Psychiatry Research EG

Background There has been speculation that abnormalities in white matter may be responsible for cognitive dysfunction in children with type 1 diabetes mellitus (T1DM). Materials and methods Twenty children and adolescents with T1DM were recruited from the diabetes Clinic, Pediatrics Ain Shams University Hospital. To define the relation between cognitive impairment and white matter changes in these patients, cognitive functions were assessed using a neurocognitive test battery and white matter microstructure was assessed using diffusion tensor imaging. Results In the patient group, the Benton visual retention test scores were significantly worse than those of the control group, indicating significant impairment in visual perception, visual memory, and visual constructive abilities. The results of fractional anisotropy (FA) were significantly lower in the superior longitudinal fasciculus and optic radiation. Scores were correlated positively to FA at the cingulum, corona radiate, optic radiation, and splenium. On the Wechsler intelligence scale for children, scores of the patients were significantly lower on block design and digit span subscales, indicating impairment in visual constructive ability and immediate memory. The digit span test was correlated positively to FA at the midbody. On the Wisconsin card sorting test, the number of categories completed was correlated positively to FA at the midbrain region. Conclusion Our results imply that there exist changes in the microstructure of the white matter among diabetic children in all the areas examined that are correlated with many neurocognitive functions and can be considered a biomarker for cognitive decline among diabetic children. Keywords: cognitive functions, diffusion tensor imaging, type 1 diabetes mellitus