摘要
目的 探讨T2DM合并勃起功能障碍(DMED)患者海马与杏仁核静息态功能连接(FC)的特征及中枢性病理神经机制。方法选取2020年1月至2021年12月于南京医科大学附属南京医院内分泌科门诊就诊的T2DM患者61例,根据国际勃起功能评分表(IIEF-5)评估勃起功能,分为单纯T2DM组(n=30)及合并DMED组(n=31);另选取同期47名体检健康者作为正常对照(NC)组。收集大脑静息态功能核磁共振成像(rs-f MRI)数据。使用DPABI软件包对各组脑影像数据进行预处理,选取双侧海马、杏仁核作为感兴趣区(ROI),计算全脑FC值。通过REST软件包对两组间各脑区FC值进行双样本t检验。结果左侧海马为ROI:与NC组比较,T2DM组左侧颞上回颞极FC值增加,DMED组左侧额上回内侧、左侧颞下回、左侧中央后回和右侧直回FC值下降。与T2DM组比较,DMED组左侧顶下回、左侧缘上回、左侧枕中回和右侧中央后回FC值下降。右侧海马为ROI:与NC组比较,T2DM组右侧颞中回和右侧罗兰多壳盖FC值增加,右侧矩状裂FC值下降,DMED组双侧前扣带回、右侧颞中回和左侧直回FC值下降。与T2DM组比较,DMED组左侧额中回、左侧顶下回和右侧颞下回FC值下降。左侧杏仁核为ROI:与NC组比较,T2DM组左侧海马旁回、左侧梭状回和右侧岛叶FC值增加,DMED组左侧颞中回FC值下降。与T2DM组比较,DMED组左侧额中回和左侧缘上回FC值下降。右侧杏仁核为ROI:与NC组比较,T2DM组和左侧岛叶、右侧海马旁回、右侧颞上回和右侧缘上回FC值增加,右侧尾状核FC值下降,DMED组右侧额中回、左侧直回和左侧枕中回FC值下降。与T2DM组比较,DMED组左侧额中回和左侧顶下回FC值下降。结论DMED患者海马和杏仁核与其他部分脑区,尤其是额叶FC值存在异常,可能是DMED患者脑功能改变所致。
Objective To explore the functional connectivity(FC)changes of hippocampus and amygdala in type 2 diabetes mellitus(T2DM)patients with erectile dysfunction(DMED),and the central pathological neural mechanisms underlying DMED.Methods 61 T2DM patients who visited Department of Endocrinology,Nanjing First Hospital,Nanjing Medical University from January 2020 to December 2021 were selected and divided into a simple T2DM group(n=30)and a combined DMED group(n=31).Another 47 healthy individuals were selected as control group(NC).The international erectile function scale(IIEF-5)was used to evaluate the erectile function.Resting-state functional magnetic resonance imaging(rs-fMRI)data were acquired from all participants.MRI data were preprocessed by the DPABI software package.Bilateral hippocampus and amygdala were selected as regions of interest(ROI)and the whole brain FC values were calculated.The FC values of brain regions between groups were tested by two-sample t-test with REST software package.Results Left hippocampus as ROI:compared with theNC group,FC values of the left superior temporal gyrus increased in the T2DM group,FC values of the left superior frontal gyrus,left inferior temporal gyrus,left posterior central gyrus and rectus gyrus decreased in the DMED group.Compared with the T2DM group,FC values of the left inferior parietal gyrus,left supramarginal gyrus,left middle occipital gyrus and right posterior central gyrus decreased in the DMED group.Right hippocampus as ROI:compared with the NC group,FC values of the right middle temporal gyrus and right rolandic operculum increased while FC values of the right calcarine fissure decreased in the T2DM group;FC values of bilateral anterior cingulate gyrus,right middle temporal gyrus and left rectus gyrus decreased in the DMED group.Compared with the T2DM group,FC values of the left middle frontal gyrus,left inferior parietal gyrus and right inferior temporal gyrus decreased in the DMED group.Left amygdala as ROI:compared with the NC group,FC values in the left parahippocampal gyrus,left fusiform gyrus and right insula increased in the T2DM group;FC value of the left middle temporal gyrus decreased in the DMED group.Compared with the T2DM group,FC values of the left middle frontal gyrus and left supramarginal gyrus decreased in the DMED group.Right amygdala as ROI:compared with the NC group,FC values of the left insula,right parahippocampal gyrus,right superior temporal gyrus and right supramarginal gyrus increased while FC values in the right caudate decreased in the T2DM group;FC values of the right middle frontal gyrus,left rectus gyrus and left middle occipital gyrus decreased in the DMED group.Compared with the T2DM group,FC values of the left middle frontal gyrus and left inferior parietal gyrus decreased in the DMED group.Conclusions DMED patients have abnormalities in the hippocampus,amygdala and other brain regions,especially the frontal lobe functional cortex,which may be related to changes in their brain function.
作者
孙睿
余海洋
章雯
沈赟
张鹏
刘晓梅
杨毓洋
陈建淮
吴锦丹
SUN Rui;YU Haiyang;ZHANG Wen(Department of Endocrinology,Nanjing First Hospital,Nanjing Medical University,Nanjing 210006,China;不详)
出处
《中国糖尿病杂志》
北大核心
2025年第9期667-672,共6页
Chinese Journal of Diabetes
基金
南京市医学科技发展项目(ZKX20036)
江苏省中医药科技发展计划项目-面上项目(MS2022023)
江苏省中医院“优秀青年博士培养计划”项目(2023QB0126)
江苏省中医院院级创新发展基金专项课题(Y2021CX24)
江苏省研究生科研与实践创新计划项目-校助面上项目(SJCX23_0804)。
关键词
糖尿病
2型
勃起功能障碍
静息态功能核磁共振成像
海马
杏仁核
功能连接
Diabetes mellitus,type 2
Erectile dysfunction
Resting state functional magnetic resonance imaging
Hippocampus
Amygdala
Functional connectivity
