title: Resting-state brain networks in type 1 diabetic patients with and without microangiopathy and their relation to cognitive functions and disease variables.
abstract: Cognitive functioning depends on intact brain networks that can be assessed with functional magnetic resonance imaging (fMRI) techniques. We hypothesized that cognitive decrements in type 1 diabetes mellitus (T1DM) are associated with alterations in resting-state neural connectivity and that these changes vary according to the degree of microangiopathy. T1DM patients with (MA(+): n = 49) and without (MA(-): n = 52) microangiopathy were compared with 48 healthy control subjects. All completed a neuropsychological assessment and resting-state fMRI. Networks were identified using multisubject independent component analysis; specific group differences within each network were analyzed using the dual-regression method, corrected for confounding factors and multiple comparisons. Relative to control subjects, MA(-) patients showed increased connectivity in networks involved in motor and visual processes, whereas MA(+) patients showed decreased connectivity in networks involving attention, working memory, auditory and language processing, and motor and visual processes. Better information-processing speed and general cognitive ability were related to increased degree of connectivity. T1DM is associated with a functional reorganization of neural networks that varies, dependent on the presence or absence of microangiopathy.
authors.affiliation: Diabetes Center/Department of Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands. e.vanduinkerken@vumc.nl
authors.forename: Eelco
authors.initials: E
authors.lastname: van Duinkerken
authors.forename: Menno M
authors.initials: MM
authors.lastname: Schoonheim
authors.forename: Ernesto J
authors.initials: EJ
authors.lastname: Sanz-Arigita
authors.forename: Richard G
authors.initials: RG
authors.lastname: IJzerman
authors.forename: Annette C
authors.initials: AC
authors.lastname: Moll
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Snoek
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Ryan
authors.forename: Martin
authors.initials: M
authors.lastname: Klein
authors.forename: Michaela
authors.initials: M
authors.lastname: Diamant
authors.forename: Frederik
authors.initials: F
authors.lastname: Barkhof
mesh_terms: D000328:Adult; D001307:Auditory Perception / Q000502:physiology; D002540:Cerebral Cortex / Q000098:blood supply / Q000502:physiology*; D059345:Cerebral Small Vessel Diseases / Q000503:physiopathology*; D003071:Cognition / Q000502:physiology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology; D008875:Middle Aged; D009415:Nerve Net / Q000098:blood supply / Q000503:physiopathology*; D009483:Neuropsychological Tests; D011597:Psychomotor Performance / Q000502:physiology; D014796:Visual Perception / Q000502:physiology