The impact of type 1 diabetes on neural activity serving attention

Abstract

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.

High‐definition transcranial direct current stimulation dissociates fronto‐visual theta lateralization during visual selective attention

“…; Embury et al . ). Previous studies using modifications of the Eriksen flanker task have primarily characterized the role of medial prefrontal and anterior cingulate in conflict and error monitoring, while the role of more lateralized nodes is less well understood.…”

“…Visual selective attention is often described as the capacity to discriminate and focus on visual features of interest within the larger visual field, while simultaneously inhibiting distracting visual input (Driver, 2001;Carrasco, 2011). Previous work has implicated a variety of regions important for this process, including but not limited to: lateral prefrontal cortex, medial prefrontal, anterior cingulate, superior parietal lobules, and the supplementary motor area (Botvinick et al 1999;Hazeltine et al 2000;van Veen et al 2001;Bunge et al 2002;Lau et al 2006;McDermott et al 2017;Lew et al 2018;Wilson et al 2018;Embury et al 2019). Previous studies using modifications of the Eriksen flanker task have primarily characterized the role of medial prefrontal and anterior cingulate in conflict and error monitoring, while the role of more lateralized nodes is less well understood.…”

“…; Embury et al . ), the underlying oscillatory dynamics and dynamic connectivity serving such processes are less well understood. Such data would be integral to revealing the mechanistic recruitment of neural networks that govern behavioural adaptation during interference.…”

“…Further, these regions appear to be intricately connected to posterior cortex including parietal regions and bottom-up processors, with hierarchical organization of these networks implicating PFC specifically in top-down control mechanisms (Miller, 2000;Brass et al 2005;Miller & D'Esposito, 2005). Importantly, while neuropsychological, lesion and neuroimaging studies have largely characterized the spatial extent of PFC involvement during cognitive processes such as visual selective attention (Botvinick et al 1999;Hazeltine et al 2000;Bunge et al 2002;Lau et al 2006;McDermott et al 2017McDermott et al , 2019Lew et al 2018;Embury et al 2019), the underlying oscillatory dynamics and dynamic connectivity serving such processes are less well understood. Such data would be integral to revealing the mechanistic recruitment of neural networks that govern behavioural adaptation during interference.…”

Altered motor dynamics in type 1 diabetes modulate behavioral performance

“…For example, gray matter volume reductions and decreased white matter integrity have been found in T1D (Biessels and Reijmer, 2014; Moran et al, 2017), and the condition has been linked to widespread functional deficits in regional recruitment and network connectivity in the brain, particularly during episodic hypoglycemia (Bolo et al, 2011; Bolo et al, 2015; Musen et al, 2008; Rooijackers et al, 2016). Further, cortical dynamics have been shown to be altered in relatively healthy adults with T1D (i.e., without major comorbidities or complications) during attention- and working memory-related tasks, involving widespread cortical regions from parieto-occipital to frontal cortices (Embury et al, 2018a; Embury et al, 2018b). These studies have further shown that participants with T1D tend to recruit task-relevant brain regions more strongly, and utilize contralateral homologue areas to maintain adequate task performance, which may suggest compensatory processing in T1D.…”