Abstract
Aims/hypothesesIn adults, type 2 diabetes and obesity have been associated with structural brain changes, even in the absence of dementia. Some evidence suggested similar changes in adolescents with type 2 diabetes but comparisons with a non-obese control group have been lacking. The aim of the current study was to examine differences in microstructure of gray and white matter between adolescents with type 2 diabetes, obese adolescents and healthy weight adolescents.MethodsMagnetic resonance imaging data were collected from 15 adolescents with type 2 diabetes, 21 obese adolescents and 22 healthy weight controls. Volumetric differences in the gray matter between the three groups were examined using voxel based morphology, while tract based spatial statistics was used to examine differences in the microstructure of the white matter.ResultsAdolescents with type 2 diabetes and obese adolescents had reduced gray matter volume in the right hippocampus, left putamen and caudate, bilateral amygdala and left thalamus compared to healthy weight controls. Type 2 diabetes was also associated with significant regional changes in fractional anisotropy within the corpus callosum, fornix, left inferior fronto-occipital fasciculus, left uncinate, left internal and external capsule. Fractional anisotropy reductions within these tracts were explained by increased radial diffusivity, which may suggest demyelination of white matter tracts. Mean diffusivity and axial diffusivity did not differ between the groups.Conclusion/interpretationOur data shows that adolescent obesity alone results in reduced gray matter volume and that adolescent type 2 diabetes is associated with both white and gray matter abnormalities.
Highlights
There has been a marked world-wide increase in the prevalence of type 2 diabetes among young persons (Pinhas-Hamiel and Zeitler, 2005; Alberti et al, 2004)
Gray matter reductions have been identified by Voxel Based Morphometry (VBM; a neuroimaging analysis technique using statistical parametric mapping), in adults with type 2 diabetes compared with healthy weight controls (Chen et al, 2012)
We found reduced fractional anisotropy (FA) in adolescents with type 2 diabetes compared to the normal weight control participants in a range of central brain areas, and these reductions were best explained by increases in radial diffusivity
Summary
There has been a marked world-wide increase in the prevalence of type 2 diabetes among young persons (Pinhas-Hamiel and Zeitler, 2005; Alberti et al, 2004). Adolescents with type 2 diabetes are reported to have significantly reduced volume in hippocampus and prefrontal brain regions and higher rates of global cerebral atrophy compared to obese adolescents (Bruehl et al, 2011). These associations are similar to those reported for adults with type 2 diabetes (Moulton et al, 2015; Brundel et al, 2010; Anan et al, 2012; Hsu et al, 2012; Chen et al, 2012). Differences in cortical white matter in adults with type 2 diabetes compared with healthy controls have been found (Hsu et al, 2012; Chen et al, 2012)
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