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Ventral striatum, but not cortical volume loss, is related to cognitive dysfunction in type 1 diabetic patients with

Eelco van Duinkerken1, Menno M Schoonheim2, Martijn D Steenwijk3

  • 1Diabetes Center/Department of Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands Department of Medical Psychology, VU University Medical Center, Amsterdam, the Netherlands e.vanduinkerken@vumc.nl.

Diabetes Care
|June 29, 2014
PubMed
Abstract

Insights

Longstanding type 1 diabetes is linked to subcortical brain volume loss and cognitive dysfunction, regardless of microangiopathy. This study highlights changes in the putamen, thalamus, and nucleus accumbens, impacting cognitive function in diabetic patients.

Area of Science:

  • Neuroscience
  • Endocrinology
  • Diabetology

Background:

  • Longstanding type 1 diabetes can lead to microangiopathy and cognitive dysfunction due to chronic hyperglycemia.
  • The relationship between microangiopathy and hyperglycemia-induced brain changes remains unclear.
  • Subcortical volume loss, not cortical, is associated with cognitive impairment in other populations.

Purpose of the Study:

  • To investigate subcortical and cortical brain volume differences in type 1 diabetes patients with and without microangiopathy.
  • To determine the association between these brain changes and cognitive function.

Main Methods:

  • Compared subcortical volume, cortical thickness, and volume in type 1 diabetes patients (with/without proliferative retinopathy) and controls.
  • Performed analyses adjusted for age, sex, blood pressure, and A1C.
  • Correlated brain volume differences with cognitive dysfunction.

Main Results:

  • Both type 1 diabetes groups showed putamen and right thalamic volume loss compared to controls.
  • Patients with proliferative retinopathy also exhibited bilateral nucleus accumbens volume loss.
  • No significant differences in cortical thickness or volume were observed between groups.
  • Lower left nucleus accumbens volume correlated with cognitive dysfunction in pooled analyses.

Conclusions:

  • Subcortical, not cortical, brain volume loss is associated with cognitive dysfunction in longstanding type 1 diabetes.
  • These brain changes occur irrespective of microangiopathy status.
  • Further longitudinal and mechanistic studies are needed to understand the clinical relevance and pathophysiology.

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