Neuroanatomical correlates of dysglycemia in young children with type 1 diabetes mellitus

  1. for the Diabetes Research in Children Network (DirecNet)**
  1. 1Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences
  2. 2Department of Bioengineering, Stanford University
  3. 3Washington University in St. Louis, Departments of Psychiatry, Neurology and Radiology
  4. 4University of Iowa, Pediatric Endocrinology
  5. 5Yale University, Pediatric Endocrinology
  6. 6Nemours Children’s Clinic, Pediatric Endocrinology
  7. 7Washington University in St. Louis, Department of Pediatrics
  8. 8Department of Pediatrics Stanford University
  9. 9Jaeb Center for Health Research
  10. 10Department of Radiology, Stanford University.
  1. Corresponding author: Katrina J. Ruedy, e-mail: direcnet{at}jaeb.org

Abstract

Studies of brain structure in type 1 diabetes mellitus (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 controls (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 controls, 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 IQ to GMV were found in cerebellar-occipital regions and medial prefrontal cortex for controls, 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.

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