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Ahmed S, Cano MÁ, Sánchez M, Hu N, Ibañez G. Effect of exposure to maternal diabetes during pregnancy on offspring's brain cortical thickness and neurocognitive functioning. Child Neuropsychol 2023; 29:588-606. [PMID: 35867480 PMCID: PMC9867783 DOI: 10.1080/09297049.2022.2103105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Little is known about the long-term effects of maternal diabetes during pregnancy (DP), either gestational diabetes or preexisting diabetes (type 1 or type 2), on offspring's brain morphometry and neurocognitive functioning (NCF). This study examined the effect of prenatal exposure to maternal DP on the brain structure and NCF in children between 9 and 10 years of age. This study used cross-sectional neuroimaging and NCF data from the baseline wave of the Adolescent Brain and Cognitive Development® study. Exposure to maternal DP was assigned from the developmental history questionnaire. Differences in the brain cortical thickness (CTh) and five cognitive abilities (executive function, working and episodic memory, processing speed, and language abilities) were examined in diabetes-exposed and diabetes-unexposed children. Linear mixed effect models and generalized linear models were used to adjust for the effect of confounding variables. A total of 9,967 children (718 diabetes-exposed and 9249 unexposed) were included in the analysis. Diabetes-exposed children had lower whole-brain CTh [mean: exposed vs unexposed = 2.725 mm vs 2.732 mm; difference (95%CI): -0.007 mm (-0.013, -0.001)] compared to unexposed children after adjusting for confounding variables. Diabetes-exposed children had lower CTh in most part of the occipital lobe of both hemispheres, right postcentral gyrus, and left superior parietal cortex. Diabetes-exposed children also had lower scores in processing speed task [mean difference (95%CI): -1.7 (-2.8, -0.6)] and total cognition [mean difference (95%CI): -0.6 (-1.2, -0.02)]. Diabetes-exposed children have reduced CTh and NCF during preadolescence, which might have implications for psychomotor development during later life. Prospective studies are needed to confirm our findings.
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Affiliation(s)
- Shyfuddin Ahmed
- Corresponding author: Shyfuddin Ahmed, Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC-5 (level 4), Miami, Florida 33199, (786) 461-5574,
| | - Miguel Ángel Cano
- Corresponding author: Shyfuddin Ahmed, Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC-5 (level 4), Miami, Florida 33199, (786) 461-5574,
| | - Mariana Sánchez
- Corresponding author: Shyfuddin Ahmed, Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC-5 (level 4), Miami, Florida 33199, (786) 461-5574,
| | - Nan Hu
- Corresponding author: Shyfuddin Ahmed, Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC-5 (level 4), Miami, Florida 33199, (786) 461-5574,
| | - Gladys Ibañez
- Corresponding author: Shyfuddin Ahmed, Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC-5 (level 4), Miami, Florida 33199, (786) 461-5574,
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Miura G. Visual Evoked Potentials for the Detection of Diabetic Retinal Neuropathy. Int J Mol Sci 2023; 24:ijms24087361. [PMID: 37108524 PMCID: PMC10138821 DOI: 10.3390/ijms24087361] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/14/2023] [Accepted: 04/16/2023] [Indexed: 04/29/2023] Open
Abstract
Visual evoked potentials (VEP) are visually evoked signals that extract electroencephalographic activity in the visual cortex that can detect retinal ganglion cells, optic nerves, chiasmal and retrochiasmal dysfunction, including optic radiations, and the occipital cortex. Because diabetes causes diabetic retinopathy due to microangiopathy and neuropathy due to metabolic abnormalities and intraneural blood flow disorders, assessment of diabetic visual pathway impairment using VEP has been attempted. In this review, evidence on the attempts to assess the visual pathway dysfunction due to abnormal blood glucose levels using VEP is presented. Previous studies have provided significant evidence that VEP can functionally detect antecedent neuropathy before fundus examination. The detailed correlations between VEP waveforms and disease duration, HbA1c, glycemic control, and short-term increases and decreases in blood glucose levels are evaluated. VEP may be useful for predicting postoperative prognosis and evaluating visual function before surgery for diabetic retinopathy. Further controlled studies with larger cohorts are needed to establish a more detailed relationship between diabetes mellitus and VEP.
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Affiliation(s)
- Gen Miura
- Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Inohana 1-8-1, Chuo-ku, Chiba 260-8677, Japan
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Manuello J, Verdejo-Román J, Torres Espínola F, Escudero-Marín M, Catena A, Cauda F, Campoy C. Influence of Gestational Diabetes and Pregestational Maternal BMI on the Brain of Six-Year-Old Offspring. Pediatr Neurol 2022; 133:55-62. [PMID: 35759804 DOI: 10.1016/j.pediatrneurol.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 03/02/2022] [Accepted: 05/10/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Gestational diabetes (GD) and maternal excess weight are common pregnancy conditions that increase the risk of future complications for both the mother and her offspring. Their consequences on neurodevelopment are widely described in the literature, but less is known concerning the potential transgenerational influence on the brain structure. METHODS We used a combination of support vectors machine and hierarchical clustering to investigate the potential presence of anatomical brain differences in a sample of 109 children aged six years, born to mothers with overweight or obesity, or to mothers diagnosed with GD during pregnancy. RESULTS Significant effects are visible in the brain of children born to mothers with GD associated with pregestational excess weight, especially overweight instead of obesity. No differences in children's brain were observed when considering those born to normal-weight mothers. CONCLUSIONS Our study highlights the need for clinical attention of pregnant women at risk to develop GD, and especially those with pregestational excess weight, since this status was found to be associated with detectable transgenerational brain changes. These effects may be due to the absence of specific and individualized intervention in these mothers during pregnancy.
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Affiliation(s)
- Jordi Manuello
- Gcs-Fmri, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Focus Lab, Department of Psychology, University of Turin, Turin, Italy
| | - Juan Verdejo-Román
- Mind, Brain and Behavior Research Centre, University of Granada, Granada, Spain
| | - Francisco Torres Espínola
- Euristikos Excellence Centre For Pediatric Research, University of Granada, Granada, Spain; Department of Pediatrics, School of Medicine, University of Granada, Granada, Spain; DR. Federico Oloriz Neurosciences Institute, University of Granada, Granada, Spain
| | - Mireia Escudero-Marín
- Euristikos Excellence Centre For Pediatric Research, University of Granada, Granada, Spain; Department of Pediatrics, School of Medicine, University of Granada, Granada, Spain; DR. Federico Oloriz Neurosciences Institute, University of Granada, Granada, Spain
| | - Andrés Catena
- Mind, Brain and Behavior Research Centre, University of Granada, Granada, Spain
| | - Franco Cauda
- Gcs-Fmri, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Focus Lab, Department of Psychology, University of Turin, Turin, Italy
| | - Cristina Campoy
- Euristikos Excellence Centre For Pediatric Research, University of Granada, Granada, Spain; Department of Pediatrics, School of Medicine, University of Granada, Granada, Spain; DR. Federico Oloriz Neurosciences Institute, University of Granada, Granada, Spain; Spanish Network of Biomedical Research In Epidemiology and Public Health (Ciberesp), Granada's Node, Institute of Health Carlos III, Madrid, Spain; Biohealth Research Institute (IBS), Granada, Health Sciences Technological Park, Granada, Spain.
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Shuffrey LC, Rodriguez C, Rodriguez DJ, Mahallati H, Jayaswal M, Barbosa JR, Syme S, Gimenez LA, Pini N, Lucchini M, Fifer WP. Delayed maturation of P2 flash visual evoked potential (VEP) latency in newborns of gestational diabetic mothers. Early Hum Dev 2021; 163:105503. [PMID: 34741833 DOI: 10.1016/j.earlhumdev.2021.105503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 07/22/2021] [Accepted: 10/25/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The prevalence of gestational diabetes mellitus (GDM) has rapidly increased, yet few prior studies have investigated parameters of early brain development in infants born to gestational diabetic mothers. The present study assessed visual evoked potentials (VEPs) in healthy infants born to gestational diabetic mothers and matched controls. METHODS After exclusions, in this prospective study we examined VEPs in 73 neonates between 37 weeks and 41 weeks gestation at birth (n = 37 infants of gestational diabetic mothers). Stroboscopic flashes were presented through closed eyelids during passive electroencephalography (EEG) recording to derive VEP waveforms during natural sleep. RESULTS There was a statistically significant moderate correlation between gestational age at birth and P2 latency of the flash VEP where P2 latency significantly decreased with increasing gestational age (Pearson's R(73) = -0.32, p < .01). There was also a significant moderate correlation between postnatal age (hours of life) and P2 latency of the flash VEP where P2 latency significantly decreased with increasing postnatal age (Pearson's R(73) = -0.23, p < .05). When controlling for gestational age at birth, postnatal age, and sex, there was a significant effect of group (GDM-exposed vs. control) on P2 latency of the flash VEP (p < .05). Infants of gestational diabetic mothers had a significantly longer P2 latency (M: 215.29 ± SD: 2.58 ms) than controls (M: 206.41 ± SD: 2.62 ms). CONCLUSION Our findings suggest P2 flash VEP latency is a potential measure of cortical maturation and marker of immature development in infants of gestational diabetic mothers.
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Affiliation(s)
- Lauren C Shuffrey
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032, United States of America; Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032, United States of America.
| | - Cynthia Rodriguez
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032, United States of America
| | - Daianna J Rodriguez
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032, United States of America
| | - Hana Mahallati
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032, United States of America
| | - Minna Jayaswal
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032, United States of America
| | - Jennifer R Barbosa
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032, United States of America
| | - Samantha Syme
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032, United States of America
| | - Lissete A Gimenez
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032, United States of America
| | - Nicolò Pini
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032, United States of America
| | - Maristella Lucchini
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032, United States of America; Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032, United States of America
| | - William P Fifer
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032, United States of America; Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032, United States of America; Department of Pediatrics, Columbia University Irving Medical Center, New York, NY 10032, United States of America
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Abstract
BACKGROUND A good metabolic control before conception and throughout pregnancy with diabetes decreases the risk of short- and long-term adverse outcomes of the mothers and their offsprings. Insulin treatment remains the gold standard treatment recommended for any type of diabetes. New technologies including new insulins and insulin analogues, continuous subcutaneous insulin infusion without and with sensors, the low-glucose predictive suspension function, and closed-loop systems that persistently and automatically self-adjust according to patients' continuous glucose monitoring readings have expanded the offer to clinicians for achieving tight glucose control. AREAS OF UNCERTAINTY Unsafe effects of insulin and insulin analogues in pregnancy with diabetes could be linked with changes in insulin immunogenicity, teratogenicity, and mitogenicity. Second-generation insulin analogues need to be tested and proven. Effectiveness and safety of new insulin delivery systems in real life of diabetic women in pregnancy need further confirmations. SOURCES MEDLINE, EMBASE, Web of Science, Cochrane Library, randomized controlled trials, systematic review and meta-analysis, observational prospective and retrospective studies, case series reports for the most recent insulin analogues, published in English impacted journals, and consensus statements from scientific societies I excluded 60 from 221 papers as not suitable for the purpose of the subject. RESULTS Subcutaneous insulin infusion can be safely used during pregnancy and delivery of well-trained women. Sensors are increasingly accurate tools that improve the efficacy and safety of integrated systems' functioning. Continuous glucose monitoring provides metrics ("time in range" time in "hypoglycemia" and in "hyperglycemia," glucose variability, average glucose levels in different time intervals) used as a guide to diabetes management; these new metrics are object of discussion in special populations. Randomized controlled trials have shown that sensor-augmented pump therapy improves pregnancy outcomes in women with type 1 diabetes. Closed-loop insulin delivery provides better glycemic control than sensor-augmented pump therapy during pregnancy, before, and after delivery. CONCLUSION Second-generation insulin analogues and newer insulin infusion systems that automatically self-adjust according to patients continuous glucose monitor readings are important tools improving the treatment and quality of life of these women. Multi-institutional and disciplinary teams are working to develop and evaluate a pregnancy-specific artificial pancreas.
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Torres-Espínola FJ, Berglund SK, García S, Pérez-García M, Catena A, Rueda R, Sáez JA, Campoy C. Visual evoked potentials in offspring born to mothers with overweight, obesity and gestational diabetes. PLoS One 2018; 13:e0203754. [PMID: 30208080 PMCID: PMC6135499 DOI: 10.1371/journal.pone.0203754] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 08/27/2018] [Indexed: 01/24/2023] Open
Abstract
Background Overweight, obesity, and gestational diabetes (GD) during pregnancy may negatively affect neurodevelopment in the offspring. However, the mechanisms are unclear and objective measures of neurodevelopment in infancy are scarce. We hypothesized that these maternal metabolic pathologies impair cortical visual evoked potentials (cVEPs), a proxy for visual and neuronal maturity. Design The PREOBE study included 331 pregnant women stratified into four groups; normal weight (controls), overweight, obesity, and GD (the latter including mothers with normal weight, overweight and obesity). In a subsample of the offspring at 3 months (n = 157) and at 18 months (n = 136), we assessed the latencies and amplitudes of the P100 wave from cVEPs and calculated visual acuity. Results At 3 months of age, visual acuity was significantly poorer in offspring born to GD mothers. At 18 months of age, there were no differences in visual acuity but infants born to GD mothers had significantly longer latencies of cVEPs when measured at 15’, and 30’ of arc. The group differences at 30’ remained significant after confounder adjustment (mean [SD] 121.0 [16.0] vs. 112.6 [7.6] ms in controls, p = 0.007) and the most prolonged latencies were observed in offspring to GD mothers with concurrent overweight (128.9 [26.9] ms, p = 0.002) and obesity (118.5 [5.1] ms, p = 0.020). Conclusions Infants born to mothers with GD, particularly those with concurrent overweight or obesity, have prolonged latencies of visual evoked potentials at 18 months of age, suggesting that this maternal metabolic profile have a long lasting, non-optimal, effect on infants´ brain development.
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Affiliation(s)
- Francisco J. Torres-Espínola
- Centre of Excellence for Paediatric Research EURISTIKOS, University of Granada, Granada, Spain
- Department of Paediatrics, University of Granada, Granada, Spain
| | - Staffan K. Berglund
- Centre of Excellence for Paediatric Research EURISTIKOS, University of Granada, Granada, Spain
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
| | - Salomé García
- Clinical Service of Neurophysiology, Clinical University Hospital San Cecilio, Granada, Spain
| | - Miguel Pérez-García
- Mind, Brain and Behaviour International Research Centre (CIMCYC), University of Granada, Granada, Spain
- Department of Personality, Neuropsychology and Behavior, University of Granada, Granada, Spain
| | - Andrés Catena
- Mind, Brain and Behaviour International Research Centre (CIMCYC), University of Granada, Granada, Spain
- Department of Experimental Psychology, University of Granada, Granada, Spain
| | - Ricardo Rueda
- Scientific Department of Abbott Nutrition, Granada, Spain
| | - Jose Antonio Sáez
- Clinical Service of Neurophysiology, Clinical University Hospital San Cecilio, Granada, Spain
| | - Cristina Campoy
- Centre of Excellence for Paediatric Research EURISTIKOS, University of Granada, Granada, Spain
- Department of Paediatrics, University of Granada, Granada, Spain
- CIBERESP: Spanish National Network in Epidemiology and Public Health, Institute Carlos III Granada’s node, Granada, Spain
- * E-mail:
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Kulkarni A, Garcia-Cañadilla P, Khan A, Lorenzo JM, Beckerman K, Valenzuela-Alcaraz B, Cruz-Lemini M, Gomez O, Gratacos E, Crispi F, Bijnens B. Remodeling of the cardiovascular circulation in fetuses of mothers with diabetes: A fetal computational model analysis. Placenta 2018; 63:1-6. [PMID: 29486850 DOI: 10.1016/j.placenta.2017.12.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 12/25/2017] [Accepted: 12/30/2017] [Indexed: 10/18/2022]
Abstract
AIMS Myocardial structural and functional abnormalities are known to occur in fetuses of mothers with diabetes mellitus (FMDM). The main aim of this investigation was to explore the cardiovascular circulatory patterns in FMDM using a validated lumped computational model of the cardiovascular system. METHODS This was a multi-institutional study involving FMDM compared to fetuses of maternal controls (FC). Fetal echocardiographic Doppler data from left and right ventricular outflow tracts, aortic isthmus, middle cerebral and umbilical arteries were fitted into a validated fetal circulation computational model to estimate patient-specific placental and vascular properties. Non-parametric comparisons were made between resistances, compliances and flows in the brain and placenta in FMDM and FC. RESULTS Data from 23 FMDM and 31 FC were fitted into the model. In FMDM, compared to FC, placental relative resistance was lower (0.59 ± 0.50 versus 0.91 ± 0.41; p < .05) with higher brain relative resistance (2.36 ± 1.65 versus 1.60 ± 0.85; p < .05). Middle cerebral artery flow was lower in FMDM than FC (0.12 ± 0.14 vs. 0.27 ± 0.21 ml/min; p 0.04) with a lower cerebral-placental flow ratio. Combined stroke volume was lower in FMDM (3.65 ± 2.05 ml) than FC (4.97 ± 2.45 ml) (p 0.04). CONCLUSIONS Blood flow is redistributed in FMDM to the placenta, away from the brain. This alteration may play a role in the postnatal health of these fetuses.
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Affiliation(s)
- Aparna Kulkarni
- Division of Pediatric Cardiology, Bronx Lebanon Hospital Center, Bronx, NY, USA.
| | - Patricia Garcia-Cañadilla
- Physense, DTIC, Universitat Pompeu Fabra, Barcelona, Spain; BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Fetal i+D Fetal Medicine Research Center, Institut Clinic de Ginecologia, Obstetricia i Neonatologia, IDIBAPS, CIBER-ER, University of Barcelona, Spain
| | - Abdullah Khan
- Division of Pediatric Cardiology, Bronx Lebanon Hospital Center, Bronx, NY, USA
| | - Jose Miguel Lorenzo
- Division of Pediatric Cardiology, Bronx Lebanon Hospital Center, Bronx, NY, USA
| | - Karen Beckerman
- Department of Obstetrics, Bronx Lebanon Hospital Center, Bronx, NY, USA
| | - Brenda Valenzuela-Alcaraz
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Fetal i+D Fetal Medicine Research Center, Institut Clinic de Ginecologia, Obstetricia i Neonatologia, IDIBAPS, CIBER-ER, University of Barcelona, Spain
| | - Monica Cruz-Lemini
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Fetal i+D Fetal Medicine Research Center, Institut Clinic de Ginecologia, Obstetricia i Neonatologia, IDIBAPS, CIBER-ER, University of Barcelona, Spain
| | - Olga Gomez
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Fetal i+D Fetal Medicine Research Center, Institut Clinic de Ginecologia, Obstetricia i Neonatologia, IDIBAPS, CIBER-ER, University of Barcelona, Spain
| | - Eduard Gratacos
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Fetal i+D Fetal Medicine Research Center, Institut Clinic de Ginecologia, Obstetricia i Neonatologia, IDIBAPS, CIBER-ER, University of Barcelona, Spain
| | - Fatima Crispi
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Fetal i+D Fetal Medicine Research Center, Institut Clinic de Ginecologia, Obstetricia i Neonatologia, IDIBAPS, CIBER-ER, University of Barcelona, Spain
| | - Bart Bijnens
- Physense, DTIC, Universitat Pompeu Fabra, Barcelona, Spain; ICREA, Barcelona, Spain
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Assessment of Attention Deficits in Adolescent Offspring Exposed to Maternal Type 1 Diabetes. PLoS One 2017; 12:e0169308. [PMID: 28072839 PMCID: PMC5224808 DOI: 10.1371/journal.pone.0169308] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 12/14/2016] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE The aim of this study was to examine the potential association between intrauterine exposure to maternal diabetes and attention deficits in the offspring. RESEARCH DESIGN AND METHODS Adolescent offspring of a prospectively followed cohort of women with type 1 diabetes (n = 269) and a control group from the background population (n = 293) participated in a follow-up assessment in 2012-2013. We used scores from Conners Continuous Performance Test II to assess attention and based on a principal component analysis we evaluated scores on five different attention factors: focused attention, vigilance, hyperactivity/impulsivity, sustained attention and response style. RESULTS A higher frequency of the exposed offspring had a parent/self-reported use of Attention Deficit Hyperactivity Disorder (ADHD) medication compared to the control group (2.2% vs. 0.0%, p = 0.01). Clinical significant differences between adolescents exposed to maternal diabetes and unexposed controls were not found in either single scores on Conners Continuous Performance Test or on any of the five attention factors identified. CONCLUSIONS Exposure to maternal type 1 diabetes did not seem to increase the risk of attention deficits in the adolescent offspring. However, a higher self-reported use of ADHD medication in the exposed group could suggest a difference in attention not revealed by the applied test.
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Abstract
OBJECTIVE Pregnancies complicated by diabetes mellitus impair offspring memory functions during infancy and early childhood. The purpose of this study was to investigate the long-term consequences of such pregnancies on memory and memory-related brain regions in 10-year-old children. METHODS Nineteen children of diabetic mothers (CDMs) and 35 children of nondiabetic mothers participated in this 10-year follow-up study. Memory performance was assessed using a continuous recognition memory task during which children made old/new judgments in response to pictures of concrete and abstract objects presented after different lags or delays. In addition, the volume of the hippocampal formation (HF) was measured using high-resolution structural images. RESULTS At 10 years of age, recognition memory performance of CDMs did not differ from children of nondiabetic mothers. Similarly, the volume of the HF did not differ between groups. However, the size of the HF in CDMs predicted the time those children needed to provide accurate responses in the continuous recognition memory task. CONCLUSIONS CDMs do not show memory impairments by 10 years of age, despite evidence for such impairments early in life. However, subtle differences in underlying neural processes may still be present. These results have important implications for long-term cognitive development of CDMs.
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Comparison of refractive error and central corneal thickness in neonates of diabetic and healthy mothers. Eur J Ophthalmol 2015; 25:396-9. [PMID: 25837645 DOI: 10.5301/ejo.5000601] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine the refractive error and central corneal thickness of neonates born to diabetic mothers and to compare these parameters with those of healthy neonates born to healthy mothers. METHODS This prospective, cross-sectional study was conducted on 16 consecutive full-term neonates born to diabetic mothers and 17 full-term healthy neonates. The neonates underwent ophthalmic examination within the first week of life. Refractive measurements were assessed by retinoscopy. Central corneal thickness was recorded by using ultrasound pachymeter. RESULTS The mean spherical equivalent for both eyes in the diabetic group was +2.9 ± 2.6 and significantly greater than that of the nondiabetic group (+1.3 ± 2.1 D) (p = 0.008). The mean sphere value was +2.6 ± 2.4 D in the diabetic group and +1.0 ± 2.0 D in the nondiabetic group, significantly higher in the diabetic group (p = 0.008). In both groups, mean astigmatism was less than 1.00 D, it was lower in the diabetic group, and there was no statistically significant difference between groups (p = 0.95). There were 2 patients in each group with anisometropia. The mean central corneal thickness in the nondiabetic group was 542.9 ± 21.9 μm whereas it was 592.0 ± 40.2 μm in the diabetic group, which was significantly thicker (p = 0.05). CONCLUSIONS Our study revealed that neonates of diabetic mothers seem to be more hypermetropic compared to full-term healthy neonates; however, we did not observe any significant astigmatism in either group. Neonates of diabetic mothers had thicker corneas.
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Jing YH, Song YF, Yao YM, Yin J, Wang DG, Gao LP. Retardation of fetal dendritic development induced by gestational hyperglycemia is associated with brain insulin/IGF-I signals. Int J Dev Neurosci 2014; 37:15-20. [PMID: 24953263 DOI: 10.1016/j.ijdevneu.2014.06.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 06/12/2014] [Accepted: 06/12/2014] [Indexed: 01/26/2023] Open
Abstract
Hyperglycemia is an essential risk factor for mothers and fetuses in gestational diabetes. Clinical observation has indicated that the offspring of mothers with diabetes shows impaired somatosensory function and IQ. However, only a few studies have explored the effects of hyperglycemia on fetal brain development. Neurodevelopment is susceptible to environmental conditions. Thus, this study aims to investigate the effects of maternal hyperglycemia on fetal brain development and to evaluate insulin and insulin-like growth factor-I (IGF-I) signals in fetal brain under hyperglycemia or controlled hyperglycemia. At day 1 of pregnancy, gestational rats were intraperitoneally injected with streptozocin (60 mg/kg). Some of the hyperglycemic gestational rats were injected with insulin (20 IU, two times a day) to control hyperglycemia; the others were injected with saline of equal volume. The gestational rats were sacrificed at days 14, 16, and 18 of embryo development. The dendritic spines of subplate cortex neurons in the fetal brain were detected by Golgi-Cox staining. The mRNA levels of insulin receptors (IRs) and IGF-IR in the fetal brain were measured using qRT-PCR. The protein levels of synaptophysin, IR, and IGF-IR in the fetal brain were detected by western blot. No significant difference in fetal brain formation was observed between the maternal hyperglycemic group and insulin-treated group. By contrast, obvious retardation of dendritic development in the fetus was observed in the maternal hyperglycemic group. Similarly, synaptophysin expression was lower in the fetus of the maternal hyperglycemic group than in that of the insulin-treated group. The mRNA and protein expression levels of IRs in the fetal brain were higher in the hyperglycemic group than in the insulin-treated group. By contrast, the levels of IGF-IR in the brain were lower in the fetus of the maternal hyperglycemic group than in that of the insulin-treated group. These results suggested that maternal hyperglycemia can retard dendritic development in the fetal brain and that these changes partially resulted from abnormal insulin/IGF-I signaling in the fetal brain.
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Affiliation(s)
- Yu-Hong Jing
- Institute of Anatomy and Embryology, School of Basic Medical Sciences, Lanzhou University, Lanzhou, PR China; Key Laboratory of Preclinical Study for New Drugs of Gansu Province, Lanzhou University, Lanzhou, PR China.
| | - Yan-Feng Song
- Institute of Anatomy and Embryology, School of Basic Medical Sciences, Lanzhou University, Lanzhou, PR China
| | - Ya-Ming Yao
- Institute of Anatomy and Embryology, School of Basic Medical Sciences, Lanzhou University, Lanzhou, PR China
| | - Jie Yin
- Institute of Anatomy and Embryology, School of Basic Medical Sciences, Lanzhou University, Lanzhou, PR China
| | - De-Gui Wang
- Institute of Anatomy and Embryology, School of Basic Medical Sciences, Lanzhou University, Lanzhou, PR China
| | - Li-Ping Gao
- Institute of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Lanzhou University, Lanzhou, PR China
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