title: Functional Brain Networks Are Altered in Type 2 Diabetes and Prediabetes: Signs for Compensation of Cognitive Decrements? The Maastricht Study.
abstract: Type 2 diabetes is associated with cognitive decrements, accelerated cognitive decline, and increased risk for dementia. Patients with the metabolic syndrome, a major risk factor for diabetes, may display comparable cognitive decrements as seen in type 2 diabetes. Currently, the impact of diabetes and prediabetes on cognition and the underlying organization of functional brain networks still remain to be elucidated. This study investigated whether functional brain networks are affected in type 2 diabetes and prediabetes. Forty-seven participants with diabetes, 47 participants with prediabetes, and 45 control participants underwent detailed cognitive testing and 3-Tesla resting state functional MRI. Graph theoretical network analysis was performed to investigate alterations in functional cerebral networks. Participants with diabetes displayed altered network measures, characterized by a higher normalized cluster coefficient and higher local efficiency, compared with control participants. The network measures of the participants with prediabetes fell between those with diabetes and control participants. Lower processing speed was associated with shorter path length and higher global efficiency. Participants with type 2 diabetes have altered functional brain networks. This alteration is already apparent in the prediabetic stage to a somewhat lower level, hinting at functional reorganization of the cerebral networks as a compensatory mechanism for cognitive decrements.
authors.affiliation: Departments of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Frank C G
authors.initials: FC
authors.lastname: van Bussel
authors.affiliation: Departments of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Walter H
authors.initials: WH
authors.lastname: Backes
authors.affiliation: Departments of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Tamar M
authors.initials: TM
authors.lastname: van Veenendaal
authors.affiliation: Departments of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Paul A M
authors.initials: PA
authors.lastname: Hofman
authors.affiliation: School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Martin P J
authors.initials: MP
authors.lastname: van Boxtel
authors.affiliation: Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Miranda T
authors.initials: MT
authors.lastname: Schram
authors.affiliation: Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Simone J S
authors.initials: SJ
authors.lastname: Sep
authors.affiliation: Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands Department of Epidemiology, Maastricht University Medical Center, Maastricht, the Netherlands CAPHRI School for Public Health and Primary Care, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Pieter C
authors.initials: PC
authors.lastname: Dagnelie
authors.affiliation: Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands CAPHRI School for Public Health and Primary Care, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Nicolaas
authors.initials: N
authors.lastname: Schaper
authors.affiliation: Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Coen D A
authors.initials: CD
authors.lastname: Stehouwer
authors.affiliation: Departments of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Joachim E
authors.initials: JE
authors.lastname: Wildberger
authors.affiliation: Departments of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands jansen@mumc.nl.
authors.forename: Jacobus F A
authors.initials: JF
authors.lastname: Jansen
mesh_terms: D000368:Aged; D001921:Brain / Q000378:metabolism / Q000503:physiopathology; D001931:Brain Mapping; D003071:Cognition / Q000502:physiology; D003072:Cognition Disorders / Q000378:metabolism / Q000503:physiopathology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000378:metabolism* / Q000503:physiopathology*