Exploratory Multisite MR Spectroscopic Imaging Shows White Matter Neuroaxonal Loss Associated with Complications of Type 1 Diabetes in Children.

Humans Child White Matter / diagnostic imaging Diabetes Mellitus, Type 1 / complications Diabetic Ketoacidosis Glycated Hemoglobin Pilot Projects Brain / diagnostic imaging Aspartic Acid Creatine Choline

Journal

AJNR. American journal of neuroradiology
ISSN: 1936-959X
Titre abrégé: AJNR Am J Neuroradiol
Pays: United States
ID NLM: 8003708

Informations de publication

Date de publication:
07 2023
Historique:
received: 18 02 2023
accepted: 03 05 2023
pmc-release: 01 07 2024
medline: 14 7 2023
pubmed: 2 6 2023
entrez: 1 6 2023
Statut: ppublish

Résumé

Type 1 diabetes affects over 200,000 children in the United States and is associated with an increased risk of cognitive dysfunction. Prior single-site, single-voxel MRS case reports and studies have identified associations between reduced NAA/Cr, a marker of neuroaxonal loss, and type 1 diabetes. However, NAA/Cr differences among children with various disease complications or across different brain tissues remain unclear. To better understand this phenomenon and the role of MRS in characterizing it, we conducted a multisite pilot study. In 25 children, 6-14 years of age, with type 1 diabetes across 3 sites, we acquired T1WI and axial 2D MRSI along with phantom studies to calibrate scanner effects. We quantified tissue-weighted NAA/Cr in WM and deep GM and modeled them against study covariates. We found that MRSI differentiated WM and deep GM by NAA/Cr on the individual level. On the population level, we found significant negative associations of WM NAA/Cr with chronic hyperglycemia quantified by hemoglobin A1c ( Our pilot study suggests that MRSI differentiates GM and WM by NAA/Cr in this population, disease complications may lead to neuroaxonal loss in WM in children, and deeper investigation is warranted to further untangle how diabetic ketoacidosis and chronic hyperglycemia affect brain health and cognition in type 1 diabetes.

Sections du résumé

BACKGROUND AND PURPOSE
Type 1 diabetes affects over 200,000 children in the United States and is associated with an increased risk of cognitive dysfunction. Prior single-site, single-voxel MRS case reports and studies have identified associations between reduced NAA/Cr, a marker of neuroaxonal loss, and type 1 diabetes. However, NAA/Cr differences among children with various disease complications or across different brain tissues remain unclear. To better understand this phenomenon and the role of MRS in characterizing it, we conducted a multisite pilot study.
MATERIALS AND METHODS
In 25 children, 6-14 years of age, with type 1 diabetes across 3 sites, we acquired T1WI and axial 2D MRSI along with phantom studies to calibrate scanner effects. We quantified tissue-weighted NAA/Cr in WM and deep GM and modeled them against study covariates.
RESULTS
We found that MRSI differentiated WM and deep GM by NAA/Cr on the individual level. On the population level, we found significant negative associations of WM NAA/Cr with chronic hyperglycemia quantified by hemoglobin A1c (
CONCLUSIONS
Our pilot study suggests that MRSI differentiates GM and WM by NAA/Cr in this population, disease complications may lead to neuroaxonal loss in WM in children, and deeper investigation is warranted to further untangle how diabetic ketoacidosis and chronic hyperglycemia affect brain health and cognition in type 1 diabetes.

Identifiants

DOI: 10.3174/ajnr.A7895 PMID: 37263786 PMC: PMC10337627
pubmed: 37263786
pii: ajnr.A7895
doi: 10.3174/ajnr.A7895
pmc: PMC10337627
doi:

Substances chimiques

Glycated Hemoglobin 0
Aspartic Acid 30KYC7MIAI
Creatine MU72812GK0
Choline N91BDP6H0X

Types de publication

Multicenter Study Journal Article Research Support, N.I.H., Extramural Research Support, U.S. Gov't, Non-P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

820-827

Subventions

Organisme : NIDDK NIH HHS
ID : P30 DK116073
Pays : United States
Organisme : NIGMS NIH HHS
ID : T32 GM007347
Pays : United States
Organisme : NIDDK NIH HHS
ID : U34 DK123894
Pays : United States
Organisme : NIDDK NIH HHS
ID : U34 DK123895
Pays : United States

Informations de copyright

© 2023 by American Journal of Neuroradiology.

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Auteurs

L Y Cai (LY)

From the Department of Biomedical Engineering (L.Y.C., A.W.A., B.A.L.) leon.y.cai@vanderbilt.edu.
ORCID: 0000-0002-5812-5397

C Tanase (C)

Departments of Psychiatry and Behavioral Sciences (C.T.).

A W Anderson (AW)

From the Department of Biomedical Engineering (L.Y.C., A.W.A., B.A.L.).
Vanderbilt University Institute of Imaging Science (A.W.A., B.A.L.).
Departments of Radiology and Radiological Sciences (A.W.A., S.P., B.A.L.).

N J Patel (NJ)

Pediatrics (N.J.P., R.S.J., S.S.J., L.C.J.).
ORCID: 0000-0002-4592-6451

C A Lee (CA)

Neurology (C.A.L., L.C.J.).
ORCID: 0000-0002-5701-6463

R S Jones (RS)

Pediatrics (N.J.P., R.S.J., S.S.J., L.C.J.).
ORCID: 0000-0001-7230-3068

L M LeStourgeon (LM)

Medicine (L.M.L.).

A Mahon (A)

Psychology (A.M., S.G.), University of California, Davis, Davis, California.
ORCID: 0000-0003-1378-1320

I Taki (I)

Department of Pediatrics (I.T., A.R., M.J.R.).

J Juvera (J)

Department of Psychiatry (J.J.), University of Colorado Anschutz Medical Campus, Aurora, Colorado.
ORCID: 0000-0002-0005-0679

S Pruthi (S)

Departments of Radiology and Radiological Sciences (A.W.A., S.P., B.A.L.).
ORCID: 0000-0002-4035-0852

K Gwal (K)

Departments of Radiology (K.G., A.O.).
ORCID: 0000-0001-7737-8034

A Ozturk (A)

Departments of Radiology (K.G., A.O.).
ORCID: 0000-0003-4958-7212

H Kang (H)

Biostatistics (H.K.), Vanderbilt University Medical Center, Nashville, Tennessee.
ORCID: 0000-0001-6876-4021

A Rewers (A)

Department of Pediatrics (I.T., A.R., M.J.R.).
ORCID: 0000-0002-2992-9273

M J Rewers (MJ)

Department of Pediatrics (I.T., A.R., M.J.R.).

G T Alonso (GT)

Barbara Davis Center (G.T.A.).
ORCID: 0000-0002-5676-761X

N Glaser (N)

Pediatrics (N.G.), University of California Davis Health, University of California Davis School of Medicine, Sacramento, California.

S Ghetti (S)

Psychology (A.M., S.G.), University of California, Davis, Davis, California.

S S Jaser (SS)

Pediatrics (N.J.P., R.S.J., S.S.J., L.C.J.).
ORCID: 0000-0002-7958-7662

B A Landman (BA)

From the Department of Biomedical Engineering (L.Y.C., A.W.A., B.A.L.).
Vanderbilt University Institute of Imaging Science (A.W.A., B.A.L.).
Department of Electrical and Computer Engineering (B.A.L.), Vanderbilt University, Nashville, Tennessee.
Departments of Radiology and Radiological Sciences (A.W.A., S.P., B.A.L.).
ORCID: 0000-0001-5733-2127

L C Jordan (LC)

Pediatrics (N.J.P., R.S.J., S.S.J., L.C.J.).
Neurology (C.A.L., L.C.J.).
ORCID: 0000-0001-7240-0415

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questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Projets pilotes › Exploratory Multisite MR Spectroscopic Imaging...
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