Structural Gray and White Matter Differences in Patients With Type 1 Diabetes and Impaired Awareness of Hypoglycemia
Por:
Stantonyonge, N, Sampedro, F, Mendez, J, Martinez-Horta, S, Chico, A, Gomez-Anson, B
Publicada:
1 feb 2021
Resumen:
Context: Type 1 diabetes (T1D) is associated with an increased risk of cognitive decline, where severe hypoglycemia (SH) and impaired awareness of hypoglycemia (IAH) may play a role. While there is evidence of a possible association between IAH and brain damage, the potential brain changes remain poorly characterized by magnetic resonance imaging (MRI).
Objective: To investigate whether there are structural brain differences in a group of T1D patients with IAH compared with normal awareness of hypoglycemia (NAH).
Design: General practice, population-based, cross-sectional study (July 2018 to July 2019).
Setting: Endocrinology Department, Hospital Santa Creu i Sant Pau.
Participants: A total of 40 T1D patients (20 each with IAH and NAH) matched for age, sex, T1D duration, and education level.
Main Outcome Measures: Using different neuroimaging techniques, we compared whole-brain gray matter (GM) and white matter (WM) differences. We used voxel-based morphometry and cortical surface area analysis methods to assess GM differences, and fractional anisotropy (FA) to assess WM differences.
Results: Compared with patients with T1D-NAH, patients with T1D-IAH had reduced GM volumes and cortical surface areas, especially in frontal and parietal regions (P<0.05 corrected), and also showed reduced FA values in major WM tracts. The observed MRI differences correlated with both SH frequency and IAH severity.
Conclusions: MRI for patients with T1D show that IAH is associated with brain changes involving both GM and WM. Further research is needed to elucidate whether the observed differences are a consequence of increased SH episode frequency and increased IAH severity.
Filiaciones:
Stantonyonge, N:
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona 08041, Spain
Autonomous Univ Barcelona, Dept Med, Barcelona 08193, Spain
Sampedro, F:
Inst Invest Biomed St Pau IIB St Pau, Barcelona 08041, Spain
CIBER Neurodegenerat Dis CIBER NED, Madrid 28031, Spain
Hosp Santa Creu & Sant Pau, Movement Disorders Unit, Dept Neurol, Barcelona 08041, Spain
Mendez, J:
Autonomous Univ Barcelona, Radiol Dept, Neuroradiol, Hosp Santa Creu & St Pau, Barcelona 08041, Spain
Martinez-Horta, S:
Inst Invest Biomed St Pau IIB St Pau, Barcelona 08041, Spain
CIBER Neurodegenerat Dis CIBER NED, Madrid 28031, Spain
Hosp Santa Creu & Sant Pau, Movement Disorders Unit, Dept Neurol, Barcelona 08041, Spain
Chico, A:
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona 08041, Spain
Autonomous Univ Barcelona, Dept Med, Barcelona 08193, Spain
Inst Salud Carlos III, CIBER Bioengn Biomat & Nanotechnol CIBER BBN, Madrid 08193, Spain
Gomez-Anson, B:
Autonomous Univ Barcelona, Radiol Dept, Neuroradiol, Hosp Santa Creu & St Pau, Barcelona 08041, Spain
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