Impairments in cognition and resting-state connectivity of the hippocampus in elderly subjects with type 2 diabetes

Type 2 diabetes mellitus (T2DM) is associated with an increased risk of Alzheimer's disease, which involves hippocampus-mediated cognitive impairment. The present study investigated whether the resting-state functional connectivity of the hippocampus would be changed in patients with T2DM. A region of interest-based resting-state functional magnetic resonance imaging (fMRI) approach was applied to explore functional connectivity differences between 21 elderly patients with T2DM and 19 well-matched healthy controls, with all participants assessed by multi-dimensional neuropsychological tests. We found that T2DM patients performed significantly worse in the Auditory Verbal Learning Test (AVLT) (especially for Delayed Recall and Recognition) and Clock Drawing Test (CDT) when compared with the control group, and cognitive function was negatively related to BMI and HbA1c. Importantly, the hippocampus showed reduced functional connectivity bilaterally to widespread regions, including fusiform gyrus, frontal gyrus, temporal gyrus, anterior cingulate gyrus, medial frontal gyrus, posterior cingulate gyrus, precuneus and inferior parietal lobule in T2DM patients compared to healthy controls. T2DM is associated with an impaired pattern of default network function, and the specific disconnection pattern identified may be involved in the neuropathophysiology of this disease.