Resting-State Brain Networks in Type 1 Diabetic Patients With and Without Microangiopathy and Their Relation to Cognitive Functions and Disease Variables
- Eelco van Duinkerken1,2⇓,
- Menno M. Schoonheim3,4,
- Ernesto J. Sanz-Arigita3,5,
- Richard G. IJzerman1,
- Annette C. Moll6,
- Frank J. Snoek2,
- Christopher M. Ryan7,
- Martin Klein2,
- Michaela Diamant1 and
- Frederik Barkhof3
- 1Diabetes Center/Department of Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands
- 2Diabetes Psychology Research Group/Department of Medical Psychology, VU University Medical Center, Amsterdam, the Netherlands
- 3Department of Radiology, VU University Medical Center, Amsterdam, the Netherlands
- 4Department of Anatomy and Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
- 5Department of Radiology, Centro de Investigación y Terapias Avanzadas (CITA)-Alzheimer Foundation, San Sebastian, Spain
- 6Department of Ophthalmology, VU University Medical Center, Amsterdam, the Netherlands
- 7Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Corresponding author: Eelco van Duinkerken, .
Cognitive functioning depends on intact brain networks that can be assessed with functional magnetic resonance imaging (fMRI) techniques. We hypothesized that cognitive decrements in type 1 diabetes mellitus (T1DM) are associated with alterations in resting-state neural connectivity and that these changes vary according to the degree of microangiopathy. T1DM patients with (MA+: n = 49) and without (MA−: n = 52) microangiopathy were compared with 48 healthy control subjects. All completed a neuropsychological assessment and resting-state fMRI. Networks were identified using multisubject independent component analysis; specific group differences within each network were analyzed using the dual-regression method, corrected for confounding factors and multiple comparisons. Relative to control subjects, MA− patients showed increased connectivity in networks involved in motor and visual processes, whereas MA+ patients showed decreased connectivity in networks involving attention, working memory, auditory and language processing, and motor and visual processes. Better information-processing speed and general cognitive ability were related to increased degree of connectivity. T1DM is associated with a functional reorganization of neural networks that varies, dependent on the presence or absence of microangiopathy.
This article contains Supplementary Data online at http://diabetes.diabetesjournals.org/lookup/suppl/doi:10.2337/db11-1358/-/DC1.
See accompanying commentary, p. 1653 .
- Received September 29, 2011.
- Accepted February 9, 2012.
- © 2012 by the American Diabetes Association.
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.