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Diabetes. 2015 May;64(5):1770-9. doi: 10.2337/db14-1445. Epub 2014 Dec 8.

Longitudinal assessment of neuroanatomical and cognitive differences in young children with type 1 diabetes: association with hyperglycemia.

Author information

1
Division of Endocrinology, Diabetes & Metabolism, Nemours Children's Clinic, Jacksonville, FL nmauras@nemours.org.
2
Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA.
3
Department of Pediatrics, Stanford University School of Medicine, Stanford, CA.
4
Department of Pediatrics, Yale University School of Medicine, New Haven, CT.
5
Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO.
6
Pediatric Endocrinology, University of Iowa, Iowa City, IA.
7
Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO Department of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO.
8
Division of Neurology, Nemours Children's Clinic, Jacksonville, FL.
9
Jaeb Center for Health Research, Tampa, FL.
10
Division of Endocrinology, Diabetes & Metabolism, Nemours Children's Clinic, Jacksonville, FL.
11
Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA Department of Bioengineering, Stanford University School of Medicine, Stanford, CA.
12
Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD.
13
Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA Department of Pediatrics, Stanford University School of Medicine, Stanford, CA Department of Radiology, Stanford University School of Medicine, Stanford, CA.

Abstract

Significant regional differences in gray and white matter volume and subtle cognitive differences between young diabetic and nondiabetic 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 MRI 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 function scores between groups at 18 months. However, children with diabetes had slower total gray and white matter growth than control subjects. Gray matter regions (left precuneus, right temporal, frontal, and parietal lobes and 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 with age-matched control subjects over 18 months, suggesting that chronic hyperglycemia may be detrimental to the developing brain.

PMID:
25488901
PMCID:
PMC4407847
DOI:
10.2337/db14-1445
[Indexed for MEDLINE]
Free PMC Article

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