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

Tandy Aye, Naama Barnea-Goraly, Christian Ambler, Sherry Hoang, Kristin Schleifer, Yaena Park, Jessica Drobny, Darrell M Wilson, Allan L Reiss, Bruce A Buckingham, Tandy Aye, Naama Barnea-Goraly, Christian Ambler, Sherry Hoang, Kristin Schleifer, Yaena Park, Jessica Drobny, Darrell M Wilson, Allan L Reiss, Bruce A Buckingham

Abstract

Objective: To detect clinical correlates of cognitive abilities and white matter (WM) microstructural changes using diffusion tensor imaging (DTI) in young children with type 1 diabetes.

Research design and methods: Children, ages 3 to <10 years, with type 1 diabetes (n = 22) and age- and sex-matched healthy control subjects (n = 14) completed neurocognitive testing and DTI scans.

Results: Compared with healthy controls, children with type 1 diabetes had lower axial diffusivity (AD) values (P = 0.046) in the temporal and parietal lobe regions. There were no significant differences between groups in fractional anisotropy and radial diffusivity (RD). Within the diabetes group, there was a significant, positive correlation between time-weighted HbA(1c) and RD (P = 0.028). A higher, time-weighted HbA(1c) value was significantly correlated with lower overall intellectual functioning measured by the full-scale intelligence quotient (P = 0.03).

Conclusions: Children with type 1 diabetes had significantly different WM structure (as measured by AD) when compared with controls. In addition, WM structural differences (as measured by RD) were significantly correlated with their HbA(1c) values. Additional studies are needed to determine if WM microstructural differences in young children with type 1 diabetes predict future neurocognitive outcome.

Trial registration: ClinicalTrials.gov NCT00449891.

Figures

Figure 1
Figure 1
Greater HbA1c levels predicted lower overall intellectual functioning measured by FSIQ in children with type 1 diabetes (R2 = 0.215, P = 0.03). Each box represents one subject.
Figure 2
Figure 2
Regions of significant reductions in AD (shown in yellow) in children with type 1 diabetes as compared with healthy controls subjects, shown in serial images in the axial orientation. Group differences were “thickened” for visualization purposes (shown in red). (A high-quality digital representation of this figure is available in the online issue.)
Figure 3
Figure 3
Regions of significant positive correlation between HbA1c values and RD (shown in light blue) within the type 1 diabetes group, shown in serial images in the axial orientation. Group differences were “thickened” for visualization purposes (shown in dark blue). (A high-quality digital representation of this figure is available in the online issue.)

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