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ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1491377
Potential Compensatory Mechanism for Cognitive Impairment in Type 2 Diabetes and Prediabetes: Altered Structure-Function Coupling
Provisionally accepted- 1 Guangzhou University of Chinese Medicine, Guangzhou, China
- 2 The First Affiliated Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
coupling may be more sensitive to detecting changes in the brain than any single modality. The aim of this study was to investigate the effects of SC-FC coupling changes on cognition and their interactions in patients with prediabetes and type 2 diabetes mellitus (T2DM).Methods: A total of 493 participants (119 with normal glucose metabolism (NGM), 125 with prediabetes, and 249 with T2DM) were included in the study. Diffusionweighted MRI and resting state functional MRI data were used to quantify SC-FC coupling. General linear model and linear regression analysis were used to evaluate the relationship between glucose metabolism, SC-FC coupling, and cognition.Mediation models were used to evaluate the mediating role of regional SC-FC coupling between diabetes-related measures and cognition.Results: The regional coupling strength of SC-FC varied greatly in different brain regions, but was strongest in the ventral attention and somatmotor network areas.Compared with NGM patients, T2DM patients had higher SC-FC coupling in the default mode network but lower SC-FC coupling in the limbic network. In addition, fasting glucose and HbA1c were associated with weaker SC-FC coupling in the limbic network, fasting insulin with higher SC-FC coupling in the limbic network, and HbA1c with higher SC-FC coupling in the dorsal attention network. Furthermore, through mediated models we found that SC-FC coupling in the limbic network suppressed the association between diabetes-related measures and cognition.T2DM and diabetes-related measures were associated with abnormal SC-FC coupling of the limbic network. The recombination of SC-FC coupling relationships in the limbic network may indicate a potential compensatory mechanism for cognitive decline that begins in prediabetes.
Keywords: type 2 diabetes mellitus, diffusion-weighted MRI, resting state functional MRI, Structure-function coupling, cognitive impairment
Received: 04 Sep 2024; Accepted: 03 Mar 2025.
Copyright: © 2025 Lu, Huang, Shen, Wang, Wang, Diao and Qiu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Shijun Qiu, The First Affiliated Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong Province, China
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