The Feasibility of Detecting Neuropsychologic and Neuroanatomic Effects of Type 1 Diabetes in Young Children
- Tandy Aye, MD1⇓,
- Allan L. Reiss, MD2,3,4,
- Shelli Kesler, PHD2,
- Sherry Hoang, PHD1,
- Jessica Drobny, MS1,
- Yaena Park, BS2,
- Kristin Schleifer, PHD1,
- Heidi Baumgartner, BS2,
- Darrell M. Wilson, MD1 and
- Bruce A. Buckingham, MD1
- 1Department of Pediatrics, Division of Pediatric Endocrinology and Diabetes, Stanford University School of Medicine, Stanford, California
- 2Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry, Stanford University School of Medicine, Stanford, California
- 3Department of Radiology, Stanford University School of Medicine, Stanford, California
- 4Department of Pediatrics, Stanford University School of Medicine, Stanford, California
- Corresponding author: Tandy Aye, .
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.
- Received November 17, 2010.
- Accepted March 25, 2011.
- © 2011 by the American Diabetes Association.
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