title: Spatial working memory impairment in primary onset middle-age type 2 diabetes mellitus: An ethology and BOLD-fMRI study.
abstract: OBJECTIVE
  To explore mild cognitive dysfunction and/or spatial working memory impairment in patients with primary onset middle-age type 2 diabetes mellitus (T2DM] using ethology (behavior tests) and blood oxygen level-dependent functional magnetic resonance imaging (BOLD-fMRI).
  
  
  METHODS
  Eighteen primary onset T2DM patients and 18 matched subjects with normal blood glucose levels were all tested using the Montreal cognitive assessment scale test, the Wechsler Memory Scale Chinese-revised test, and scanned using BOLD-fMRI (1.5T, EPI sequence) while performing the n-back task to find the activation intensity of some cognition-related areas.
  
  
  RESULTS
  The ethology results showed that T2DM patients had a mild cognitive impairment and memory dysfunction (P < 0.05). The fMRI scan identified a neural network consisting of bilateral dorsolateral prefrontal cortex (DLPFC), bilateral premotor area (PreMA), bilateral parietal lobe (PA), and anterior cingulate cortex (ACC) / supplementary motor area (SMA) that was activated during the n-back task, with right hemisphere dominance. However, only the right PA and ACC/SMA showed a load effect via quantitative analysis in the T2DM group; the activation intensity of most working memory-related brain areas for the T2DM group were lower than for the control group under three memory loads. Furthermore, we found that the activation intensity of some cognition-related areas, including the right insular lobe, left caudate nucleus, and bilateral hippocampus/parahippocampal gyrus were lower than the control group under the memory loads.
  
  
  CONCLUSIONS
  Diabetes-related brain damage of primary onset middle-age T2DM patients with right DLPFC-posterior parietal lobe and parahippocampal gyrus default network causes impairment of spatial working memory and mild cognitive dysfunction.
authors.affiliation: Department of Radiology, First Affiliated Hospital, Medical College of Shantou University, Shantou, Guangdong Province, PR China.|Department of Radiology, Yantaishan Hospital, Yantai, Shandong Province, PR China.|Guang Dong Key Laboratory of Medical Molecular Imaging, Shantou, PR China.
authors.forename: Ran-Ran
authors.initials: RR
authors.lastname: Huang
authors.affiliation: Guang Anmen Hospital, China Traditional Chinese Medical Sciences, Beijing, China.
authors.forename: Bao-Hui
authors.initials: BH
authors.lastname: Jia
authors.affiliation: Department of Radiology, First Affiliated Hospital, Medical College of Shantou University, Shantou, Guangdong Province, PR China.|Guang Dong Key Laboratory of Medical Molecular Imaging, Shantou, PR China.
authors.forename: Lei
authors.initials: L
authors.lastname: Xie
authors.affiliation: Department of Radiology, First Affiliated Hospital, Medical College of Shantou University, Shantou, Guangdong Province, PR China.|Guang Dong Key Laboratory of Medical Molecular Imaging, Shantou, PR China.
authors.forename: Shu-Hua
authors.initials: SH
authors.lastname: Ma
authors.affiliation: Department of Radiology, First Affiliated Hospital, Medical College of Shantou University, Shantou, Guangdong Province, PR China.|Guang Dong Key Laboratory of Medical Molecular Imaging, Shantou, PR China.
authors.forename: Jing-Jing
authors.initials: JJ
authors.lastname: Yin
authors.affiliation: Department of Radiology, First Affiliated Hospital, Medical College of Shantou University, Shantou, Guangdong Province, PR China.|Guang Dong Key Laboratory of Medical Molecular Imaging, Shantou, PR China.
authors.forename: Zong-Bo
authors.initials: ZB
authors.lastname: Sun
authors.affiliation: Department of Radiology, First Affiliated Hospital, Medical College of Shantou University, Shantou, Guangdong Province, PR China.|Guang Dong Key Laboratory of Medical Molecular Imaging, Shantou, PR China.
authors.forename: Hong-Bo
authors.initials: HB
authors.lastname: Le
authors.affiliation: Department of Radiology, First Affiliated Hospital, Medical College of Shantou University, Shantou, Guangdong Province, PR China.
authors.forename: Wen-Can
authors.initials: WC
authors.lastname: Xu
authors.affiliation: Department of Radiology, First Affiliated Hospital, Medical College of Shantou University, Shantou, Guangdong Province, PR China.|Guang Dong Key Laboratory of Medical Molecular Imaging, Shantou, PR China.
authors.forename: Jin-Zhuang
authors.initials: JZ
authors.lastname: Huang
authors.affiliation: Department of Radiology, First Affiliated Hospital, Medical College of Shantou University, Shantou, Guangdong Province, PR China.|Guang Dong Key Laboratory of Medical Molecular Imaging, Shantou, PR China.
authors.forename: Dong-Xue
authors.initials: DX
authors.lastname: Luo
mesh_terms: D000328:Adult; D001931:Brain Mapping / Q000379:methods; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D006624:Hippocampus / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D008570:Memory, Short-Term; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: cognitive function; diabetes mellitus; functional magnetic resonance imaging; spatial working memory