White Matter Function and Network Abnormalities in Patients with Diabetic Retinopathy

Background: This study aims to explore changes in white matter function and network connectivity in individuals with DR.

Methods: This study included 46 patients with DR and 43 age- and gender-matched healthy control (HC) participants were enrolled in the study. The aim was to investigate inter-group differences in white matter (WM) function and to analyze changes in the WM network among DR patients.

Results: Increased degree centrality (DC) values were observed in the middle cerebellar peduncle and genu of the corpus callosum, while higher fractional amplitude of low-frequency fluctuations (fALFF) values were found in the left superior corona radiata, right anterior corona radiata, and right superior longitudinal fasciculus. Conversely, reduced regional homogeneity (ReHo) values were noted in the left posterior thalamic radiation among patients with DR compared to HC, with statistical correction applied The SVM classification accuracy for distinguishing between DR and HC patients based on WM measures indicated values of 81.52%, 80.43%, and 89.13% for DC, fALFF, and ReHo, respectively, with respective area under the curve (AUC) values of 0.87, 0.85, and 0.93. Furthermore, alterations were detected within specific brain regions including the body of corpus callosum (BCC), splenium of corpus callosum (SCC), genu of corpus callosum (GCC), left posterior thalamic radiation (PTR), right anterior corona radiata (ACR), and right posterior corona radiata (PCR) in the DR group compared to HCs, with an intra-network decrease in connectivity. Interestingly, the left superior longitudinal fasciculus (SLF) within the DR group exhibited an intra-network increase compared to the HC group.

Conclusion: DR exhibited abnormal white matter functional alterations, particularly affecting the fiber pathways linking the visual network to the sensory-motor network.