Right Frontoinsular Cortex: A Potential Imaging Biomarker to Evaluate T2DM-Induced Cognitive Impairment

Abstract

Cognitive impairment in type 2 diabetes mellitus (T2DM) is associated with functional and structural abnormalities in the intrinsic brain network. The salience network (SN) is a neurocognitive network that maintains normal cognitive function, but it has received little attention in T2DM. We explored SN changes in patients with T2DM with normal cognitive function (DMCN) and in patients with T2DM with mild cognitive impairment (DMCI). Sixty-five T2DM patients and 31 healthy controls (HCs) underwent a neuropsychological assessment, independent component analysis (ICA), and voxel-based morphometry (VBM) analysis. The ICA extracted the SN for VBM to compare SN functional connectivity (FC) and gray matter (GM) volume (GMV) between groups. A correlation analysis examined the relationship between abnormal FC and GMV and clinical/cognitive variables. Compared with HCs, DMCN patients demonstrated increased FC in the left frontoinsular cortex (FIC), right anterior insula, and putamen, while DMCI patients demonstrated decreased right middle/inferior frontal gyrus FC. Compared with DMCN patients, DMCI patients showed decreased right FIC FC. There was no significant difference in SN GMV in DMCN and DMCI patients compared with HCs. FIC GMV was decreased in the DMCI patients compared with DMCN patients. In addition, right FIC FC and SN GMV positively correlated with Montreal Cognitive Assessment and Mini-Mental State Examination (MMSE) scores. These findings indicate that changes in SN FC, and GMV are complex non-linear processes accompanied by increased cognitive dysfunction in patients with T2DM. The right FIC may be a useful imaging biomarker for supplementary assessment of early cognitive dysfunction in patients with T2DM.

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

“…We scrutinized references in studies that have not been ruled out, seven more references were found that met the criteria for inclusion. We excluded 69 studies after reading the full text because six studies had serious complications ( 51 – 56 ), eight studies had no healthy controls ( 57 – 64 ), 28 studies had ROI analyses only ( 65 – 92 ), nine studies were methods of brain structural analysis ( 93 – 101 ), nine studies did not report coordinates ( 102 – 110 ) (sent to the author for help, no results), the data used in the two studies are the same as the articles included in this study ( 111 , 112 ), and seven studies had a quality score of less than 17 ( 113 – 119 ). The final meta-analysis included 23 eligible trials with 27 data sets ( Figure 1 ).…”

Striatal dopamine gene network moderates the effect of early adversity on the risk for adult psychiatric and cardiometabolic comorbidity

“…The insula is involved in emotional recognition and processing, cognition and motivation 64 . Altered insular gray matter volumes occur in patients with type II diabetes and are associated with increased anxiety and depression 65 as well as cognitive impairment 66 . Importantly, insulin resistance moderates the relationship between childhood abuse and insula-precuneus connectivity in depressed and overweight youth 67 ..…”

Dysfunctional Interaction Between the Dorsal Attention Network and the Default Mode Network in Patients With Type 2 Diabetes Mellitus

“…Integrity of the SN is necessary for the efficient regulation of flexibly coupling either with the DAN or DMN networks during different brain states, and that a failure of this regulation leads to attentional lapses and other inefficient cognitive control (Bonnelle et al, 2012). Our previous studies have shown that there are abnormal changes in the SN of patients with T2DM under different cognitive stages, the right frontoinsular cortex (the core region of the SN) may be a useful imaging biomarker for supplementary assessment of early cognitive dysfunction in patients with T2DM (Zhang et al, 2021). This study found the anti-correlation between DAN and DMN showed disease-related disruptions in patients with T2DM.…”