Cognitive performance in type 1 diabetes patients is associated with cerebral white matter volume

A. M. Wessels*, S. A R B Rombouts, P. L. Remijnse, Y. Boom, P. Scheltens, F. Barkhof, R. J. Heine, F. J. Snoek

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Aims/hypothesis: Cognitive performance in type 1 diabetes may be compromised as a result of chronic hyperglycaemia. The aim of this study was to investigate the cognitive functioning of patients with type 1 diabetes (including a subgroup with a microvascular complication) and nondiabetic controls, and to assess the relationship between cognition and cerebral grey and white matter volumes. Materials and methods: Twenty-five patients with type 1 diabetes (of whom ten had proliferative retinopathy) and nine nondiabetic controls (matched in terms of sex, age and education) underwent a neuropsychological examination and magnetic resonance imaging of the brain. Fractional brain tissue volumes (tissue volume relative to total intracranial volume) were obtained from each participant. Results: Compared with nondiabetic controls, patients with diabetes performed worse on tests measuring speed of information processing and visuoconstruction; patients with microvascular disease performed worse on the former cognitive domain (p=0.03), whereas patients without complications performed worse on the latter domain (p=0.01). Patients with a microvascular complication had a significantly smaller white matter volume than nondiabetic controls (p=0.04), and smaller white matter volume was associated with worse performance on the domains of speed of information processing and attention and executive function. Conclusions/interpretation: Patients with diabetes demonstrated several subtle neuropsychological deficits, which were found to be related to white matter volume. Since patients with diabetic retinopathy had a smaller white matter volume, this suggests that cognitive decline is at least partly mediated by microvascular disease. This needs to be addressed in future studies.

Original languageEnglish
Pages (from-to)1763-1769
Number of pages7
Issue number8
Publication statusPublished - 1 Aug 2007

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