Atrophy patterns of hippocampal subfields in T2DM patients with cognitive impairment

Author(s): MengChun Li ¹ ^, ² ^, ³ , LiLi Huang ¹ ^, ² ^, ³ , Dan Yang ¹ ^, ² ^, ³ , CaiMei Luo ¹ ^, ² ^, ³ , RuoMeng Qin ¹ ^, ² ^, ³ , Bing Zhang ¹ ^, ² ^, ⁴ , Hui Zhao ¹ ^, ² ^, ³ ^, , Yun Xu ¹ ^, ² ^, ³ ^,

Publication date (Electronic): 14 March 2020

Journal: Endocrine

Publisher: Springer US

Keywords: Type 2 diabetes mellitus, Cognitive impairment, Hippocampal subfields, FreeSurfer, Magnetic resonance

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Abstract

Purpose

To identify the volume changes of hippocampus subfields in T2DM patients with cognitive impairment and to determine how these atrophy patterns associate with impairments in different cognitive domain.

Methods

A total of 117 individuals were recruited, including T2DM patients with cognitive impairment (T2DM-CI) ( n = 34), T2DM patients without cognitive impairment (T2DM-non-CI) ( n = 36) and normal controls (NC) ( n = 47). All subjects went through a 3.0 T magnetic resonance (MR) scan and a neuropsychological assessment. Hippocampal subfield volumes were processed using the FreeSurfer 6.0.0 and compared among the three groups. Partial correlation analyses were used to estimate the relationship between cognitive function and hippocampal subfield volume, with age, sex, education, and eTIV (estimated total intracranial volume) as covariants.

Results

The total hippocampal volume had a reduction trend among the three groups, and the significantly statistical difference only was found between T2DM-CI group and NC group. Regarding the hippocampal subfields, the volumes of left subiculum, left presubiculum, left fimbria, right CA1 and right molecular layer HP decreased significantly in the T2DM-CI group ( P < 0.05/12). Partial correlation analyses showed that the volumes of the left subiculum, left fimbria, and left presubiculum were significantly related to executive function. The right hippocampal CA1 volume was significantly correlated with memory in the T2DM-CI group ( P < 0.05). But in T2DM-non-CI group, the correlation between the left fimbria volume and the memory, the left subiculum volume and MoCA were different with the T2DM-CI group and NC group ( P < 0.05).

Conclusions

The smaller the volume of left presubiculum, the worse the executive function, and the atrophy of the right CA1 was related to memory impairment in T2DM-CI group. However the result was the opposite in T2DM-non-CI group. There might be a compensation mechanism of hippocampus of T2DM patients before cognitive impairment.

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Most cited references 32

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F Ségonne, A M Dale, E. Busa … (2004)

We present a novel skull-stripping algorithm based on a hybrid approach that combines watershed algorithms and deformable surface models. Our method takes advantage of the robustness of the former as well as the surface information available to the latter. The algorithm first localizes a single white matter voxel in a T1-weighted MRI image, and uses it to create a global minimum in the white matter before applying a watershed algorithm with a preflooding height. The watershed algorithm builds an initial estimate of the brain volume based on the three-dimensional connectivity of the white matter. This first step is robust, and performs well in the presence of intensity nonuniformities and noise, but may erode parts of the cortex that abut bright nonbrain structures such as the eye sockets, or may remove parts of the cerebellum. To correct these inaccuracies, a surface deformation process fits a smooth surface to the masked volume, allowing the incorporation of geometric constraints into the skull-stripping procedure. A statistical atlas, generated from a set of accurately segmented brains, is used to validate and potentially correct the segmentation, and the MRI intensity values are locally re-estimated at the boundary of the brain. Finally, a high-resolution surface deformation is performed that accurately matches the outer boundary of the brain, resulting in a robust and automated procedure. Studies by our group and others outperform other publicly available skull-stripping tools. Copyright 2004 Elsevier Inc.

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Severity classification on the Hamilton Depression Rating Scale.

Mark Zimmerman, Jennifer H Martinez, Diane Young … (2013)

Symptom severity as a moderator of treatment response has been the subject of debate over the past 20 years. Each of the meta- and mega-analyses examining the treatment significance of depression severity used the Hamilton Depression Rating Scale (HAMD), wholly, or in part, to define severity, though the cutoff used to define severe depression varied. There is limited empirical research establishing cutoff scores for bands of severity on the HAMD. The goal of the study is to empirically establish cutoff scores on the HAMD in their allocation of patients to severity groups. Six hundred twenty-seven outpatients with current major depressive disorder were evaluated with a semi-structured diagnostic interview. Scores on the 17-item HAMD were derived from ratings according to the conversion method described by Endicott et al. (1981). The patients were also rated on the Clinical Global Index of Severity (CGI). Receiver operating curves were computed to identify the cutoff that optimally discriminated between patients with mild vs. moderate and moderate vs. severe depression. HAMD scores were significantly lower in patients with mild depression than patients with moderate depression, and patients with moderate depression scored significantly lower than patients with severe depression. The cutoff score on the HAMD that maximized the sum of sensitivity and specificity was 17 for the comparison of mild vs. moderate depression and 24 for the comparison of moderate vs. severe depression. The present study was conducted in a single outpatient practice in which the majority of patients were white, female, and had health insurance. Although the study was limited to a single site, a strength of the recruitment procedure was that the sample was not selected for participation in a treatment study, and exclusion and inclusion criteria did not reduce the representativeness of the patient groups. The analyses were based on HAMD scores extracted from ratings on the SADS. However, we used Endicott et al.'s (1981) empirically established formula for deriving a HAMD score from SADS ratings, and our results concurred with other small studies of the mean and median HAMD scores in severity groups. Based on this large study of psychiatric outpatients with major depressive disorder we recommend the following severity ranges for the HAMD: no depression (0-7); mild depression (8-16); moderate depression (17-23); and severe depression (≥24). Copyright © 2013 Elsevier B.V. All rights reserved.

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Anterior hippocampus: the anatomy of perception, imagination and episodic memory.

Peter Zeidman, Eleanor A. Maguire (2016)

The brain creates a model of the world around us. We can use this representation to perceive and comprehend what we see at any given moment, but also to vividly re-experience scenes from our past and imagine future (or even fanciful) scenarios. Recent work has shown that these cognitive functions--perception, imagination and recall of scenes and events--all engage the anterior hippocampus. In this Opinion article, we capitalize on new findings from functional neuroimaging to propose a model that links high-level cognitive functions to specific structures within the anterior hippocampus.

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Author and article information

Contributors

Hui Zhao: zhaohuigyc2002@163.com

Yun Xu: xuyun20042001@aliyun.com

Journal

Journal ID (nlm-ta): Endocrine

Journal ID (iso-abbrev): Endocrine

Title: Endocrine

Publisher: Springer US (New York )

ISSN (Print): 1355-008X

ISSN (Electronic): 1559-0100

Publication date (Electronic): 14 March 2020

Publication date PMC-release: 14 March 2020

Publication date (Print): 2020

Volume: 68

Issue: 3

Pages: 536-548

Affiliations

[1 ]GRID grid.41156.37, ISNI 0000 0001 2314 964X, Department of Neurology, Affiliated Drum Tower Hospital, , Nanjing University Medical School, ; Nanjing, Jiangsu China

[2 ]GRID grid.41156.37, ISNI 0000 0001 2314 964X, Jiangsu Key Laboratory for Molecular Medicine, , Nanjing University Medical School, ; Nanjing, China

[3 ]Nanjing Medicine Center For Neurological and Psychiatric Diseases, Nanjing, China

[4 ]GRID grid.41156.37, ISNI 0000 0001 2314 964X, Department of Radiology, Affiliated Drum Tower Hospital, , Nanjing University Medical School, ; Nanjing, Jiangsu China

Article

Publisher ID: 2249

DOI: 10.1007/s12020-020-02249-w

PMC ID: 7308251

PubMed ID: 32172485

SO-VID: 5156a990-0c70-4ae5-94e7-bd13c9feb3c0

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 12 November 2019

Date accepted : 26 February 2020

Funding

Funded by: FundRef https://doi.org/10.13039/http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;

Award ID: 81630028

Award Recipient : Yun Xu

Funded by: FundRef https://doi.org/10.13039/, National Natural Science Foundation of China (CN);

Award ID: 81771157

Award Recipient : Hui Zhao

Custom metadata

ScienceOpen disciplines: Endocrinology & Diabetes

Keywords: type 2 diabetes mellitus,cognitive impairment,hippocampal subfields,freesurfer,magnetic resonance

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ScienceOpen disciplines: Endocrinology & Diabetes

Keywords: type 2 diabetes mellitus, cognitive impairment, hippocampal subfields, freesurfer, magnetic resonance

Atrophy patterns of hippocampal subfields in T2DM patients with cognitive impairment

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Abstract

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Conclusions

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Karger: Neurology and Neuroscience

Most cited references 32

A hybrid approach to the skull stripping problem in MRI.

Severity classification on the Hamilton Depression Rating Scale.

Anterior hippocampus: the anatomy of perception, imagination and episodic memory.

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