Altered Intrinsic Brain Activity Related to Neurologic and Motor Dysfunction in Diabetic Peripheral Neuropathy Patients.

Brain functional alterations in type 2 diabetes with diabetic peripheral neuropathy (DPN) related to motor dysfuction remain largely unknown. We aim to explore intrinsic resting brain activity in DPN. A total of 28 DPN patients, 43 diabetics without DPN (NDPN) and 32 healthy controls (HCs) were recruited and underwent resting-state functional MRI. We calculated the amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF) and regional homogeneity (ReHo). One-way analysis of covariance was applied to evaluate above indicators among the three groups, and the mean ALFF/fALFF/ReHo values of altered brain regions were then correlated to clinical features of patients. Compared with NDPN group, the DPN group showed significantly decreased ALFF values in the right orbital superior frontal gyrus (ORBsup), medial superior frontal gyrus (SFGmed) and incresead ALFF values in the left inferior temporal gyrus (ITG) and decreased fALFF values in the right SFGmed. Compared with HCs, the NDPN group showed increased ALFF values in the right ORBsup, middle frontal gyrus, left orbital middle frontal gyrus and decreased fALFF values in the right middle temporal gyrus. Notably, the mean ALFF values of the right ORBsup were significantly negatively correlated with Toronto Clinical Scoring System scores and gait speed in diabetics. The mean ALFF/fALFF values of right SFGmed, the mean ALFF values of left ITG and right ORBsup were significantly differentiated between DPN and NDPN patients in ROC curve analysis. DPN patients have abnormal brain activity in sensorimotor and cognitive brain areas, which may implicate the underlying neurophysiological mechanisms in intrinsic brain activity.