{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T21:24:03Z","timestamp":1782768243769,"version":"3.54.5"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T00:00:00Z","timestamp":1731283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The mechanisms associated between diabetic peripheral neuropathy (DPN) and various brain function abnormalities in patients remains unclear. This study attempted to indirectly evaluate the effect of DPN on brain function in patients with type 2 diabetes mellitus (T2DM) by characterizing the resting-state functional connectivity (FC) of the lower limb sensorimotor cortex (LSM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty-four T2DM patients with diabetic peripheral neuropathy (DPN), 39 T2DM patients without diabetic peripheral neuropathy (ND), and 43 healthy controls (HCs) underwent a neuropsychological assessment and resting-state functional magnetic resonance imaging examinations to examine the differences in FC between the LSM and the whole brain. The relationships of FC with clinical\/cognitive variables were examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In comparison with the HCs group, the ND group showed reduced FC of the LSM with the right lateral occipitotemporal cortex (LOTC) and increased FC with the medial superior frontal gyrus (SFGmed), while the DPN group showed reduced FC of the LSM with the right cerebellar lobule VI, the right LOTC, the rostral prefrontal cortex (rPFC), and the anterior cingulate gyrus (ACC). Moreover, in comparison with the ND group, the DPN group showed reduced FC of the LSM with the ACC, SFGmed, and rPFC. In the DPN group, the FC between the LSM and right cerebellar lobule VI was significantly correlated with fasting blood glucose levels (r = -0.490, <jats:italic>p<\/jats:italic> = 0.001), and that between the LSM and ACC was significantly correlated with the Montreal Cognitive Assessment score (r = 0.479, <jats:italic>p<\/jats:italic> = 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with T2DM may show abnormal motion-related visual perceptual function before the appearance of DPN. Importantly, DPN can influence the brain regions that maintain motion and motor control, and this effect is not limited to motor function, which may be the central neuropathological basis for diabetic peripheral neuropathy.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2024.1448225","type":"journal-article","created":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T04:36:03Z","timestamp":1731299763000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Potential effects of peripheral neuropathy on brain function in patients with type 2 diabetes mellitus"],"prefix":"10.3389","volume":"15","author":[{"given":"Dongsheng","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoling","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanting","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yitong","family":"Guan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Lei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Ai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuejiao","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,11,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-2042","article-title":"Diabetic neuropathy: A position statement by the american diabetes association","volume":"40","author":"Pop-Busui","year":"2017","journal-title":"Diabetes Care"},{"key":"B2","doi-asserted-by":"crossref","DOI":"10.2337\/db20182-1","volume-title":"Diagnosis and Management of Diabetic Foot Complications","author":"Boulton","year":"2018"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(19)30081-6","article-title":"Diabetic peripheral neuropathy: advances in diagnosis and strategies for screening and early intervention","volume":"7","author":"Selvarajah","year":"2019","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2023.e18368","article-title":"Changes in the central nervous system in diabetic neuropathy","volume":"9","author":"Zang","year":"2023","journal-title":"Heliyon"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgab158","article-title":"Decreased microstructural integrity of the central somatosensory tracts in diabetic peripheral neuropathy","volume":"106","author":"Fang","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-021-00496-z","article-title":"Pathogenesis, diagnosis and clinical management of diabetic sensorimotor peripheral neuropathy","volume":"17","author":"Sloan","year":"2021","journal-title":"Nat Rev Endocrinol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroscience.2015.05.020","article-title":"Circuitry and plasticity of the dorsal horn\u2013toward a better understanding of neuropathic pain","volume":"300","author":"West","year":"2015","journal-title":"Neuroscience"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-2610","article-title":"Magnetic resonance neuroimaging study of brain structural differences in diabetic peripheral neuropathy","volume":"37","author":"Selvarajah","year":"2014","journal-title":"Diabetes Care"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.24834","article-title":"Sensorimotor and pain-related alterations of the gray matter and white matter in Type 2 diabetic patients with peripheral neuropathy","volume":"41","author":"Zhang","year":"2020","journal-title":"Hum Brain Mapp"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-2463","article-title":"The relationship between brain volume and walking outcomes in older adults with and without diabetic peripheral neuropathy","volume":"35","author":"Manor","year":"2012","journal-title":"Diabetes Care"},{"key":"B11","doi-asserted-by":"publisher","first-page":"796","DOI":"10.2337\/db18-0509","article-title":"Structural and functional abnormalities of the primary somatosensory cortex in diabetic peripheral neuropathy: A multimodal MRI study","volume":"68","author":"Selvarajah","year":"2019","journal-title":"Diabetes"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgac651","article-title":"Altered intrinsic brain activity related to neurologic and motor dysfunction in diabetic peripheral neuropathy patients","volume":"108","author":"Xin","year":"2023","journal-title":"J Clin Endocrinol Metab"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-0746","article-title":"Altered motor and motor perceptual cognitive imagery task-related activation in diabetic peripheral neuropathy: insights from functional MRI","volume":"42","author":"Venkataraman","year":"2019","journal-title":"Diabetes Care"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2011.12.021","article-title":"Relation between risk of falling and postural sway complexity in diabetes","volume":"35","author":"Morrison","year":"2012","journal-title":"Gait Posture"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-017-0295-y","article-title":"Diabetic neuropathy and gait: A review","volume":"8","author":"Alam","year":"2017","journal-title":"Diabetes Ther"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/9305025","article-title":"Postural control and gait performance in the diabetic peripheral neuropathy: A systematic review","volume":"2016","author":"Mustapa","year":"2016","journal-title":"BioMed Res Int"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1177\/0733464815602341","article-title":"Sensory functions, balance, and mobility in older adults with type 2 diabetes without overt diabetic peripheral neuropathy: A brief report","volume":"36","author":"Deshpande","year":"2017","journal-title":"J Appl Gerontol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2013.06.007","article-title":"Postural control and functional strength in patients with type 2 diabetes mellitus with and without peripheral neuropathy","volume":"94","author":"Vaz","year":"2013","journal-title":"Arch Phys Med Rehabil"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1093\/cercor\/bhw157","article-title":"The human brainnetome atlas: A new brain atlas based on connectional architecture","volume":"26","author":"Fan","year":"2016","journal-title":"Cereb Cortex"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.22933","article-title":"Connectivity-based parcellation: Critique and implications","volume":"36","author":"Eickhoff","year":"2015","journal-title":"Hum Brain Mapp"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3389\/fnana.2012.00034","article-title":"Connectivity-based structural and functional parcellation of the human cortex using diffusion imaging and tractography","volume":"6","author":"Cloutman","year":"2012","journal-title":"Front Neuroanat"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.24004","article-title":"Sensorimotor network alterations in children and youth with prenatal alcohol exposure","volume":"39","author":"Long","year":"2018","journal-title":"Hum Brain Mapp"},{"key":"B23","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1038\/s41398-023-02616-x","article-title":"Metformin improves cognitive impairment in patients with schizophrenia: associated with enhanced functional connectivity of dorsolateral prefrontal cortex","volume":"13","author":"Shao","year":"2023","journal-title":"Transl Psychiatry"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-1303","article-title":"Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments","volume":"33","author":"Tesfaye","year":"2010","journal-title":"Diabetes Care"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.51918","article-title":"Structural and functional connectivity alteration patterns of the cingulate gyrus in Type 2 diabetes","volume":"10","author":"Zhang","year":"2023","journal-title":"Ann Clin Transl Neurol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1093\/arclin\/15.5.425","article-title":"Equivalence of the color trails test and trail making test in nonnative english-speakers","volume":"15","author":"Dugbartey","year":"2000","journal-title":"Arch Clin Neuropsychol"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.12779\/dnd.2018.17.3.100","article-title":"Usefulness of the clock drawing test as a cognitive screening instrument for mild cognitive impairment and mild dementia: an evaluation using three scoring systems","volume":"17","author":"Kim","year":"2018","journal-title":"Dement Neurocogn Disord"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1002\/1097-4679(199311)49:6<883::aid-jclp2270490616>3.0.co;2-6","article-title":"Rey Auditory-Verbal Learning Test: structure analysis","volume":"49","author":"Vakil","year":"1993","journal-title":"J Clin Psychol"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2018.01.014","article-title":"Symbol Digit Modalities Test adaptation for Magnetic Resonance Imaging environment: A systematic review and meta-analysis","volume":"20","author":"Silva","year":"2018","journal-title":"Mult Scler Relat Disord"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.32.6.1318","article-title":"A new rating scale for age-related white matter changes applicable to MRI and CT","volume":"32","author":"Wahlund","year":"2001","journal-title":"Stroke"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2011.10.018","article-title":"Spurious but systematic correlations in functional connectivity MRI networks arise from subject motion","volume":"59","author":"Power","year":"2012","journal-title":"Neuroimage"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.23843","article-title":"Reproducibility of R-fMRI metrics on the impact of different strategies for multiple comparison correction and sample sizes","volume":"39","author":"Chen","year":"2018","journal-title":"Hum Brain Mapp"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.25217","article-title":"Influence of sample size and analytic approach on stability and interpretation of brain-behavior correlations in task-related fMRI data","volume":"42","author":"Grady","year":"2021","journal-title":"Hum Brain Mapp"},{"key":"B34","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1016\/j.tics.2022.12.011","article-title":"Statistical power in network neuroscience","volume":"27","author":"Helwegen","year":"2023","journal-title":"Trends Cognit Sci"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1016\/j.tics.2015.03.006","article-title":"The lateral occipitotemporal cortex in action","volume":"19","author":"Lingnau","year":"2015","journal-title":"Trends Cognit Sci"},{"key":"B36","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1007\/s00426-011-0392-x","article-title":"Neural representations of faces and limbs neighbor in human high-level visual cortex: evidence for a new organization principle","volume":"77","author":"Weiner","year":"2013","journal-title":"Psychol Res"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2022.119450","article-title":"Representation of motion concepts in occipitotemporal cortex: fMRI activation, decoding and connectivity analyses","volume":"259","author":"Zhang","year":"2022","journal-title":"Neuroimage"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2006.01.033","article-title":"Building a motor simulation de novo: observation of dance by dancers","volume":"31","author":"Cross","year":"2006","journal-title":"Neuroimage"},{"key":"B39","doi-asserted-by":"publisher","first-page":"586","DOI":"10.1016\/j.neuron.2010.09.032","article-title":"Topographic representation of the human body in the occipitotemporal cortex","volume":"68","author":"Orlov","year":"2010","journal-title":"Neuron"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1162\/jocn_a_00195","article-title":"Viewpoint (in)dependence of action representations: an MVPA study","volume":"24","author":"Oosterhof","year":"2012","journal-title":"J Cognit Neurosci"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2020.585588","article-title":"Aberrant brain network integration and segregation in diabetic peripheral neuropathy revealed by structural connectomics","volume":"14","author":"Yang","year":"2020","journal-title":"Front Neurosci"},{"key":"B42","doi-asserted-by":"publisher","first-page":"107404","DOI":"10.1016\/j.jdiacomp.2019.07.001","article-title":"Combined exercise and visual gaze training improves stepping accuracy in people with diabetic peripheral neuropathy","volume":"33","author":"Handsaker","year":"2019","journal-title":"J Diabetes Complications"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuropsychologia.2013.02.002","article-title":"Pre-SMA actively engages in conflict processing in human: a combined study of epicortical ERPs and direct cortical stimulation","volume":"51","author":"Usami","year":"2013","journal-title":"Neuropsychologia"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21609","article-title":"Different cerebral cortical areas influence the effect of subthalamic nucleus stimulation on parkinsonian motor deficits and freezing of gait","volume":"22","author":"Lyoo","year":"2007","journal-title":"Mov Disord"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-021-08488-3","article-title":"Functional MRI evidence for primary motor cortex plasticity contributes to the disease's severity and prognosis of cervical spondylotic myelopathy patients","volume":"32","author":"Zhao","year":"2022","journal-title":"Eur Radiol"},{"key":"B46","doi-asserted-by":"publisher","first-page":"3","DOI":"10.2337\/db19-0321","article-title":"Brain and body: A review of central nervous system contributions to movement impairments in diabetes","volume":"69","author":"Ferris","year":"2020","journal-title":"Diabetes"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0835746100","article-title":"Modular organization of internal models of tools in the human cerebellum","volume":"100","author":"Imamizu","year":"2003","journal-title":"Proc Natl Acad Sci U.S.A"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1038\/35003194","article-title":"Human cerebellar activity reflecting an acquired internal model of a new tool","volume":"403","author":"Imamizu","year":"2000","journal-title":"Nature"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1038\/nrn1953","article-title":"The primate cortico-cerebellar system: anatomy and function","volume":"7","author":"Ramnani","year":"2006","journal-title":"Nat Rev Neurosci"},{"key":"B50","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.pscychresns.2018.06.002","article-title":"Higher fasting plasma glucose is associated with smaller striatal volume and poorer fine motor skills in a longitudinal cohort","volume":"278","author":"Zhang","year":"2018","journal-title":"Psychiatry Res Neuroimaging"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.7554\/eLife.65906","article-title":"Disrupting cortico-cerebellar communication impairs dexterity","volume":"10","author":"Guo","year":"2021","journal-title":"Elife"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1006\/nimg.2001.0839","article-title":"On the functional neuroanatomy of intrinsic and phasic alertness","volume":"14","author":"Sturm","year":"2001","journal-title":"Neuroimage"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1093\/cercor\/bhs057","article-title":"Preparatory attention relies on dynamic interactions between prelimbic cortex and anterior cingulate cortex","volume":"23","author":"Totah","year":"2013","journal-title":"Cereb Cortex"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1016\/j.copsyc.2019.08.002","article-title":"The role of attention in motor control and learning","volume":"29","author":"Song","year":"2019","journal-title":"Curr Opin Psychol"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2013.02.006","article-title":"Similar scaling of contralateral and ipsilateral cortical responses during graded unimanual force generation","author":"Derosiere","year":"2014","journal-title":"Neuroimage"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2016.06.019","article-title":"Atypical within- and between-hemisphere motor network functional connections in children with developmental coordination disorder and attention-deficit\/hyperactivity disorder","volume":"12","author":"McLeod","year":"2016","journal-title":"NeuroImage Clin"},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2015.08.003","article-title":"Eye and hand motor interactions with the Symbol Digit Modalities Test in early multiple sclerosis","volume":"4","author":"Nygaard","year":"2015","journal-title":"Mult Scler Relat Disord"},{"key":"B58","doi-asserted-by":"publisher","DOI":"10.1016\/j.bandc.2013.04.003","article-title":"Task-load manipulation in the Symbol Digit Modalities Test: an alternative measure of information processing speed","volume":"82","author":"Forn","year":"2013","journal-title":"Brain Cognit"},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.1177\/0300060518789299","article-title":"Positive correlation between cognitive impairment and renal microangiopathy in patients with type 2 diabetic nephropathy: a multicenter retrospective study","volume":"46","author":"Li","year":"2018","journal-title":"J Int Med Res"},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2021.692911","article-title":"Association between diabetic retinopathy and cognitive impairment: A systematic review and meta-analysis","volume":"13","author":"Cheng","year":"2021","journal-title":"Front Aging Neurosci"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2024.1448225\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T04:36:07Z","timestamp":1731299767000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2024.1448225\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,11]]},"references-count":60,"alternative-id":["10.3389\/fendo.2024.1448225"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2024.1448225","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,11]]},"article-number":"1448225"}}