Brain Function Differences in Children With Type 1 Diabetes: A Functional MRI Study of Working Memory
Lara C. Foland‐Ross, Gabby Tong, Nelly Mauras, Allison Cato, Tandy Aye, Michael J. Tansey, Neil H. White, Stuart A. Weinzimer, Kimberly Englert, Hanyang Shen, Paul K. Mazaika, Allan L. Reiss, Eva Tsalikian, Michael J. Tansey, Julie Coffey, Joanne Cabbage, Sara Salamat, Rachel Bisbee, Nelly Mauras, Larry A. Fox, Allison Cato, Kim Englert, Kaitlin Sikes, Tina Ewen, Keisha Bird, Bruce A. Buckingham, Darrell M. Wilson, Tandy Aye, Ryan Kingman, Stuart A. Weinzimer, William V. Tamborlane, Jodie M. Ambrosino, Amy Steffen, Kate Weyman, Melinda Zgorski, Neil H. White, Ana María Arbeláez, L. Levandoski, Angie Starnes, Tamara Hershey, Allan L. Reiss, Lara C. Foland‐Ross, Matthew Marzelli, Paul K. Mazaika, Gabby Tong, Mark A. Sperling, Dorothy Becker, Patricia A. Cleary, Carla J. Greenbaum, Antoinette Moran
Abstract
Glucose is a primary fuel source to the brain, yet the influence of dysglycemia on neurodevelopment in children with type 1 diabetes remains unclear. We examined brain activation using functional MRI in 80 children with type 1 diabetes (mean ± SD age 11.5 ± 1.8 years; 46% female) and 47 children without diabetes (control group) (age 11.8 ± 1.5 years; 51% female) as they performed a visuospatial working memory (N-back) task. Results indicated that in both groups, activation scaled positively with increasing working memory load across many areas, including the frontoparietal cortex, caudate, and cerebellum. Between groups, children with diabetes exhibited reduced performance on the N-back task relative to children in the control group, as well as greater modulation of activation (i.e., showed greater increase in activation with higher working memory load). Post hoc analyses indicated that greater modulation was associated in the diabetes group with better working memory function and with an earlier age of diagnosis. These findings suggest that increased modulation may occur as a compensatory mechanism, helping in part to preserve working memory ability, and further, that children with an earlier onset require additional compensation. Future studies that test whether these patterns change as a function of improved glycemic control are warranted.