title: The feasibility of detecting neuropsychologic and neuroanatomic effects of type 1 diabetes in young children.
abstract: OBJECTIVE
  To determine if frequent exposures to hypoglycemia and hyperglycemia during early childhood lead to neurocognitive deficits and changes in brain anatomy.
  
  
  METHODS
  In this feasibility, cross-sectional study, young children, aged 3 to 10 years, with type 1 diabetes and age- and sex-matched healthy control (HC) subjects completed neuropsychologic (NP) testing and magnetic resonance imaging (MRI) scans of the brain.
  
  
  RESULTS
  NP testing and MRI scanning was successfully completed in 98% of the type 1 diabetic and 93% of the HC children. A significant negative relationship between HbA1c and Wechsler Intelligence Scale for Children (WISC) verbal comprehension was observed. WISC index scores were significantly reduced in type 1 diabetic subjects who had experienced seizures. White matter volume did not show the expected increase with age in children with type 1 diabetes compared with HC children (diagnosis by age interaction, P=0.005). A similar trend was detected for hippocampal volume. Children with type 1 diabetes who had experienced seizures showed significantly reduced gray matter and white matter volumes relative to children with type 1 diabetes who had not experienced seizures.
  
  
  CONCLUSIONS
  It is feasible to perform MRI and NP testing in young children with type 1 diabetes. Further, early signs of neuroanatomic variation may be present in this population. Larger cross-sectional and longitudinal studies of neurocognitive function and neuroanatomy are needed to define the effect of type 1 diabetes on the developing brain.
authors.affiliation: Department of Pediatrics, Division of Pediatric Endocrinology and Diabetes, Stanford University School of Medicine, Stanford, California, USA. taye@stanford.edu
authors.forename: Tandy
authors.initials: T
authors.lastname: Aye
authors.forename: Allan L
authors.initials: AL
authors.lastname: Reiss
authors.forename: Shelli
authors.initials: S
authors.lastname: Kesler
authors.forename: Sherry
authors.initials: S
authors.lastname: Hoang
authors.forename: Jessica
authors.initials: J
authors.lastname: Drobny
authors.forename: Yaena
authors.initials: Y
authors.lastname: Park
authors.forename: Kristin
authors.initials: K
authors.lastname: Schleifer
authors.forename: Heidi
authors.initials: H
authors.lastname: Baumgartner
authors.forename: Darrell M
authors.initials: DM
authors.lastname: Wilson
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Buckingham
mesh_terms: D001921:Brain / Q000254:growth & development / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000209:etiology*; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000473:pathology* / Q000523:psychology*; D006801:Humans; D006943:Hyperglycemia / Q000150:complications*; D007003:Hypoglycemia / Q000150:complications*; D008279:Magnetic Resonance Imaging; D012640:Seizures / Q000150:complications; D014888:Wechsler Scales