Differential Resting State Connectivity Responses to Glycemic State in Type 1 Diabetes.

Abstract

CONTEXT:

Individuals with type 1 diabetes mellitus (T1DM) have alterations in brain activity that have been postulated to contribute to the adverse neurocognitive consequences of T1DM; however, the impact of T1DM and hypoglycemic unawareness on the brain's resting state activity remains unclear.

OBJECTIVE:

To determine whether individuals with T1DM and hypoglycemia unawareness (T1DM-Unaware) had changes in the brain resting state functional connectivity compared to healthy controls (HC) and those with T1DM and hypoglycemia awareness (T1DM-Aware).

DESIGN:

Observational study.

SETTING:

Academic medical center.

PARTICIPANTS:

27 individuals with T1DM and 12 HC volunteers participated in the study.

INTERVENTION:

All participants underwent blood oxygenation level dependent (BOLD) resting state functional magnetic brain imaging during a 2-step hyperinsulinemic euglycemic (90 mg/dL)-hypoglycemic (60 mg/dL) clamp.

OUTCOME:

Changes in resting state functional connectivity.

RESULTS:

Using 2 separate methods of functional connectivity analysis, we identified distinct differences in the resting state brain responses to mild hypoglycemia between HC, T1DM-Aware, and T1DM-Unaware participants, particularly in the angular gyrus, an integral component of the default mode network (DMN). Furthermore, changes in angular gyrus connectivity also correlated with greater symptoms of hypoglycemia (r = 0.461, P = 0.003) as well as higher scores of perceived stress (r = 0.531, P = 0.016).

CONCLUSION:

These findings provide evidence that individuals with T1DM have changes in the brain's resting state connectivity patterns, which may be further associated with differences in awareness to hypoglycemia. These changes in connectivity may be associated with alterations in functional outcomes among individuals with T1DM.

• Authors: Lisa Parikh, Dongju Seo, Cheryl Lacadie, Renata Belfort-Deaguiar, Derek Groskreutz, Muhammad Hamza, Feng Dai, Dustin Scheinost, Rajita Sinha, R Todd Constable, Robert Sherwin, Janice Jin Hwang
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 105 Issue 1 (01 01 2020) ISSN: 1945-7197 [Electronic] United States
• PMID: 31511876 (Publication Type: Journal Article, Observational Study)
• Copyright: © Endocrine Society 2019. All rights reserved. For permissions, please e-mail: [email protected].

Chemical References

• Biomarkers
• Hypoglycemic Agents

Topics

• Adult
• Biomarkers (analysis)
• Brain (drug effects, pathology)
• Brain Mapping
• Case-Control Studies
• Connectome
• Diabetes Mellitus, Type 1 (drug therapy, pathology)
• Female
• Follow-Up Studies
• Humans
• Hypoglycemia (chemically induced, pathology)
• Hypoglycemic Agents (adverse effects)
• Magnetic Resonance Imaging
• Male
• Neural Pathways (drug effects, pathology)
• Prognosis