Dysfunctional Interaction Between the Dorsal Attention Network and the Default Mode Network in Patients With Type 2 Diabetes Mellitus

The risk of cognitive impairment in patients with type 2 diabetes mellitus (T2DM) is significantly higher than that in the general population, but the exact neurophysiological mechanism underlying this is still unclear. An abnormal change in the intrinsic anticorrelation of the dorsal attention network (DAN) and the default mode network (DMN) is thought to be the mechanism underlying cognitive deficits that occur in many psychiatric disorders, but this association has rarely been tested in T2DM. This study explored the relationship between the interaction patterns of the DAN-DMN and clinical/cognitive variables in patients with T2DM. Forty-four patients with T2DM and 47 sex-, age-, and education-matched healthy controls (HCs) underwent neuropsychological assessments, independent component analysis (ICA), and functional network connection analysis (FNC). The relationship of DAN-DMN anticorrelation with the results of a battery of neuropsychological tests was also assessed. Relative to the HC group, the DMN showed decreased functional connectivity (FC) in the right precuneus, and the DAN showed decreased FC in the left inferior parietal lobule (IPL) in patients with T2DM. Subsequent FNC analysis revealed that, compared with the HC group, the T2DM patients displayed significantly increased inter-network connectivity between the DAN and DMN. These abnormal changes were correlated with the scores of multiple neuropsychological assessments (P < 0.05). These findings indicate abnormal changes in the interaction patterns of the DAN-DMN may be involved in the neuropathology of attention and general cognitive dysfunction in T2DM patients.