhanced (Yang et al, 2020). Furthermore, a previous study showed that brain functional alterations in some pathological conditions may occur prior to structural changes and clinical performance (Jin et al, 2012).…”