Hershey Tamara, Lillie Rema, Sadler Michelle, White Neil H
Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
J Int Neuropsychol Soc. 2003 Jul;9(5):740-50. doi: 10.1017/S1355617703950077.
Performance on long delays of delayed response tasks is associated with medial temporal function, a region of the brain affected by severe hypoglycemia. A previous study showed that children with type 1 diabetes mellitus (T1DM) with higher risk for severe hypoglycemia performed worse than controls on long delays of a spatial delayed response (SDR) task. We tested the more specific hypothesis that frequency of severe hypoglycemia would relate to long delay SDR performance. Children with T1DM (n = 51) and controls (n = 32) performed the SDR task with short and long delays. Information was collected on children's past severe hypoglycemia. In children with T1DM, number of past severe hypoglycemic episodes accounted for a significant portion of the variance in long delay SDR after controlling for age and age of onset. This relationship was not seen with short delay SDR or with other tasks (verbal or object memory, attention, motor speed). These results support the hypothesis that severe hypoglycemia has specific, negative effects on memory skills in children. If this relationship is extrapolated to children with higher frequency of severe hypoglycemia, due to longer duration of disease or poorer glucose control, it may affect daily functioning and thus need to be considered in treatment decisions.
延迟反应任务在长延迟情况下的表现与内侧颞叶功能相关，内侧颞叶是大脑中受严重低血糖影响的区域。先前的一项研究表明，严重低血糖风险较高的1型糖尿病（T1DM）儿童在空间延迟反应（SDR）任务的长延迟情况下表现比对照组差。我们检验了一个更具体的假设，即严重低血糖的频率与长延迟SDR表现有关。T1DM儿童（n = 51）和对照组（n = 32）进行了短延迟和长延迟的SDR任务。收集了儿童过去严重低血糖的信息。在T1DM儿童中，在控制年龄和发病年龄后，过去严重低血糖发作的次数占长延迟SDR变异的很大一部分。短延迟SDR或其他任务（言语或物体记忆、注意力、运动速度）未发现这种关系。这些结果支持了严重低血糖对儿童记忆技能有特定负面影响的假设。如果将这种关系外推到严重低血糖频率较高的儿童，由于病程较长或血糖控制较差，可能会影响日常功能，因此在治疗决策中需要考虑这一点。
