Functional Brain Connectivity and Neurocognitive Functioning in Patients With Long-Standing Type 1 Diabetes With and Without Microvascular Complications

Duinkerken, Eelco van; Klein, Martin; Schoonenboom, Niki S.M.; Hoogma, Roel P.L.M.; Moll, Annette C.; Snoek, Frank J.; Stam, Cornelis J.; Diamant, Michaëla

doi:10.2337/db09-0425

Cited by 65 publications

(72 citation statements)

References 38 publications

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“…This is contrary to earlier structural and functional connectivity findings in this cohort, in which proliferative retinopathy was independently correlated with these measures, and decrements were exacerbated by proliferative retinopathy (6)(7)(8). The results presented in this study indicate that cumulative hyperglycemic exposure may be related to striatal and thalamic volume loss, but that presence of clinically manifest microangiopathy does not lead to increased volume loss rates.…”

Section: Discussioncontrasting

confidence: 57%

“…It has been shown that alterations in neuronal communication (i.e., functional connectivity) and white matter integrity (i.e., structural connectivity) were most pronounced in type 1 diabetic patients with proliferative retinopathy, but were also noted in those without microvascular complications (6)(7)(8)10). These cerebral alterations were directly associated with type 1 diabetes-related cognitive decrements (6)(7)(8)10).…”

mentioning

confidence: 86%

“…For a detailed description of all tests, please review van Duinkerken et al (6,8). Tests for estimated intelligence quotient (IQ), general cognitive ability, memory, information-processing speed, executive functions, attention, and motor and psychomotor speed were administered.…”

Section: Neuropsychological Assessmentmentioning

confidence: 99%

“…in type 1 diabetes (4)(5)(6)(7)(8), has been identified as a surrogate marker for cumulative hyperglycemic exposure (9).…”

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confidence: 99%

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Ventral Striatum, but Not Cortical Volume Loss, Is Related to Cognitive Dysfunction in Type 1 Diabetic Patients With and Without Microangiopathy

et al. 2014

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OBJECTIVEPatients with longstanding type 1 diabetes may develop microangiopathy due to high cumulative glucose exposure. Also, chronic hyperglycemia is related to cerebral alterations and cognitive dysfunction. Whether the presence of microangiopathy is conditional to the development of hyperglycemia-related cerebral compromise is unclear. Since subcortical, rather than cortical, volume loss was previously related to cognitive dysfunction in other populations, we measured these brain correlates and cognitive functions in patients with longstanding type 1 diabetes with and without microangiopathy. RESEARCH DESIGN AND METHODSWe evaluated differences in subcortical volume and cortical thickness and volume in type 1 diabetic patients with (n = 51) and without (n = 53) proliferative retinopathy and 49 control subjects and related volume differences to cognitive dysfunction. Analyses were corrected for age, sex, systolic blood pressure, and A1C. RESULTSPutamen and right thalamic volume loss was noted in both patients with and without proliferative retinopathy compared with control subjects (all P < 0.05). Additionally, in patients with proliferative retinopathy relative to control subjects, volume loss of the bilateral nucleus accumbens was found (all P < 0.05). No differences were observed between the two patient groups. Cortical thickness and volume were not different between groups. In pooled analyses, lower left nucleus accumbens volume was associated with cognitive dysfunction (P < 0.035). CONCLUSIONSThis study shows subcortical, but not cortical, volume loss in relation to cognitive dysfunction in patients with longstanding type 1 diabetes, irrespective of microangiopathy. The time course, pathophysiology, and clinical relevance of these findings need to be established in longitudinal and mechanistic studies.Longstanding type 1 diabetes mellitus may lead to development of microangiopathy, mediated by cumulative hyperglycemic exposure (1). Cognitive dysfunction is also related to prolonged hyperglycemia (2,3). Proliferative retinopathy, the presence of which has been found to be independently related to cognition and cerebral alterations

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Section: Discussioncontrasting

confidence: 57%

mentioning

confidence: 86%

Section: Neuropsychological Assessmentmentioning

confidence: 99%

“…in type 1 diabetes (4)(5)(6)(7)(8), has been identified as a surrogate marker for cumulative hyperglycemic exposure (9).…”

mentioning

confidence: 99%

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Ventral Striatum, but Not Cortical Volume Loss, Is Related to Cognitive Dysfunction in Type 1 Diabetic Patients With and Without Microangiopathy

et al. 2014

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“…A consistent finding across these studies is that individuals with T1DM and comorbid proliferative retinopathy (a marker of microvascular damage) show decreases in functional connectivity relative to individuals with T1DM without retinopathy or age-matched healthy control participants (15). In the first study to examine ICNs using fMRI, reductions in ICN strength were localized to networks involved in attention, language and working memory.…”

Section: Introductionmentioning

confidence: 96%

Age of Childhood Onset in Type 1 Diabetes and Functional Brain Connectivity in Midlife: Erratum

2016

Psychosom Med

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Objective-The development of type 1 diabetes (T1DM) within the first 7 years of life has been linked to poorer cognitive performance. Adults with T1DM have altered functional brain connectivity, but no studies have examined whether earlier age of T1DM onset is associated with functional connectivity later in life. Accordingly, we tested the relationship between age of onset and resting state functional connectivity in a cohort of middle-aged adults with childhood-onset T1DM.Methods-Subjects were from a subsample of the Pittsburgh Epidemiology of Diabetes Complications cohort and included 66 adults (mean age = 47.54 years; 32 Male). Resting state blood oxygen level dependent activity was used to calculate mean connectivity for eight functional brain networks. A multivariate analysis of variance examined associations between age of onset and network connectivity. Diffusion tensor and fluid attenuated inversion recovery images were analyzed to identify microstructural alterations and white matter hyperintensity volumes.Results-Later childhood onset of T1DM was associated with lower connectivity (F (8,57) = 2.40, p = .026). A significant interaction was present for current age such that an inverse association with age of onset for functional connectivity was present in older individuals (F (8,55) = 2.88, p = .035). Lower connectivity was associated with older age, increased white matter hyperintensity volume, and lower microstructural integrity.Conclusions-Diagnosis of T1DM later in childhood may be associated with lower brain functional connectivity, particularly in those surviving into older ages. These alterations may be an Corresponding author: John Ryan, PhD, University of Pittsburgh School of Medicine, Department of Psychiatry, 3811 O'Hara St., Pittsburgh, Pennsylvania 15213, Phone: 412-246-5765, Fax: 412-586-9111, ryanjp@upmc.edu. Conflicts of Interest:The authors declare no conflicts of interest HHS Public Access Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript early marker for subsequent cognitive decrements. Future studies are warranted to understand the pathways underlying these associations.

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Current literature in diabetes

2010

Diabetes Metabolism Res

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of diabetes/metabolism. Each bibliography is divided into 26 sections: 1 Reviews; 2 General; 3 Genetics; 4 Epidemiology; 5 Immunology; 6 Obesity; 7 Prediction and Prevention; 8 Intervention: a) General; b) Care; c) Drug Therapy; d)Economics; e) Gene therapy; f) Nursing; g) Nutrition; h) Surgery; i) Transplantation; 9 Pathology and Complications: a) General; b) Cardiovascular; c) Eye disease; d) Gestational and fetal; e) Neurological; f) Podiatrical; g) Renal; 10 Endocrinology & Metabolism; 11 Experimental Studies; 12 Diagnosis and Techniques. Within each section, articles are listed in alphabetical order with respect to author

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Functional Brain Connectivity and Neurocognitive Functioning in Patients With Long-Standing Type 1 Diabetes With and Without Microvascular Complications

Cited by 65 publications

References 38 publications

Ventral Striatum, but Not Cortical Volume Loss, Is Related to Cognitive Dysfunction in Type 1 Diabetic Patients With and Without Microangiopathy

Ventral Striatum, but Not Cortical Volume Loss, Is Related to Cognitive Dysfunction in Type 1 Diabetic Patients With and Without Microangiopathy

Age of Childhood Onset in Type 1 Diabetes and Functional Brain Connectivity in Midlife: Erratum

Current literature in diabetes

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