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White matter structural differences in young children with type 1 diabetes: a diffusion tensor imaging study

Tandy Aye1, Naama Barnea-Goraly, Christian Ambler

  • 1Department of Pediatrics, Division of Pediatric Endocrinology and Diabetes, Stanford University School of Medicine, Stanford, CA, USA. taye@stanford.edu

Diabetes Care
|September 12, 2012
PubMed

Insights

Young children with type 1 diabetes show altered white matter (WM) structure, specifically lower axial diffusivity (AD). WM differences correlate with glycemic control (HbA1c) and cognitive function.

Area of Science:

  • Neuroscience
  • Pediatrics
  • Radiology

Background:

  • Type 1 diabetes (T1D) can impact brain development in children.
  • White matter (WM) integrity is crucial for cognitive function.
  • Diffusion tensor imaging (DTI) is a sensitive tool for assessing WM microstructure.

Purpose of the Study:

  • To investigate clinical correlates of cognitive abilities and WM microstructural changes in young children with T1D.
  • To compare WM structure between children with T1D and healthy controls using DTI.
  • To explore relationships between glycemic control, WM integrity, and neurocognitive outcomes in T1D.

Main Methods:

  • A cohort of children aged 3 to <10 years with T1D (n=22) and age/sex-matched healthy controls (n=14) underwent neurocognitive testing and DTI scans.
  • DTI parameters including axial diffusivity (AD) and radial diffusivity (RD) were analyzed.
  • Glycemic control was assessed via time-weighted HbA1c.

Main Results:

  • Children with T1D exhibited significantly lower AD in temporal and parietal regions compared to controls (P=0.046).
  • No significant group differences were found in fractional anisotropy or RD.
  • Within the T1D group, higher time-weighted HbA1c correlated positively with RD (P=0.028) and negatively with full-scale intelligence quotient (P=0.03).

Conclusions:

  • Young children with T1D demonstrate altered WM structure, evidenced by reduced AD.
  • WM microstructural differences, particularly RD, are associated with glycemic control (HbA1c) in this population.
  • Further research is warranted to determine if these early WM changes predict long-term neurocognitive outcomes in T1D.
Abstract

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