title: Neuroanatomical correlates of dysglycemia in young children with type 1 diabetes.
abstract: Studies of brain structure in type 1 diabetes (T1D) describe widespread neuroanatomical differences related to exposure to glycemic dysregulation in adults and adolescents. In this study, we investigate the neuroanatomical correlates of dysglycemia in very young children with early-onset T1D. Structural magnetic resonance images of the brain were acquired in 142 children with T1D and 68 age-matched control subjects (mean age 7.0 ± 1.7 years) on six identical scanners. Whole-brain volumetric analyses were conducted using voxel-based morphometry to detect regional differences between groups and to investigate correlations between regional brain volumes and measures of glycemic exposure (including data from continuous glucose monitoring). Relative to control subjects, the T1D group displayed decreased gray matter volume (GMV) in bilateral occipital and cerebellar regions (P < 0.001) and increased GMV in the left inferior prefrontal, insula, and temporal pole regions (P = 0.002). Within the T1D group, hyperglycemic exposure was associated with decreased GMV in medial frontal and temporal-occipital regions and increased GMV in lateral prefrontal regions. Cognitive correlations of intelligence quotient to GMV were found in cerebellar-occipital regions and medial prefrontal cortex for control subjects, as expected, but not for the T1D group. Thus, early-onset T1D affects regions of the brain that are associated with typical cognitive development.
authors.affiliation: Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Marzelli
authors.forename: Paul K
authors.initials: PK
authors.lastname: Mazaika
authors.forename: Naama
authors.initials: N
authors.lastname: Barnea-Goraly
authors.forename: Tamara
authors.initials: T
authors.lastname: Hershey
authors.forename: Eva
authors.initials: E
authors.lastname: Tsalikian
authors.forename: William
authors.initials: W
authors.lastname: Tamborlane
authors.forename: Nelly
authors.initials: N
authors.lastname: Mauras
authors.forename: Neil H
authors.initials: NH
authors.lastname: White
authors.forename: Bruce
authors.initials: B
authors.lastname: Buckingham
authors.forename: Roy W
authors.initials: RW
authors.lastname: Beck
authors.forename: Katrina J
authors.initials: KJ
authors.lastname: Ruedy
authors.forename: Craig
authors.initials: C
authors.lastname: Kollman
authors.forename: Peiyao
authors.initials: P
authors.lastname: Cheng
authors.forename: Allan L
authors.initials: AL
authors.lastname: Reiss
mesh_terms: D001786:Blood Glucose; D001921:Brain / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000473:pathology* / Q000523:psychology; D005260:Female; D006801:Humans; D007361:Intelligence Tests; D008279:Magnetic Resonance Imaging; D008297:Male; D009929:Organ Size
chemical_list: D001786:Blood Glucose