Altered intrinsic brain activity in patients with diabetic retinopathy and nephropathy: a resting-state fMRI study

ABSTRACT

Objective: We used percent amplitude of fluctuation (PerAF) to investigate the alterations in diabetic retinopathy and nephropathy (DRN) patients. Method: Twenty DRN patients were recruited in the DRN patient group (PG), while 20 matched healthy subjects were recruited in the healthy control group (HG). The PerAF method was applied to all individuals to assess spontaneous brain activity changes. A sliding window method was utilized to explore the altered dynamics of PerAF in patients with DRN. The PerAF values of the DRN patients were distinguished from those of the HCs using a receiver operating characteristic curve (ROC). Results: In the PG, the PerAF values of the medial side of the temporal lobe and the left putamen were increased to varying degrees. The PerAF values of the left medial superior frontal gyrus and the right precuneus were decreased to varying degrees. In the PG, the HADS score was significantly negatively correlated with PerAF of the left medial superior frontal lobe (r=−0.9127, P<0.0001 for anxiety and r=−0.9378, P<0.0001 for depression). The area under the ROC curve (AUC) was 1.000 (p＜0.0001;95% CI:1.000–1.000) for the medial side of the temporal lobe (aal) and 0.915 for left putamen (aal) (p＜0.0001; 95% CI:0.823–1.000). The area under the ROC curve was 0.993 (p ＜ 0.0001; 95% CI:0.973–1.000) for the left medial superior frontal lobe (aal) and 0.930 for the right precuneus (aal) (p＜0.0001; 95% CI: 0.849–1.000). Conclusion: DRN is associated with abnormal variability of PerAF in the specific cerebral region, possibly providing new insights into its pathophysiology and prevention and treatment of DRN patients. 80