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Stanisławska-Kubiak M, Majewska KA, Krasińska A, Wais P, Majewski D, Mojs E, Kȩdzia A. Brain functional and structural changes in diabetic children. How can intellectual development be optimized in type 1 diabetes? Ther Adv Chronic Dis 2024; 15:20406223241229855. [PMID: 38560719 PMCID: PMC10981223 DOI: 10.1177/20406223241229855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 01/11/2024] [Indexed: 04/04/2024] Open
Abstract
The neuropsychological functioning of people with type 1 diabetes (T1D) is of key importance to the effectiveness of the therapy, which, in its complexity, requires a great deal of knowledge, attention, and commitment. Intellectual limitations make it difficult to achieve the optimal metabolic balance, and a lack of this alignment can contribute to the further deterioration of cognitive functions. The aim of this study was to provide a narrative review of the current state of knowledge regarding the influence of diabetes on brain structure and functions during childhood and also to present possible actions to optimize intellectual development in children with T1D. Scopus, PubMed, and Web of Science databases were searched for relevant literature using selected keywords. The results were summarized using a narrative synthesis. Disturbances in glucose metabolism during childhood may have a lasting negative effect on the development of the brain and related cognitive functions. To optimize intellectual development in children with diabetes, it is essential to prevent disorders of the central nervous system by maintaining peri-normal glycemic levels. Based on the performed literature review, it seems necessary to take additional actions, including repeated neuropsychological evaluation with early detection of any cognitive dysfunctions, followed by the development of individual management strategies and the training of appropriate skills, together with complex, multidirectional environmental support.
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Affiliation(s)
- Maia Stanisławska-Kubiak
- Department of Clinical Psychology, Poznan University of Medical Sciences, ul. Bukowska 70, Poznan 60-812, Poland
| | - Katarzyna Anna Majewska
- Department of Pediatric Diabetes, Auxology and Obesity, Poznan University of Medical Sciences, Poznan, Poland
| | - Agata Krasińska
- Department of Pediatric Diabetes, Auxology and Obesity, Poznan University of Medical Sciences, Poznan, Poland
| | - Paulina Wais
- Department of Pediatric Diabetes, Auxology and Obesity, Poznan University of Medical Sciences, Poznan, Poland
| | - Dominik Majewski
- Department of Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Ewa Mojs
- Department of Clinical Psychology, Poznan University of Medical Sciences, Poznan, Poland
| | - Andrzej Kȩdzia
- Department of Pediatric Diabetes, Auxology and Obesity, Poznan University of Medical Sciences, Poznan, Poland
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Croosu SS, Hansen TM, Røikjer J, Mørch CD, Ejskjaer N, Frøkjær JB. Gray Matter Brain Alterations in Type 1 Diabetes - Findings Based on Detailed Phenotyping of Neuropathy Status. Exp Clin Endocrinol Diabetes 2022; 130:730-739. [PMID: 35668671 DOI: 10.1055/a-1835-1877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS This study investigated brain structure in patients of type 1 diabetes with diabetic peripheral neuropathy (DPN) and type 1 diabetes with neuropathic pain and the associations to clinical, peripheral, and cognitive measurements. METHODS Sixty individuals with type 1 diabetes and 20 healthy controls were included in the study. Nineteen individuals with type 1 diabetes and neuropathic pain, 19 with type 1 diabetes and DPN, 18 with type 1 diabetes without DPN, and 20 healthy controls were included in the brain analyses. We utilized structural brain magnetic resonance imaging to investigate total and regional gray matter volume. RESULTS Significant lower gray matter volume was found in type 1 diabetes with neuropathic pain and in type 1 diabetes without DPN compared to healthy controls (p=0.024 and p=0.019, respectively). Lower insula volume was observed in all three diabetes groups (all p≤0.050). Thalamus and hippocampus volume was lower in type 1 diabetes with neuropathic pain, cerebellum volume was lower in type 1 diabetes with DPN, and somatosensory cortex volume was lower in type 1 diabetes without DPN (all p≤0.018). Attenuated memory was associated with lower gray matter volume in type 1 diabetes with DPN. No associations were found between gray matter volume and clinical/peripheral measurements. CONCLUSION We demonstrated lower gray matter volume in individuals with type 1 diabetes regardless of the presence of DPN and neuropathic pain. Hence, central gray matter alteration was not associated with peripheral alterations.
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Affiliation(s)
- Suganthiya S Croosu
- Department of Radiology, Aalborg University Hospital, Hobrovej Aalborg, Denmark.,Steno Diabetes Center North Denmark, Aalborg University Hospital, Mølleparkvej Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Søndre Skovvej Aalborg, Denmark
| | - Tine M Hansen
- Department of Radiology, Aalborg University Hospital, Hobrovej Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Søndre Skovvej Aalborg, Denmark
| | - Johan Røikjer
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Mølleparkvej Aalborg, Denmark.,Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health Science and Technology, Aalborg University, Fredrik Bajers Vej Aalborg, Denmark
| | - Carsten D Mørch
- Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health Science and Technology, Aalborg University, Fredrik Bajers Vej Aalborg, Denmark
| | - Niels Ejskjaer
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Mølleparkvej Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Søndre Skovvej Aalborg, Denmark.,Department of Endocrinology, Aalborg University Hospital, Mølleparkvej Aalborg, Denmark
| | - Jens B Frøkjær
- Department of Radiology, Aalborg University Hospital, Hobrovej Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Søndre Skovvej Aalborg, Denmark
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Zhou C, Li J, Dong M, Ping L, Lin H, Wang Y, Wang S, Gao S, Yu G, Cheng Y, Xu X. Altered White Matter Microstructures in Type 2 Diabetes Mellitus: A Coordinate-Based Meta-Analysis of Diffusion Tensor Imaging Studies. Front Endocrinol (Lausanne) 2021; 12:658198. [PMID: 34012420 PMCID: PMC8127836 DOI: 10.3389/fendo.2021.658198] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/07/2021] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE Type 2 diabetes mellitus (T2DM) is often accompanied by cognitive decline and depressive symptoms. Numerous diffusion tensor imaging (DTI) studies revealed microstructural white matter (WM) abnormalities in T2DM but the findings were inconsistent. The present study aimed to conduct a coordinate-based meta-analysis (CBMA) to identify statistical consensus of DTI studies in T2DM. METHODS We performed a systematic search on relevant studies that reported fractional anisotropy (FA) differences between T2DM patients and healthy controls (HC). The anisotropic effect size seed-based d mapping (AES-SDM) approach was used to explore WM alterations in T2DM. A meta-regression was then used to analyze potential influences of sample characteristics on regional FA changes. RESULTS A total of eight studies that comprised 245 patients and 200 HC, along with 52 coordinates were extracted. The meta-analysis identified FA reductions in three clusters including the left inferior network, the corpus callosum (CC), and the left olfactory cortex. Besides, FA in the CC was negatively correlated with body mass index (BMI) in the patients group. CONCLUSIONS T2DM could lead to subtle WM microstructural alterations, which might be associated with cognitive deficits or emotional distress symptoms. This provides a better understanding of the pathophysiology of neurodegeneration and complications in T2DM. SYSTEMATIC REVIEW REGISTRATION Registered at PROSPERO (http://www.crd.york.ac.uk/PROSPERO), registration number: CRD42020218737.
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Affiliation(s)
- Cong Zhou
- School of Mental Health, Jining Medical University, Jining, China
- *Correspondence: Cong Zhou,
| | - Jie Li
- Department of Psychiatry, Jining Psychiatric Hospital, Jining, China
| | - Man Dong
- School of Mental Health, Jining Medical University, Jining, China
| | - Liangliang Ping
- Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen, China
| | - Hao Lin
- School of Mental Health, Jining Medical University, Jining, China
| | - Yuxin Wang
- School of Mental Health, Jining Medical University, Jining, China
| | - Shuting Wang
- School of Mental Health, Jining Medical University, Jining, China
| | - Shuo Gao
- School of Mental Health, Jining Medical University, Jining, China
| | - Ge Yu
- School of Mental Health, Jining Medical University, Jining, China
| | - Yuqi Cheng
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xiufeng Xu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China
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