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The feasibility of detecting neuropsychologic and neuroanatomic effects of type 1 diabetes in young children.

Aye T, Reiss AL, Kesler S, Hoang S, Drobny J, Park Y, Schleifer K, Baumgartner H, Wilson DM, Buckingham BA - Diabetes Care (2011)

Bottom Line: NP testing and MRI scanning was successfully completed in 98% of the type 1 diabetic and 93% of the HC children.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).

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Division of Pediatric Endocrinology and Diabetes, Stanford University School of Medicine, Stanford, California, USA. taye@stanford.edu

ABSTRACT

Objective: To determine if frequent exposures to hypoglycemia and hyperglycemia during early childhood lead to neurocognitive deficits and changes in brain anatomy.

Research design and 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.

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Related in: MedlinePlus

Recruitment and enrollment. Subjects were more likely to participate in the study when approached in person in the clinic. Most of the subjects with type 1 diabetes mellitus (T1DM) and the HC participants were able to complete both NP testing and the MRI.
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Figure 1: Recruitment and enrollment. Subjects were more likely to participate in the study when approached in person in the clinic. Most of the subjects with type 1 diabetes mellitus (T1DM) and the HC participants were able to complete both NP testing and the MRI.

Mentions: We approached 81 subjects with type 1 diabetes, of whom 35 received an e-mail or a telephone message (there was no response from 25 potential participants), and another 46 were directly approached in the clinic. One child was excluded for a history of a neurologic condition independent of diabetes. We enrolled 28 with type 1 diabetes. Likewise, we approached 30 HC children in person, mostly siblings or friends of our subjects with type 1 diabetes and enrolled 17 HC subjects. One was excluded for having an oral metal appliance. The most common reasons for not participating in the study were time commitment and not wanting to undergo an MRI scan. Of the 45 enrolled, only one 3-year-old child was unable to complete both the NP testing and the MRI scanning (Fig. 1). Another three subjects, two with type 1 diabetes (4 years old, 5 years old) and one HC child (6.5 years old), completed the NP testing but not the MRI scanning. Two additional subjects (6-year-old with type 1 diabetes and an 8-year-old HC child) were able to complete the MRI scanning but had only partially usable data because of movement artifact. The final groups were closely matched in age (type 1 diabetes, 7.0 ± 1.4; HC subjects, 7.2 ± 1.6 years; Table 1).


The feasibility of detecting neuropsychologic and neuroanatomic effects of type 1 diabetes in young children.

Aye T, Reiss AL, Kesler S, Hoang S, Drobny J, Park Y, Schleifer K, Baumgartner H, Wilson DM, Buckingham BA - Diabetes Care (2011)

Recruitment and enrollment. Subjects were more likely to participate in the study when approached in person in the clinic. Most of the subjects with type 1 diabetes mellitus (T1DM) and the HC participants were able to complete both NP testing and the MRI.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3120162&req=5

Figure 1: Recruitment and enrollment. Subjects were more likely to participate in the study when approached in person in the clinic. Most of the subjects with type 1 diabetes mellitus (T1DM) and the HC participants were able to complete both NP testing and the MRI.
Mentions: We approached 81 subjects with type 1 diabetes, of whom 35 received an e-mail or a telephone message (there was no response from 25 potential participants), and another 46 were directly approached in the clinic. One child was excluded for a history of a neurologic condition independent of diabetes. We enrolled 28 with type 1 diabetes. Likewise, we approached 30 HC children in person, mostly siblings or friends of our subjects with type 1 diabetes and enrolled 17 HC subjects. One was excluded for having an oral metal appliance. The most common reasons for not participating in the study were time commitment and not wanting to undergo an MRI scan. Of the 45 enrolled, only one 3-year-old child was unable to complete both the NP testing and the MRI scanning (Fig. 1). Another three subjects, two with type 1 diabetes (4 years old, 5 years old) and one HC child (6.5 years old), completed the NP testing but not the MRI scanning. Two additional subjects (6-year-old with type 1 diabetes and an 8-year-old HC child) were able to complete the MRI scanning but had only partially usable data because of movement artifact. The final groups were closely matched in age (type 1 diabetes, 7.0 ± 1.4; HC subjects, 7.2 ± 1.6 years; Table 1).

Bottom Line: NP testing and MRI scanning was successfully completed in 98% of the type 1 diabetic and 93% of the HC children.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).

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Division of Pediatric Endocrinology and Diabetes, Stanford University School of Medicine, Stanford, California, USA. taye@stanford.edu

ABSTRACT

Objective: To determine if frequent exposures to hypoglycemia and hyperglycemia during early childhood lead to neurocognitive deficits and changes in brain anatomy.

Research design and 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.

Show MeSH
Related in: MedlinePlus