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Disrupted topological organization of human brain connectome in diabetic retinopathy patients

Authors Huang X, Tong Y, Qi CX, Xu YT, Dan HD, Shen Y

Received 3 May 2019

Accepted for publication 3 August 2019

Published 27 August 2019 Volume 2019:15 Pages 2487—2502

DOI https://doi.org/10.2147/NDT.S214325

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Prof. Dr. Roumen Kirov

Peer reviewer comments 2

Editor who approved publication: Professor Jun Chen


Xin Huang, Yan Tong, Chen-Xing Qi, Yang-Tao Xu, Han-Dong Dan, Yin Shen

Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, People’s Republic of China

Correspondence: Yin Shen
Eye Center, Renmin Hospital of Wuhan University, No 238, Jie Fang Road, Wu Chang District, Wuhan 430060, Hubei, People’s Republic of China
Tel +86 1 387 155 0513
Email yinshen@whu.edu.cn

Objective: There is increasing neuroimaging evidence that type 2 diabetes patients with retinal microvascular complications show abnormal brain functional and structural architecture and are at an increased risk of cognitive decline and dementia. However, changes in the topological properties of the functional brain connectome in diabetic retinopathy (DR) patients remain unknown. The aim of this study was to explore the topological organization of the brain connectome in DR patients using graph theory approaches.
Methods: Thirty-five DR patients (18 males and 17 females) and 38 healthy controls (HCs) (18 males and 20 females), matched for age, sex, and education, underwent resting-state magnetic resonance imaging scans. Graph theory analysis was performed to investigate the topological properties of brain functional connectome at both global and nodal levels.
Results: Both DR and HC groups showed high-efficiency small-world network in their brain functional networks. Notably, the DR group showed reduction in the clustering coefficient (P=0.0572) and local efficiency (P=0.0151). Furthermore, the DR group showed reduced nodal centralities in the default-mode network (DMN) and increased nodal centralities in the visual network (VN) (P<0.01, Bonferroni-corrected). The DR group also showed abnormal functional connections among the VN, DMN, salience network (SN), and sensorimotor network (SMN). Altered network metrics and nodal centralities were significantly correlated with visual acuity and fasting blood glucose level in DR patients.
Conclusion: DR patients showed abnormal topological organization of the human brain connectome. Specifically, the DR group showed reduction in the clustering coefficient and local efficiency, relative to HC group. Abnormal nodal centralities and functional disconnections were mainly located in the DMN, VN, SN, and SMN in DR patients. Furthermore, the disrupted topological attributes showed correlations with clinical variables. These findings offer important insight into the neural mechanism of visual loss and cognitive deficits in DR patients.

Keywords: diabetic retinopathy, graph theory, functional connectome, resting-state functional magnetic resonance imaging

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