TY - JOUR
T1 - Brain function differences in children with type 1 diabetes
T2 - A functional mri study of working memory
AU - Diabetes Research in Children Network (DirecNet)
AU - Foland-Ross, Lara C.
AU - Tong, Gabby
AU - Mauras, Nelly
AU - Cato, Allison
AU - Aye, Tandy
AU - Tansey, Michael
AU - White, Neil H.
AU - Weinzimer, Stuart A.
AU - Englert, Kimberly
AU - Shen, Hanyang
AU - Mazaika, Paul K.
AU - Reiss, Allan L.
N1 - Funding Information:
The authors thank the participants and their families and the clinical and imaging staff at all the investigator sites, as well as external collaborators for the use of their imaging facilities, including University of California at San Francisco (San Francisco, CA), El Camino Hospital (Mountain View, CA), and University of Florida and Shands Jacksonville Medical Center (Jacksonville, FL). The authors also thank Karen Winer at the Eunice Kennedy Shriver National Institute of Child Health and Human Development for advice and support. Funding. This research was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH (DirecNet: HD-41906, HD-41908, HD-41915, HD-41918, HD-56526, R01-HD-078463, and U54 HD087011 to the Intellectual and Developmental Disabilities Research Center at Washington University in St. Louis); by a Washington University Institute of Clinical and Translational Sciences grant from the National Center for Advancing Translational Sciences (UL1TR000448) of the NIH; and by a Stanford University grant from the NIH and National Center for Research Resources (UL1TR001085). The authors are grateful to Medtronic for supplying the iPro2 CGM and to LifeScan for supplying the OneTouch Ultra 2 meter and test strips used in these studies.
Funding Information:
Acknowledgments. The authors thank the participants and their families and the clinical and imaging staff at all the investigator sites, as well as external collaborators for the use of their imaging facilities, including University of California at San Francisco (San Francisco, CA), El Camino Hospital (Mountain View, CA), and University of Florida and Shands Jacksonville Medical Center (Jacksonville, FL). The authors also thank Karen Winer at the Eunice Kennedy Shriver National Institute of Child Health and Human Development for advice and support. Funding. This research was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH (DirecNet: HD-41906, HD-41908, HD-41915, HD-41918, HD-56526, R01-HD-078463, and U54 HD087011 to the Intellectual and Developmental Disabilities Research Center at Washington University in St. Louis); by a Washington University Institute of Clinical and Translational Sciences grant from the National Center for Advancing Translational Sciences (UL1TR000448) of the NIH; and by a Stanford University grant from the NIH and National Center for Research Resources (UL1TR001085).
Publisher Copyright:
© 2020 by the American Diabetes Association.
PY - 2020/8
Y1 - 2020/8
N2 - Glucose is a primary fuel source to the brain, yet the influence of dysglycemia on neurodevelopment in children with type 1 diabetes remains unclear. We examined brain activation using functional MRI in 80 children with type 1 diabetes (mean ± SD age 11.5 ± 1.8 years; 46% female) and 47 children without diabetes (control group) (age 11.8 ± 1.5 years; 51% female) as they performed a visuospatial working memory (N-back) task. Results indicated that in both groups, activation scaled positively with increasing working memory load across many areas, including the frontoparietal cortex, caudate, and cerebel-lum. Between groups, children with diabetes exhibited reduced performance on the N-back task relative to children in the control group, as well as greater modulation of activation (i.e., showed greater increase in activation with higher working memory load). Post hoc analyses indicated that greater modulation was associated in the diabetes group with better working memory function and with an earlier age of diagnosis. These findings suggest that increased modulation may occur as a compensatory mech-anism, helping in part to preserve working memory ability, and further, that children with an earlier onset require additional compensation. Future studies that test whether these patterns change as a function of improved glycemic control are warranted.
AB - Glucose is a primary fuel source to the brain, yet the influence of dysglycemia on neurodevelopment in children with type 1 diabetes remains unclear. We examined brain activation using functional MRI in 80 children with type 1 diabetes (mean ± SD age 11.5 ± 1.8 years; 46% female) and 47 children without diabetes (control group) (age 11.8 ± 1.5 years; 51% female) as they performed a visuospatial working memory (N-back) task. Results indicated that in both groups, activation scaled positively with increasing working memory load across many areas, including the frontoparietal cortex, caudate, and cerebel-lum. Between groups, children with diabetes exhibited reduced performance on the N-back task relative to children in the control group, as well as greater modulation of activation (i.e., showed greater increase in activation with higher working memory load). Post hoc analyses indicated that greater modulation was associated in the diabetes group with better working memory function and with an earlier age of diagnosis. These findings suggest that increased modulation may occur as a compensatory mech-anism, helping in part to preserve working memory ability, and further, that children with an earlier onset require additional compensation. Future studies that test whether these patterns change as a function of improved glycemic control are warranted.
UR - http://www.scopus.com/inward/record.url?scp=85088495139&partnerID=8YFLogxK
U2 - 10.2337/db20-0123
DO - 10.2337/db20-0123
M3 - Article
C2 - 32471809
AN - SCOPUS:85088495139
SN - 0012-1797
VL - 69
SP - 1770
EP - 1778
JO - Diabetes
JF - Diabetes
IS - 8
ER -