Neurocognition and brain structure in pediatric patients with type 1 diabetes

Liane Kaufmann; Silvia Pixner; Marc Starke; Sibylle Zotter; Julia Köhle; Dagmar Meraner; Christian Kremser; Karl Egger; Michael Schocke; Sabine Hofer

doi:10.3233/PNR-2012-005

Journal of Pediatric Neuroradiology, Inhaltsverzeichnis

Journal of Pediatric Neuroradiology 2012; 01(01): 025-035
DOI: 10.3233/PNR-2012-005

Georg Thieme Verlag KG Stuttgart – New York

Neurocognition and brain structure in pediatric patients with type 1 diabetes

Liane Kaufmann

^aDepartment of Medical Sciences and Management, Institute of Applied Psychology, University for Health Sciences, Medical Informatics and Technology, Hall in Tyrol, Austria

^bDepartment of Pediatrics, Medical University of Innsbruck, Innsbruck, Austria

,

Silvia Pixner

^aDepartment of Medical Sciences and Management, Institute of Applied Psychology, University for Health Sciences, Medical Informatics and Technology, Hall in Tyrol, Austria

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Marc Starke

^bDepartment of Pediatrics, Medical University of Innsbruck, Innsbruck, Austria

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Sibylle Zotter

^bDepartment of Pediatrics, Medical University of Innsbruck, Innsbruck, Austria

,

Julia Köhle

^bDepartment of Pediatrics, Medical University of Innsbruck, Innsbruck, Austria

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Dagmar Meraner

^bDepartment of Pediatrics, Medical University of Innsbruck, Innsbruck, Austria

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Christian Kremser

^cDepartment of Radiology I, Medical University of Innsbruck, Innsbruck, Austria

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Karl Egger

^cDepartment of Radiology I, Medical University of Innsbruck, Innsbruck, Austria

,

Michael Schocke

^cDepartment of Radiology I, Medical University of Innsbruck, Innsbruck, Austria

,

Sabine Hofer

^bDepartment of Pediatrics, Medical University of Innsbruck, Innsbruck, Austria

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Abstract

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Abstract

Recent findings suggest that in addition to severe hypoglycemia, chronic hyperglycemia may also hamper the cognitive development of patients with type 1 diabetes. Executive and memory dysfunctions mediated by frontoparietal and temporal brain structures are frequently reported to be associated with type 1 diabetes. However, most studies investigating pediatric patients with diabetes focus on either brain function or brain structure.

The current study combines neuropsychological and structural brain imaging methods (i.e., voxel-based-morphometry) to study the neurofunctional integrity of frontoparietal brain areas. We investigated 30 children with type 1 diabetes and 19 healthy controls. Children with diabetes were divided into two groups representing better (HbA1c ≤ 7.9%) and worse (HbA1c ≥ 8.0%) glycemic control. Our findings were threefold: First, results revealed significant group differences with respect to neuropsychological performance (i.e. response accuracies on a marker task tapping frontoparietal brain functions). Second, structural imaging disclosed significant group differences between patients and controls regarding gray matter volume in frontal (anterior cingulate) and occipital (cuneus, bordering precuneus) brain regions and regarding white matter in middle temporal and occipital gyri as well as in the ventromedial temporal lobe (uncus). Third, disease duration, age at diagnosis and white matter volume in a hippocampal region-of-interest (but not HbA1c levels, intelligence, total gray/white matter or other white/gray matter regions-of-interest) explained 56% of neuropsychological performance variance. Taken together, our findings are among the first to provide evidence of a direct link between brain function and brain structure in pediatric patients with type 1 diabetes.

Keywords

Type 1 diabetes - neuropsychological performance - HbA1c - voxel-based-morphometry - gray matter - white matter - metabolic control - neurocognition - pediatrics

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