Structural and functional alterations of the hippocampal subfields in T2DM with mild cognitive impairment and insulin resistance: A prospective study

Abstract

BackgroundType 2 diabetes mellitus (T2DM) is characterized by insulin resistance (IR) and is often accompanied by mild cognitive impairment (MCI). The detrimental effects of T2DM and IR on the hippocampus have been extensively demonstrated. Few studies have examined the effects of IR on structure and function of hippocampal subfields in T2DM‐MCI patients.MethodA total of 104 T2DM patients were recruited in this prospective study and divided into four groups (T2DM‐MCI‐higherIR, n = 17; T2DM‐MCI‐lowerIR, n = 32; T2DM‐nonMCI‐higherIR, n = 19; T2DM‐nonMCI‐lowerIR, n = 36). Structure and function MRI data were captured. Clinical variables and neuropsychological scores were determined for all participants. Hippocampal subfield volume and functional connectivity were compared among four groups. Partial correlation analysis was performed between imaging indicators, clinical variables, and neuropsychological scores in all patients.ResultsT2DM‐MCI‐higher IR group had the smallest volumes of bilateral hippocampal tail, right subiculum‐body, right GC‐ML‐DG‐body, and right CA4‐body. IR in right hippocampal tail, right subiculum‐body, and right GC‐ML‐DG‐body exerted main effect. Furthermore, elevated functional connectivity was found between right subiculum‐body and bilateral dorsolateral prefrontal cortex and right anterior cingulate–medial prefrontal cortex. Hippocampal subfield volume positively correlates with total cholesterol and triglycerides and negatively correlates with fasting insulin.ConclusionThe present study found that T2DM‐MCI patients have structural and functional alterations in hippocampal subfields, and IR is a negative factor influencing the alteration of hippocampal subfields volume. These findings support the importance of IR in T2DM‐MCI patients and might be potential neuroimaging biomarkers of cerebral impairment in T2DM‐MCI patients.image