Neuroanatomical Correlates of Dysglycemia in Young Children With Type 1 Diabetes
- Matthew J. Marzelli1,2,
- Paul K. Mazaika1,
- Naama Barnea-Goraly1,
- Tamara Hershey3,
- Eva Tsalikian4,
- William Tamborlane5,
- Nelly Mauras6,
- Neil H. White7,
- Bruce Buckingham8,
- Roy W. Beck9,
- Katrina J. Ruedy9⇑,
- Craig Kollman9,
- Peiyao Cheng9,
- Allan L. Reiss1,8,10,
- for the Diabetes Research in Children Network (DirecNet)*
- 1Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA
- 2Department of Bioengineering, Stanford University, Stanford, CA
- 3Department of Psychiatry, Department of Neurology, and Department of Radiology, Washington University in St. Louis, St. Louis, MO
- 4Pediatric Endocrinology, The University of Iowa, Des Moines, IA
- 5Pediatric Endocrinology, Yale University, New Haven, CT
- 6Pediatric Endocrinology, Nemours Children’s Clinic, Jacksonville, FL
- 7Department of Pediatrics, Washington University in St. Louis, St. Louis, MO
- 8Department of Pediatrics, Stanford University, Stanford, CA
- 9Jaeb Center for Health Research, Tampa, FL
- 10Department of Radiology, Stanford University, Stanford, CA
- Corresponding author: Katrina J. Ruedy, .
Studies of brain structure in type 1 diabetes (T1D) describe widespread neuroanatomical differences related to exposure to glycemic dysregulation in adults and adolescents. In this study, we investigate the neuroanatomical correlates of dysglycemia in very young children with early-onset T1D. Structural magnetic resonance images of the brain were acquired in 142 children with T1D and 68 age-matched control subjects (mean age 7.0 ± 1.7 years) on six identical scanners. Whole-brain volumetric analyses were conducted using voxel-based morphometry to detect regional differences between groups and to investigate correlations between regional brain volumes and measures of glycemic exposure (including data from continuous glucose monitoring). Relative to control subjects, the T1D group displayed decreased gray matter volume (GMV) in bilateral occipital and cerebellar regions (P < 0.001) and increased GMV in the left inferior prefrontal, insula, and temporal pole regions (P = 0.002). Within the T1D group, hyperglycemic exposure was associated with decreased GMV in medial frontal and temporal-occipital regions and increased GMV in lateral prefrontal regions. Cognitive correlations of intelligence quotient to GMV were found in cerebellar-occipital regions and medial prefrontal cortex for control subjects, as expected, but not for the T1D group. Thus, early-onset T1D affects regions of the brain that are associated with typical cognitive development.
- Received February 1, 2013.
- Accepted August 15, 2013.
- © 2014 by the American Diabetes Association.
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