title: Relationships of DTI findings with neurocognitive dysfunction in children with Type 1 diabetes mellitus.
abstract: OBJECTIVE
  To determine whether there were diffusion tensor imaging (DTI) changes in the brain among children with Type 1 diabetes mellitus (DM) and investigate the correlation between the fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values and neurocognitive functions.
  
  
  METHODS
  35 children with Type 1 DM and 21 age-matched healthy control subjects were included. Neurocognitive functions of subjects with Type 1 DM were evaluated. In both groups, FA and ADC values were calculated in 20 different locations. The association between neurocognitive function tests and FA and ADC values was investigated.
  
  
  RESULTS
  Subjects with diabetes had significant changes in FA and ADC values in widespread brain regions compared with the healthy control group. ADC values in the caudate nucleus were negatively associated with verbal point. Increased ADC values in the genu of the corpus callosum were positively associated with Stroop test. There was a negative correlation between the ADC values of the parietal white matter and the judgment of line orientation test. FA values of the inferior longitudinal fasciculus were positively correlated with performance point. However, a negative correlation was noted between FA values of mid-brain and intelligence quotient level as well as another negative correlation between FA values of the posterior crus of the internal capsule and thalamus with verbal point.
  
  
  CONCLUSIONS
  Subjects with diabetes demonstrated significant changes in FA and ADC values in widespread brain regions, and such changes could be early features of injury to myelinated fibres or axonal degeneration. Our findings suggest that brain damage may have begun at the cellular level in the initial stage of Type 1 diabetes and neurocognitive impairments may be inevitable.
  
  
  CONCLUSIONS
  DTI can demonstrate ADC and FA changes which are well correlated with neurocognitive dysfunction in the brains of children with Type 1 DM. This may help us in guiding preventive measures in early period of the disease before deterioration of neurocognitive functions.
authors.affiliation: 1 Department of Radiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Huseyin
authors.initials: H
authors.lastname: Toprak
authors.affiliation: 1 Department of Radiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Huseyin
authors.initials: H
authors.lastname: Yetis
authors.affiliation: 1 Department of Radiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Alpay
authors.initials: A
authors.lastname: Alkan
authors.affiliation: 2 Department of Child Psychology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Mekiya
authors.initials: M
authors.lastname: Filiz
authors.affiliation: 1 Department of Radiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Serpil
authors.initials: S
authors.lastname: Kurtcan
authors.affiliation: 1 Department of Radiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Ayşe
authors.initials: A
authors.lastname: Aralasmak
authors.affiliation: 3 Department of Pediatric Endocrinology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Mehmet Ş
authors.initials: MŞ
authors.lastname: Aksu
authors.affiliation: 3 Department of Pediatric Endocrinology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Yaşar
authors.initials: Y
authors.lastname: Cesur
mesh_terms: D000293:Adolescent; D016880:Anisotropy; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping / Q000379:methods; D002648:Child; D003072:Cognition Disorders / Q000150:complications* / Q000503:physiopathology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000503:physiopathology*; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests / Q000706:statistics & numerical data