Shi WQ, Zhang MX, Tang LY, Ye L, Zhang YQ, Lin Q, Li B, Shao Y, Yu Y. Altered spontaneous brain activity patterns in patients with diabetic retinopathy using amplitude of low-frequency fluctuation. World J Diabetes 2022; 13(2): 97-109 [PMID: 35211247 DOI: 10.4239/wjd.v13.i2.97]
Corresponding Author of This Article
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
Research Domain of This Article
Ophthalmology
Article-Type of This Article
Clinical and Translational Research
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
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
ARTICLE HIGHLIGHTS
Research background
Diabetic retinopathy (DR) is one of the most common complications of diabetes mellitus; however, to date, there has been little analysis of the changes in brain function in patients with DR and their relationship to the clinical manifestations in the eye. This study is the first to examine brain changes in patients with DR using the amplitude of low-frequency fluctuation (ALFF).
Research motivation
The current diagnosis of DR mainly involves fundus fluorescein imaging for examination, and the direct connection between eyes, other manifestations, and the brain is still unknown. In this study, we employed the ALFF technique to investigate abnormal brain activity in DR patients and its relationship with clinical characteristics. Our research may help with understanding how DR disease develops.
Research objectives
We investigated the underlying ALFF of local characteristics of spontaneous brain activity in DR patients and their relationship with behavioral performance. Our findings suggested possible mechanisms of clinical manifestations and behavior in DR patients.
Research methods
Twenty-four DR patients and 24 healthy controls (HCs) matched for both age and sex were recruited. We measured and recorded the average ALFF values of DR patients and HCs and then classified them using receiver operating characteristic (ROC) curves.
Research results
We found that the ALFF values of both the left and right cerebellum posterior lobe and the right anterior cingulate gyrus were remarkably higher in the DR patients compared with the HCs, but DR patients also had lower values in the bilateral calcarine. ROC curve analysis of different brain regions demonstrated high accuracy of area under the curve analysis. However, there was no remarkable relationship between ALFF mean values for different regions and clinical presentations of DR patients.
Research conclusions
We hypothesized that DR may lead to alterations in visual cortical activity. Our results showed altered spontaneous activity in three regions of the brain in patients with DR. Abnormalities in low-frequency amplitudes in the brain may be associated with alterations in contralateral best-corrected visual acuity and depression in DR patients. These findings may suggest possible mechanisms of clinical manifestations and behaviors in DR patients.
Research perspectives
Our finding that DR may lead to multiple low-frequency amplitude frequency changes in the brain may facilitate our exploration of pathological mechanisms and disease progression in DR patients. However, the drawback is that the sample size was too small. Future studies should increase the sample size in order to ensure the validity of our findings.
