Abnormal Functional Connectivity Density in New-Onset Type 1 Diabetes Mellitus Children: A Resting-State Functional Magnetic Resonance Imaging Study.

Kun Liu,Shihan Cui,Xiaoyan Huang,Wei Chen,Yongjin Zhou,Yuchuan Fu,Xiaozheng Liu,Jiahui Jin,Xiaoou Shan,Zhihan Yan,Xinjian Ye,Jiawen Song

doi:10.3389/fpsyt.2020.00284

Abstract

Type 1 diabetes mellitus (T1DM) causes cognitive changes in children, which may be due to deﬁcits in brain functions. It is unclear whether T1DM children will have brain functional changes during the initial stage of the disease. We aimed to investigate the changes in the functional brain network topology in children with new-onset T1DM. In this study, 35 new-onset T1DM children and 33 age-, sex-matched healthy controls underwent resting-state fMRI. The whole brain functional connectivity density (FCD) analysis and seed-based functional connectivity (FC) analysis were performed to investigate the changes in functional brain networks in new-onset T1DM children when compared with the controls. Pearson correlational analysis was used to explore the correlation between FCD value of differential brain areas and clinical variables in T1DM children. Compared with the controls, children with new-onset T1DM exhibited significantly decreased FCDs of the right inferior temporal gyrus (ITG) and the right posterior cingulate cortex (PCC). In the subsequent FC analysis, decreased FC was found between right PCC and right cuneus and increased FC was found between right ITG and left orbital part of inferior frontal gyrus in children with new-onset T1DM compared to the controls. The FCD values of right ITG and PCC did not correlate with HbA1c, blood glucose level before imaging, and full-scale intelligence quotient (IQ) in T1DM children. These results revealed that T1DM affect the functional activity of the immature brain at the initial stage. These findings also indicate a decrease in regional brain function and abnormalities in temporal-frontal and limbic-occipital circuitry in children with new-onset T1DM, and highlight the effects of T1DM on children's brain networks involved in visual process and memory, which may contribute to the cognition impairments observed in children with T1DM.

Highlights

Type 1 diabetes mellitus (T1DM) is a common metabolic disease that usually occurs in children and adolescents [1]
We aimed to investigate the differences in functional brain networks in children with new-onset T1DM
Technique, we found that compared with the healthy control group, there was decreased functional connectivity density (FCD) in the right inferior temporal gyrus (ITG) and the right posterior cingulate cortex (PCC) in children with new-onset T1DM, which were not correlated with HbA1c, blood glucose level before imaging, and full-scale intelligence quotient (IQ)

Summary

Introduction

Type 1 diabetes mellitus (T1DM) is a common metabolic disease that usually occurs in children and adolescents [1]. A better understanding of how T1DM affects children's brain anatomy and connectivity will help clinicians determine whether such patients are at risk of cognition decline in the future. Threedimensional T1-weighted imaging (3D-T1WI) studies found that gray matter and white matter volume were reduced in several brain regions in T1DM children [4, 5]. DTI studies showed that axial diffusivity was decreased in regional brain regions in T1DM children [6, 8]. These findings suggest that T1DM can cause changes in gray matter and white matter structures, which may be early biomarkers of neuronal, myelin and axonal injury or degeneration. Previous studies mainly focused on abnormal brain structural changes in T1DM, and the effect of T1DM on functional activity has rarely been studied

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Conclusion