Open AccessDecision-making in primary onset middle-age type 2 diabetes mellitus: a BOLD-fMRI study
Author(s) -
Dan-Miao Sun,
Ye Ma,
Zongbo Sun,
Lei Xie,
Jinzhuang Huang,
Wei-Song Chen,
Shan Duan,
Zhiyong Lin,
R. S. Guo,
Hongbo Le,
Weilai Xu,
Shuhua Ma
Publication year - 2017
Publication title -
scientific reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.24
H-Index - 213
ISSN - 2045-2322
DOI - 10.1038/s41598-017-10228-x
Subject(s) - orbitofrontal cortex , ventromedial prefrontal cortex , posterior cingulate , functional magnetic resonance imaging , anterior cingulate cortex , prefrontal cortex , insula , cingulate cortex , dorsolateral prefrontal cortex , psychology , neuroscience , type 2 diabetes mellitus , medicine , audiology , diabetes mellitus , cognition , endocrinology , central nervous system
Although type 2 diabetes mellitus (T2DM) is a well-recognized risk factor for dementia, the neural mechanisms that underlying cognitive impairment in T2DM remain unclear. We used functional magnetic resonance imaging (fMRI) during a computerized version of the Iowa Gambling Task to investigate the neural basis of decision making at the initial onset stage of T2DM. Eighteen newly diagnosed middle-aged T2DM patients, with no previous diabetic treatment history, and 18 matched controls were recruited. Results indicated that T2DM patients made more disadvantageous decisions than controls. Compared to healthy subjects, T2DM patients showed decreased activation in the ventral medial prefrontal cortex (VMPFC), orbitofrontal cortex (OFC) and anterior cingulate cortex, and increased activity in the dorsolateral prefrontal cortex, posterior cingulate cortex, insula and occipital lobes. IGT performance positively correlated with changes in brain activation in the VMPFC and OFC in both groups. Moreover, poor glycemic control was associated with decision-making function both in behavioral and brain activity in the VMPFC and OFC in patients. Conclusively, T2DM patients may suffer from weaknesses in their prefrontal cortex functions that lead to poorer decision-making under ambiguity, at least as assessed by the IGT.