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17-12-2019 | Diabetes | News | Article

Children’s brains act to offset diabetes neural impairments

medwireNews: Children with type 1 diabetes have increased activation of certain areas of the brain during attention-demanding tasks, which may compensate for diabetes-related impairments and bring their cognitive ability in line with peers without diabetes, report researchers.

During a go/no-go task performed during functional magnetic resonance imaging, the team found significantly different brain activation in 93 children, aged an average of 11.5 years, who had type 1 diabetes (median glycated hemoglobin 8.1%), compared with 57 non-diabetic controls aged an average of 11.8 years.

Specifically, during no-go trials where the children had to prevent themselves from responding to a stimulus, those with diabetes had significantly less deactivation of an area centered in the posterior node of the default mode network (DMN) compared with controls. There was no difference during go trials, in which the children had to respond to a stimulus.

“While unexpected, suppressed deactivation of the posterior DMN may provide a neural explanation for the mild cognitive deficits that have been reported in children with [type 1 diabetes],” say Lara Foland-Ross (Stanford University, California, USA) and co-researchers.

The relevant area included parts of the posterior cingulate cortex and precuneus, which they say “typically deactivate during the performance of goal-oriented cognitive tasks involving attention to external stimuli, and activate during internal, self-referential processes such as rumination and mind wandering.”

The team adds: “The robust and highly reproducible pattern of activity in this network has led to the proposal that suppression of the DMN—and thus silencing of goal-irrelevant functions—is needed to attain optimal cognitive functioning.”

But despite these differences in the DMN, there were no significant performance differences between the two groups of children for any measure on the go/no-go task, nor were there any differences in behavioral measures on the Behavior Assessment System for Children, Second Edition.

The researchers found a potential explanation when they discovered that, averaged across eight data-driven regions of interest, executive control areas were activated significantly more in the brains of children with diabetes between the no-go and go task conditions than they were in control children, at 0.116% versus 0.105%.

The areas with different activation included the dorsal anterior cingulate cortex, inferior frontal gyri, cerebellum, and supramarginal gyri. In exploratory analyses, activation of these areas correlated with the degree of suppression in the DMN.

This suggests “a putative compensatory role of brain function in [children with type 1 diabetes], whereby higher activation in task-relevant regions act[s] both to offset [type 1 diabetes]-related impairments in DMN function and to facilitate behavioral performance levels equivalent to those of their non-diabetic peers,” write the researchers in PLOS Medicine.

They add that “whether these patterns change as a function of improved glycemic control deserves further study.”

By Eleanor McDermid

medwireNews is an independent medical news service provided by Springer Healthcare. © 2019 Springer Healthcare part of the Springer Nature group

PLoS Med 2019; 16: e1002979