Published online Feb 15, 2022. doi: 10.4239/wjd.v13.i2.97
Peer-review started: January 1, 2021
First decision: July 28, 2021
Revised: August 10, 2021
Accepted: January 6, 2022
Article in press: January 6, 2022
Published online: February 15, 2022
Diabetic retinopathy (DR) is one of the most common complications of diabetes mellitus; however, to date, there has been little analysis of the changes in brain function in patients with DR and their relationship to the clinical manifestations in the eye. This study is the first to examine brain changes in patients with DR using the amplitude of low-frequency fluctuation (ALFF).
The current diagnosis of DR mainly involves fundus fluorescein imaging for examination, and the direct connection between eyes, other manifestations, and the brain is still unknown. In this study, we employed the ALFF technique to investigate abnormal brain activity in DR patients and its relationship with clinical characteristics. Our research may help with understanding how DR disease develops.
We investigated the underlying ALFF of local characteristics of spontaneous brain activity in DR patients and their relationship with behavioral performance. Our findings suggested possible mechanisms of clinical manifestations and behavior in DR patients.
Twenty-four DR patients and 24 healthy controls (HCs) matched for both age and sex were recruited. We measured and recorded the average ALFF values of DR patients and HCs and then classified them using receiver operating characteristic (ROC) curves.
We found that the ALFF values of both the left and right cerebellum posterior lobe and the right anterior cingulate gyrus were remarkably higher in the DR patients compared with the HCs, but DR patients also had lower values in the bilateral calcarine. ROC curve analysis of different brain regions demonstrated high accuracy of area under the curve analysis. However, there was no remarkable relationship between ALFF mean values for different regions and clinical presentations of DR patients.
We hypothesized that DR may lead to alterations in visual cortical activity. Our results showed altered spontaneous activity in three regions of the brain in patients with DR. Abnormalities in low-frequency amplitudes in the brain may be associated with alterations in contralateral best-corrected visual acuity and depression in DR patients. These findings may suggest possible mechanisms of clinical manifestations and behaviors in DR patients.
Our finding that DR may lead to multiple low-frequency amplitude frequency changes in the brain may facilitate our exploration of pathological mechanisms and disease progression in DR patients. However, the drawback is that the sample size was too small. Future studies should increase the sample size in order to ensure the validity of our findings.