The effects of type 1 diabetes on cerebral white matter

Behavioral and Mental Health Research Joslin Diabetes Center, One Joslin Place Suite 350, Boston, MA 02459, USA.
Diabetologia (Impact Factor: 6.67). 04/2008; 51(3):417-25. DOI: 10.1007/s00125-007-0904-9
Source: PubMed


Studies investigating the structure, neurophysiology and functional outcomes of white matter among type 1 diabetes patients have given conflicting results. Our aim was to investigate the relationship between type 1 diabetes and white matter hyperintensities.
We assessed white matter integrity (using magnetic resonance imaging), depressive symptoms and neuropsychological function in 114 type 1 diabetes patients and 58 age-matched non-diabetic controls.
Only Fazekas grade 1 and 2 white matter hyperintensities were found among 114 long-duration, relatively young diabetes patients; the severity of lesions did not differ substantially from 58 healthy controls. White matter hyperintensities were not associated with depressive history or with clinical characteristics of diabetes, including retinopathy, severe hypoglycaemia or glycaemia control.
Our data do not support an association between diabetes characteristics and white matter hyperintensities among relatively young type 1 diabetes participants.

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Available from: Gail Musen, Oct 09, 2014
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    • "Both T1DM and T2DM are important risk factors for decreased performance in several neuropsychological functions (Roriz- Filho et al., 2009). Recent studies of cognitive functioning in patients with T1DM show poorer performance across indices of information processing speed (Brands et al., 2006; Hershey, Bhargava, Sadler, White, & Craft, 1999; Ryan, Geckle, & Orchard, 2003; Ryan, Williams, Finegold, & Orchard, 1993; Wessels et al., 2006, 2007), deficits in vocabulary (Schoenle, Schoenle, Molinari, & Largo 2002; Weinger et al., 2008), general intelligence (Schoenle et al., 2002; Northam et al., 2001), visuoconstruction (Ryan et al., 1993; Wessels et al., 2006), attention (Wessels et al., 2007), somatosensory perception, motor ability, memory (Weinger et al., 2008), and executive functions (Northam et al., 2001; Wessels et al., 2007). In comparison, cognitive problems in T2DM are most often linked to verbal learning and memory (Awad, Gagnon, & Messier, 2004; Grodstein, Chen, Wilson, & Manson, 2001), executive functions including mental flexibility and working memory (Awad et al., 2004; Fontbonne, Berr, Ducimetiere, & Alperovitch, 2001; Munshi et al., 2006), and speeded processing and complex psychomotor abilities (Munshi et al., 2006; Reaven, Thompson, Nahum, & Haskins, 1990). "
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    ABSTRACT: Introduction: Diabetes is associated with cognitive impairments, particularly in executive functioning and memory. Aim: The aim was to describe cognitive functioning in Type 1 (T1DM) and Type 2 (T2DM) diabetes compared to healthy controls in a Serbian sample. Method: We studied 15 patients with adult onset T1DM (age range 19-60 years), 37 patients with T2DM (age range 50-77 years), and 32 healthy controls (28-78 years). All participants underwent comprehensive neuropsychological assessment. Results: T2DM subjects exhibited poorer performance than healthy controls in global cognitive performance, as well as verbal learning and memory. After correcting for multiple comparisons, follow-up examination of individual tests showed significantly poorer performance only on Trail Making Test Part B (TMT-B). Effect sizes for T2DM versus healthy controls ranged from medium to large for several cognitive variables, while comparisons between T1DM and the other two groups tended to yield much smaller effects. Conclusion: T2DM is associated with poorer cognition, particularly in executive functions, learning/memory, and global cognition. Lack of group differences may be due to use of an adult onset T1DM sample, relatively young age of our T2DM sample, or characteristics of healthy control subjects in our Serbian sample.
    Full-text · Article · Dec 2014 · Journal of Clinical and Experimental Neuropsychology
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    • "Azok a mérések, amelyeket nem lehetett besorolni a fenti kognitív funkciók közzé, nem szerepelnek a metaanalízisben (1. táblázat) [18] [19] [20] [21] [22] [23] [24] [25] [26]. "
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    ABSTRACT: Introduction: Diabetes has been repeatedly associated with a wide variety of cognitive impairments. Aim: To clarify the differences in cognitive dysfunctions between the two types of diabetes. Method: Metaanalysis was performed using databases of Medline, PubMed and ScienceDirect (3 studies with type 1 and 6 with type 2 diabetes). Results: Adults with type 1 diabetes showed lower performance than control subjects in all fields. The effect size had the highest value in psychomotor activity (D = -0.69). The effect size was small for delayed verbal memory (D = -0.48), attention (D = -0.47), language (D = -0.44), visual processing (D = -0.35), immediate verbal memory (D = -0.30), working memory (D = -0.27) and executive functions (D = -0.26). Adults with type 2 diabetes showed lower performance than control subjects in all cognitive domains, except for working memory (D = +0.03). The effect size had the highest value in immediate verbal memory (D = -1.12), psychomotor activity (D = -0.82) and delayed verbal memory (D = -0.81). The effect size was moderate for general intellectual abilities (D = -0.68) and small for general memory (D = -0.37), attention (D = -0.35), language (D = -0.35), visual processing (D = -0.33) and executive functions (D = -0.33). Conclusion: Both types of diabetes are associated with reduced performance in numerous cognitive domains. Orv. Hetil., 2013, 154, 694-699.
    Full-text · Article · May 2013 · Orvosi Hetilap
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    • "In type 1 diabetes mellitus, Miles & Root (1922) reported cognition dysfunction (characterized by memory and attention impairment) in the studied subjects. Subsequent studies in type 1 diabetics reported deficits such as psychomotor inefficiency (Weinger et al., 2008), impairment of general intelligence (Northam et al., 2001) and deficits in motor speed (Wessels et al., 2007). In type 2 diabetes, cognitive impairments include deficits in executive function (Raeven et al., 1990), working memory (Munshi et al., 2006), and verbal fluency (Raeven et al.). "

    Full-text · Article · Sep 2011 · International Journal of Morphology
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