Altered spontaneous brain activity patterns in patients with diabetic retinopathy using amplitude of low-frequency fluctuation

Wen-Qing Shi; Mou-Xin Zhang; Li-Ying Tang; Lei Ye; Yu-Qing Zhang; Qi Lin; Biao Li; Yi Shao; Yao Yu

doi:10.4239/wjd.v13.i2.97

Altered spontaneous brain activity patterns in patients with diabetic retinopathy using amplitude of low-frequency fluctuation

World J Diabetes. 2022 Feb 15;13(2):97-109. doi: 10.4239/wjd.v13.i2.97.

Authors

Wen-Qing Shi¹, Mou-Xin Zhang², Li-Ying Tang³, Lei Ye¹, Yu-Qing Zhang¹, Qi Lin¹, Biao Li¹, Yi Shao¹, Yao Yu⁴

Affiliations

¹ Department of Endocrinology and Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi clinical research center for endocrine and metabolic disease, Nanchang 330006, Jiangxi Province, China.
² Xiamen Eye Center of Xiamen University, School of Medicine, Xiamen University, Xiamen 361001, Fujian Province, China.
³ Department of Ophthalmology, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361001, Fujian Province, China.
⁴ Department of Endocrinology and Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi clinical research center for endocrine and metabolic disease, Nanchang 330006, Jiangxi Province, China. 375135747@qq.com.

Abstract

Background: Diabetes mellitus is a metabolic disorder characterized by prolonged elevation of blood glucose due to various causes. Currently, the relationship between diabetic retinopathy (DR) and altered connectivity of brain function is unclear.

Aim: To investigate the relationship between this brain activity and clinical manifestations and behaviors of DR patients by using the amplitude of low-frequency fluctuation (ALFF) technique.

Methods: Twenty-four DR patients and 24 healthy controls (HCs) matched for age and gender were enrolled. We measured and recorded average ALFF values of DR patients and HCs and then classified them using receiver operating characteristic (ROC) curves.

Results: ALFF values of both left and right posterior cerebellar lobe and right anterior cingulate gyrus were remarkably higher in the DR patients than in the HCs; however, DR patients had lower values in the bilateral calcarine area. ROC curve analysis of different brain regions demonstrated high accuracy in the area under the curve analysis. There was no significant relationship between mean ALFF values for different regions and clinical presentations in DR patients. Neuronal synchronization abnormalities in some brain regions of DR patients were associated with cognitive and visual disorders.

Conclusion: Abnormal spontaneous brain activity was observed in many areas of DR patients' brains, which may suggest a possible link between clinical manifestations and behaviors in DR patients.

Keywords: Amplitude of low-frequency fluctuation; Diabetes mellitus; Diabetic retinopathy; Functional magnetic resonance imaging; Resting-state; Spontaneous activity.