Meta-analyses of structural regional cerebral effects in type 1 and type 2 diabetes

Article


Moulton, Calum D., Costafreda, Sergi G., Horton, Paul, Ismail, Khalida and Fu, C. 2015. Meta-analyses of structural regional cerebral effects in type 1 and type 2 diabetes. Brain Imaging and Behavior. 9 (4), pp. 651-662.
AuthorsMoulton, Calum D., Costafreda, Sergi G., Horton, Paul, Ismail, Khalida and Fu, C.
Abstract

Diabetes is associated with macrovascular and microvascular complications and is a major
risk factor for neurological and psychiatric disorders, such as dementia and depression. Type
1 diabetes (T1DM) and type 2 diabetes (T2DM) have distinct etiologies and
pathophysiological effects while sharing a common endpoint of persistent hyperglycemia.
Neuroimaging studies in T1DM have revealed reductions in numerous regions, including the
parahippocampal and occipital regions, while in T2DM there have been numerous reports of
hippocampal atrophy. This meta-analysis aimed to identify consistent regional abnormalities
in cerebral structures in T1DM and T2DM respectively, and also to examine the impact of
potential confounds, including age, depression and vascular risk factors. Neuroimaging
studies of both voxel-based morphometry (VBM) data and volumetric data were included.
Ten T1DM studies (n=613 patients) and 23 T2DM studies (n=1364 patients) fulfilled
inclusion criteria. The T1DM meta-analysis revealed reduced bilateral thalamus grey matter
density in adults. The T2DM meta-analysis revealed reduced global brain volume and
regional atrophy in the hippocampi, basal ganglia, orbitofrontal and occipital lobes.
Moreover, hippocampal atrophy in T2DM was not modified by hypertension, although there
were more marked reductions in younger patients relative to healthy controls. In conclusion,
T1DM and T2DM demonstrated distinct cerebral effects with generalised and specific target
areas of grey matter reduction. Thalamic atrophy in T1DM may be a substrate of associated
cognitive deficits. In T2DM, global cerebral atrophy may reflect atherosclerotic factors, while
hippocampal atrophy was an independent effect providing a potential common
neuropathological aetiology for the comorbidity of T2DM with dementia and depression.

JournalBrain Imaging and Behavior
Journal citation9 (4), pp. 651-662
ISSN1931-7565
1931-7557
Year2015
PublisherSpringer Verlag
Accepted author manuscript
License
CC BY
Web address (URL)http://dx.doi.org/10.1007/s11682-014-9348-2
Publication dates
Print07 Jan 2015
Publication process dates
Deposited10 Dec 2015
Copyright informationThe final publication is available at Springer via http://dx.doi.org/10.1007/s11682-014-9348-2
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