Longitudinal Assessment of Neuroanatomical and Cognitive Differences in Young Children with Type 1 Diabetes: Association with Hyperglycemia
Significant regional differences in gray and white matter volume, and subtle cognitive differences between young diabetic and non-diabetic children have been observed. Here, we assessed whether these differences change over time and the relation with dysglycemia.
Children ages 4 to <10 years with (N=144) and without (N=72) type 1 diabetes (T1D) had high resolution structural magnetic resonance imaging and comprehensive neurocognitive tests at baseline and 18-months, and continuous glucose monitoring and HbA1C performed quarterly for 18-months.
There were no differences in cognitive and executive functions scores between groups at 18-months. However, children with diabetes had slower total gray and white matter growth than controls. Gray matter regions (left precuneus, right temporal, frontal, and parietal lobes, right medial-frontal cortex) showed lesser growth in diabetes, as did white matter areas (splenium of the corpus callosum, bilateral superior-parietal lobe, bilateral anterior forceps, and inferior-frontal fasciculus). These changes were associated with higher cumulative hyperglycemia and glucose variability but not with hypoglycemia.
Young children with T1D have significant differences in total and regional gray and white matter growth in brain regions involved in complex sensorimotor processing and cognition compared to age-matched controls over 18-months, suggesting that chronic hyperglycemia may be detrimental to the developing brain.
- Received September 18, 2014.
- Accepted December 4, 2014.
- © 2014 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.