Clinical and Translational Research
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Feb 15, 2022; 13(2): 97-109
Published online Feb 15, 2022. doi: 10.4239/wjd.v13.i2.97
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
Wen-Qing Shi, Lei Ye, Yu-Qing Zhang, Qi Lin, Biao Li, Yi Shao, Yao Yu, 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
Mou-Xin Zhang, Xiamen Eye Center of Xiamen University, School of Medicine, Xiamen University, Xiamen 361001, Fujian Province, China
Li-Ying Tang, Department of Ophthalmology, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361001, Fujian Province, China
Author contributions: Shi WQ and Zhang MX contributed the same to the article; Shi WQ was involved in the study design, writing of the manuscript and literature search; Ye L performed the data collection and statistical analysis, and participated in the editing of the manuscript; Tang LY was involved in the data curation, and review of the manuscript; Li B took part in the data curation; Lin Q was involved in the study conceptualization; Zhang MX was involved in data validation and visualization; Tang LY participated in the methodology design and data visualization; Shao Y and Yu Y were involved in the study design, data curation, funding collection, and project administration; all authors have read and approved the final.
Institutional review board statement: The research methods and protocols were approved by the Medical Ethics Committee of the First Affiliated Hospital of Nanchang University (Ethics approval number: 2017035), following the principles of the Declaration of Helsinki. Notify all subjects of the purpose, content and potential risks of the study, and provide written informed consent.
Clinical trial registration statement: This study is registered at Medical Ethics Comitee of the First Affiliated Hospital of Nanchang University trial registry. The registration identification number is JX2017035.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: This was not an industry supported study. The authors report no conflicts of interest in this work.
Data sharing statement: The datasets used and/or analyzed during the present study are available from the corresponding author on reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yao Yu, MD, Department of Endocrinology and Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi clinical research center for endocrine and metabolic disease, No. 17 Yongwaizheng Street, Donghu, Nanchang 330006, Jiangxi Province, China. 375135747@qq.com
Received: January 1, 2021
Peer-review started: January 1, 2021
First decision: July 28, 2021
Revised: August 10, 2021
Accepted: January 6, 2022
Article in press: January 6, 2022
Published online: February 15, 2022
Processing time: 403 Days and 23 Hours
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; Functional magnetic resonance imaging; Diabetic retinopathy; Resting-state; Diabetes mellitus; Spontaneous activity

Core Tip: We found that patients with diabetic retinopathy (DR) may have multiple low-frequency amplitude frequency changes in the brain, and the generation of this change may be related to the alteration of patients' visual cortex and anxiety, which may help us to explore the pathological mechanism and disease progression in DR patients.