Department of Neurological Sciences, University of Nebraska Medical Center (UNMC), Omaha, Nebraska.
Center for Magnetoencephalography, UNMC, Omaha, Nebraska.
Hum Brain Mapp. 2019 Mar;40(4):1093-1100. doi: 10.1002/hbm.24431. Epub 2018 Oct 27.
Type 1 diabetes has been associated with alterations in attentional processing and other cognitive functions, and previous studies have found alterations in both brain structure and function in affected patients. However, these previous neuroimaging studies have generally examined older patients, particularly those with major comorbidities known to affect functioning independent of diabetes. The primary aim of the current study was to examine the neural dynamics of selective attention processing in a young group of patients with type 1 diabetes who were otherwise healthy (i.e., without major comorbidities). Our hypothesis was that these patients would exhibit significant aberrations in attention circuitry relative to closely matched controls. The final sample included 69 participants age 19-35 years old, 35 with type 1 diabetes and 34 matched nondiabetic controls, who completed an Eriksen flanker task while undergoing magnetoencephalography. Significant group differences in flanker interference activity were found across a network of brain regions, including the anterior cingulate, inferior parietal cortices, paracentral lobule, and the left precentral gyrus. In addition, neural activity in the anterior cingulate and the paracentral lobule was correlated with disease duration in patients with type 1 diabetes. These findings suggest that alterations in the neural circuitry underlying selective attention emerge early in the disease process and are specifically related to type 1 diabetes and not common comorbidities. These findings highlight the need for longitudinal studies in large cohorts to clarify the clinical implications of type 1 diabetes on cognition and the brain.
1 型糖尿病与注意力处理和其他认知功能的改变有关,先前的研究发现,受影响的患者的大脑结构和功能都发生了改变。然而,这些先前的神经影像学研究通常检查的是年龄较大的患者,特别是那些患有已知会独立于糖尿病影响功能的主要合并症的患者。本研究的主要目的是研究一组年轻的 1 型糖尿病患者(即无主要合并症)选择性注意处理的神经动力学。我们的假设是,与匹配的对照组相比,这些患者在注意力回路中会表现出明显的异常。最终样本包括 69 名年龄在 19-35 岁之间的参与者,其中 35 名为 1 型糖尿病患者,34 名为匹配的非糖尿病对照组,他们在接受脑磁图的同时完成了埃里森侧翼任务。在包括前扣带、下顶叶皮质、旁中央小叶和左中央前回在内的一系列脑区,发现了与侧翼干扰活动相关的显著组间差异。此外,1 型糖尿病患者的前扣带和旁中央小叶的神经活动与疾病持续时间相关。这些发现表明,选择性注意的神经回路的改变在疾病过程的早期就出现了,并且与 1 型糖尿病有关,而不是与常见的合并症有关。这些发现强调了在大样本中进行纵向研究的必要性,以阐明 1 型糖尿病对认知和大脑的临床意义。