Objective To evaluate the pathological changes in grey matter nuclei of brain of Par-kinson's disease patients with freezing of gait using magnetic resonance diffusion kurtosis imaging(DKI)combined with amide proton transfer(APT)sequences.Methods A total of 92 Parkinson's disease patients were enrolled as observation group,including 42 patients with freezing of gait and 50 without freezing of gait.An additional 50 healthy individuals were enrolled as control group.All partic-ipants underwent brain scans using a 3.0T MRI system with conventional sequences,DKI and APT protocols.Post processing was performed to delineate regions of interest in bilateral substantia nigra,red nucleus,globus pallidus,caudate nucleus and putamen.DKI parameters included fractional ani-sotropy(FA),mean diffusivity(MD),mean kurtosis(MK),axial kurtosis(Ka)and kurtosis radial(Kr),and APT parameter was asymmetric magnetization transfer rate of amide protons(MTRasym).Results In the affected side of the observation group,MK and Kr values in the substantia nigra,red nucleus,globus pallidus,caudate nucleus and putamen were significantly higher than those in the control group(P＜0.05).In the observation group,MK values in the substantia nigra were significantly higher in patients with freezing of gait compared to those without(P＜0.05).MTRasym values in the affected substantia nigra,red nucleus,globus pallidus,caudate nucleus and putamen were also significantly elevated in the observation group compared to the control group(P＜0.05).MTRasym values in the affected substantia nigra were significantly higher in patients with freezing of gait than those without(P＜0.05).Receiver operating characteristic(ROC)curve analysis showed that MK,Kr and MTRasym values in the affected substantia nigra had significantly larger area under the curve(AUC)for diagnosing Parkinson's disease compared to other grey matter nuclei(P＜0.05).The AUC of the MK value of the substantia nigra on the affected side combined with MTRasym in di-agnosing frozen gait in the observation group was significantly larger than that of single index(P＜0.05).Conclusion Magnetic resonance DKI and APT sequences can provide more characteristics of pathological changes in brain gray matter nuclei associated with Parkinson's disease and frozen gait.Among them,the MK value of the affected substantia nigra combined with MTRasym has im-portant application potential in assisting the clinical diagnosis of Parkinson's disease with frozen gait.

Objective To investigate the changes of brain structure and functional connectivity by multimodal magnetic resonance imaging(MRI)in patients with type 2 diabetes mellitus(T2DM)and mild cognitive impairment(MCI).Methods A total of 120 patients with T2DM who were treated in the our hospital were enrolled in this study from April 2023 to April 2024.All the patients were divided into simple T2DM group(n=62)and MCI group(n=58)according to whether they were complicated with MCI.The general data and cognitive function related indicators were compared between the two groups,and the volume of MRI subcortical structures were analyzed.The fractional amplitude of low-frequency fluctuation(fALFF)values were compared between the two groups,and the brain regions with different fALFF values were used as seed points for voxel-based functional connectivity analysis.Pearson correlation analysis was used to analyze the correlation between MRI subcortical structure volume and abnormal functional connectivity brain regions and cognitive function in T2DM patients with MCI.Results Connection test A(TMT-A),TMT-B scores and bilateral temporal angle width of ventricles were higher,while Dorsal number span test(FDST),dorsal number span test(BDST),Wechsler adult intelligence scale(WAIS-RC)arithmetic,WAIS-RC knowledge,Montreal cognitive assessment scale(MoCA)score,bilateral caudate nucleus,putamen,hippocampal volume and subcutaneous gray matter volume were lower in MCI group than in T2DM group(P<0.05).The fALFF values increased in the left pericallosal cortex,right lingual gyrus,corpus callosum and right medial and parascingulate gyrus,while fALFF values decreased in the right inferior temporal gyrus,fusiform gyrus,left suboccipital gyrus,left parietal gyrus,left anterior cuneiform lobe,left parietal lobule and left supplementary motor area.Whole brain voxel functional connectivity analysis showed that the functional connectivity of right inferior temporal gyrus and left inferior parietal gyrus was stronger,while the functional connectivity of right lingual gyrus was weaker in MCI group than in T2DM group.Pearson correlation analysis showed that FDST,BDST,WAIS-RC arithmetic,WAIS-RC knowledge,and MoCA score were positively correlated with bilateral caudate nucleus,putamen nucleus,hippocampus volume,subcortical gray matter volume,and right inferior temporal gyrus and left inferior parietal gyrus functions(P<0.05),and negatively correlated with temporal angle width of bilateral ventricles and right superior frontal gyrus function(P<0.05).TMT-a and TMT-B scores were positively correlated with bilateral temporal angle width and right superior frontal gyrus function(P<0.05),and negatively correlated with bilateral caudate nucleus,putamen nucleus,hippocampus volume,subcortical gray matter volume,right inferior temporal gyrus and left inferior parietal gyrus function(P<0.05).Conclusions The volume of subcortical structures is changed in patients with T2DM and MCI,and there are multiple brain regions with abnormal functional connectivity.These alterations demonstrate varying degrees of correlation with MCI,providing partial insight into its neuropathological basis.

Objective To investigate the changes of brain structure and functional connectivity by multimodal magnetic resonance imaging(MRI)in patients with type 2 diabetes mellitus(T2DM)and mild cognitive impairment(MCI).Methods A total of 120 patients with T2DM who were treated in the our hospital were enrolled in this study from April 2023 to April 2024.All the patients were divided into simple T2DM group(n=62)and MCI group(n=58)according to whether they were complicated with MCI.The general data and cognitive function related indicators were compared between the two groups,and the volume of MRI subcortical structures were analyzed.The fractional amplitude of low-frequency fluctuation(fALFF)values were compared between the two groups,and the brain regions with different fALFF values were used as seed points for voxel-based functional connectivity analysis.Pearson correlation analysis was used to analyze the correlation between MRI subcortical structure volume and abnormal functional connectivity brain regions and cognitive function in T2DM patients with MCI.Results Connection test A(TMT-A),TMT-B scores and bilateral temporal angle width of ventricles were higher,while Dorsal number span test(FDST),dorsal number span test(BDST),Wechsler adult intelligence scale(WAIS-RC)arithmetic,WAIS-RC knowledge,Montreal cognitive assessment scale(MoCA)score,bilateral caudate nucleus,putamen,hippocampal volume and subcutaneous gray matter volume were lower in MCI group than in T2DM group(P<0.05).The fALFF values increased in the left pericallosal cortex,right lingual gyrus,corpus callosum and right medial and parascingulate gyrus,while fALFF values decreased in the right inferior temporal gyrus,fusiform gyrus,left suboccipital gyrus,left parietal gyrus,left anterior cuneiform lobe,left parietal lobule and left supplementary motor area.Whole brain voxel functional connectivity analysis showed that the functional connectivity of right inferior temporal gyrus and left inferior parietal gyrus was stronger,while the functional connectivity of right lingual gyrus was weaker in MCI group than in T2DM group.Pearson correlation analysis showed that FDST,BDST,WAIS-RC arithmetic,WAIS-RC knowledge,and MoCA score were positively correlated with bilateral caudate nucleus,putamen nucleus,hippocampus volume,subcortical gray matter volume,and right inferior temporal gyrus and left inferior parietal gyrus functions(P<0.05),and negatively correlated with temporal angle width of bilateral ventricles and right superior frontal gyrus function(P<0.05).TMT-a and TMT-B scores were positively correlated with bilateral temporal angle width and right superior frontal gyrus function(P<0.05),and negatively correlated with bilateral caudate nucleus,putamen nucleus,hippocampus volume,subcortical gray matter volume,right inferior temporal gyrus and left inferior parietal gyrus function(P<0.05).Conclusions The volume of subcortical structures is changed in patients with T2DM and MCI,and there are multiple brain regions with abnormal functional connectivity.These alterations demonstrate varying degrees of correlation with MCI,providing partial insight into its neuropathological basis.