Altered functional connectivity during hypoglycaemia in type 1 diabetes

Jacob, Peter; Nwokolo, Munachiso; Cordon, Sally M; Macdonald, Ian A.; Zelaya, Fernando; Amiel, Stephanie A.; O’Daly, Owen; Choudhary, Pratik

doi:10.1177/0271678x221082911

Cited by 3 publications

(1 citation statement)

References 46 publications

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“…( 23 ) also found the decreased connectivity in angular gyrus within DMN was correlated with greater symptoms of hypoglycemia as well as higher scores of perceived stresses. Alterations in brain network responses to hypoglycemia are increasingly described, and the brain regions and networks that are sensitive to variations in plasma glucose levels have been identified ( 24 ). These abnormalities in brain network have been postulated to contribute to the impaired hypoglycemia awareness or adverse neurocognitive consequences ( 25 , 26 ).…”

Section: Introductionmentioning

confidence: 99%

Alterations in intra- and inter-network connectivity associated with cognition impairment in insulinoma patients

Nong,

Pang,

Jing

et al. 2023

Front. Endocrinol.

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ObjectiveCognitive dysfunction is common in insulinoma patients, but the underlying neural mechanisms are less well understood. This study aimed to explore the alterations of intra- and inter-network connectivity patterns associated with patients with insulinoma.MethodsResting-state fMRI were acquired from 13 insulinoma patients and 13 matched healthy controls (HCs). Group Independent component analysis (ICA) was employed to capture the resting-state networks (RSNs), then the intra- and inter-network connectivity patterns, were calculated and compared. Montreal Cognitive Assessment (MoCA) was used to assess the cognitive function. The relationship between connectivity patterns and MoCA scores was also examined.ResultsInsulinoma patients performed significantly worse on MoCA compared to HCs. The intra-network connectivity analysis revealed that patients with insulinoma showed decreased connectivity in the left medial superior frontal gyrus within anterior default mode network (aDMN), and decreased connectivity in right lingual gyrus within the visual network (VN). The intra-network connectivity analysis showed that patients with insulinoma had an increased connectivity between the inferior-posterior default mode network (ipDMN) and right frontoparietal network (rFPN) and decreased connectivity between the ipDMN and auditory network (AUN). There was a significant negative correlation between the ipDMN-rFPN connectivity and MoCA score.ConclusionThis study demonstrated significant abnormalities in the intra- and inter-network connectivity in patients with insulinoma, which may represent the neural mechanisms underlying the cognitive impairment in insulinoma patients.

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Section: Introductionmentioning

confidence: 99%

Alterations in intra- and inter-network connectivity associated with cognition impairment in insulinoma patients

Nong,

Pang,

Jing

et al. 2023

Front. Endocrinol.

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Altered Dynamics of Brain Spontaneous Activity and Functional Networks Associated With Cognitive Impairment in Patients With Type 2 Diabetes

Fu,

Zhang,

et al. 2024

Magnetic Resonance Imaging

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BackgroundCognitive impairment is increasingly recognized as an important comorbidity and complication of type 2 diabetes (T2D), affecting patients' quality of life and diabetes management. Dynamic brain activity indicators can reflect changes in key neural activity patterns of cognition and behavior.PurposeTo investigate dynamic functional connectivity (DFC) changes and spontaneous brain activity based on resting‐state functional magnetic resonance imaging (rs‐fMRI) in patients with T2D, exploring their correlations with clinical features.Study TypeRetrospective.SubjectsForty‐five healthy controls (HCs) (22 males and 23 females) and 102 patients with T2D (57 males and 45 females).Field Strength/Sequence3.0 T/T1‐weighted imaging and rs‐fMRI with gradient‐echo planar imaging sequence.AssessmentFunctional networks were created using independent component analysis. DFC states were determined using sliding window approach and k‐means clustering. Spontaneous brain activity was assessed using dynamic regional homogeneity (dReHo) variability.Statistical TestsOne‐way analysis of variance and post hoc analysis were used to compare the essential information including demographics, clinical data, and features of DFC and dReHo among groups. Diagnostic performance was assessed using receiver operating characteristic (ROC) curve. P‐values <0.05 were taken to indicate statistical significance.ResultsT2D group had significantly decreased mean dwell time and fractional windows in state 4 compared to HC. T2D with mild cognitive impairment showed significantly increased dReHo variability in left superior occipital gyrus compared to T2D with normal cognition. Mean dwell time and number of fractional windows of state 4 both showed significant positive correlations with the Montreal cognitive assessment scores (r = 0.309; r = 0.308, respectively) and the coefficient of variation of dReHo was significantly positively correlated with high‐density lipoprotein cholesterol (r = 0.266). The integrated index had an area under the curve of 0.693 (95% confidence interval = 0.592–0.794).Data ConclusionDifferences in DFC and dynamic characteristic of spontaneous brain activity associated with T2D‐related functional impairment may serve as indicators for predicting symptom progression and assessing cognitive dysfunction.Level of Evidence2Technical EfficacyStage 2

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Pathophysiology and management of hypoglycemia in diabetes

Sanchez‐Rangel

Deajon‐Jackson

Hwang

2022

Annals of the New York Academy of Sciences

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In the century since the discovery of insulin, diabetes has changed from an early death sentence to a manageable chronic disease. This change in longevity and duration of diabetes coupled with significant advances in therapeutic options for patients has fundamentally changed the landscape of diabetes management, particularly in patients with type 1 diabetes mellitus. However, hypoglycemia remains a major barrier to achieving optimal glycemic control. Current understanding of the mechanisms of hypoglycemia has expanded to include not only counter-regulatory hormonal responses but also direct changes in brain glucose, fuel sensing, and utilization, as well as changes in neural networks that modulate behavior, mood, and cognition. Different strategies to prevent and treat hypoglycemia have been developed, including educational strategies, new insulin formulations, delivery devices, novel technologies, and pharmacologic targets. This review article will discuss current literature contributing to our understanding of the myriad of factors that lead to the development of clinically meaningful hypoglycemia and review established and novel therapies for the prevention and treatment of hypoglycemia.

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Altered functional connectivity during hypoglycaemia in type 1 diabetes

Cited by 3 publications

References 46 publications

Alterations in intra- and inter-network connectivity associated with cognition impairment in insulinoma patients

Alterations in intra- and inter-network connectivity associated with cognition impairment in insulinoma patients

Altered Dynamics of Brain Spontaneous Activity and Functional Networks Associated With Cognitive Impairment in Patients With Type 2 Diabetes

Pathophysiology and management of hypoglycemia in diabetes

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