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Título: | Abnormal Responses in Cognitive Impulsivity Circuits Are Associated with Glycosylated Hemoglobin Trajectories in Type 1 Diabetes Mellitus and Impaired Metabolic Control | Autor: | Jorge, Helena Duarte, Isabel C. Paiva, Sandra Relvas, Ana Paula Castelo-Branco, Miguel |
Palavras-chave: | Decision making; Diabetes mellitus type 1; Glycated hemoglobin A; Impulsive behavior; Risk factors; Treatment adherence and compliance | Data: | 22-Mar-2022 | Editora: | Korean Diabetes Association | Projeto: | UID/4950/2020 DSAIPA/DS/0041/2020 PCIF/SSO/0082/2018 PTDC/PSI-GER/30852/2017 PTDC/PSI-GER/1326/2020 FIS-FIS-2015-01 DIA - DiaMarkData European Foundation for the Study of Diabetes (EFSD) 2019—Innovative Measurement of Diabetes Outcomes 2019 |
Título da revista, periódico, livro ou evento: | Diabetes & Metabolism Journal | Local de edição ou do evento: | Seoul | Resumo: | Background: Risky health decisions and impulse control profiles may impact on metabolic control in type 1 diabetes mellitus (T1DM). We hypothesize that the neural correlates of cognitive impulsivity and decision-making in T1DM relate to metabolic control trajectories. Methods: We combined functional magnetic resonance imaging (fMRI), measures of metabolic trajectories (glycosylated hemoglobin [HbA1c] over multiple time points) and behavioral assessment using a cognitive impulsivity paradigm, the Balloon Analogue Risk Task (BART), in 50 participants (25 T1DM and 25 controls). Results: Behavioral results showed that T1DM participants followed a rigid conservative risk strategy along the iterative game. Imaging group comparisons showed that patients showed larger activation of reward related, limbic regions (nucleus accumbens, amygdala) and insula (interoceptive saliency network) in initial game stages. Upon game completion differences emerged in relation to error monitoring (anterior cingulate cortex [ACC]) and inhibitory control (inferior frontal gyrus). Importantly, activity in the saliency network (ACC and insula), which monitors interoceptive states, was related with metabolic trajectories, which was also found for limbic/reward networks. Parietal and posterior cingulate regions activated both in controls and patients with adaptive decision-making, and positively associated with metabolic trajectories. Conclusion: We found triple converging evidence when comparing metabolic trajectories, patients versus controls or risk averse (non-learners) versus patients who learned by trial and error. Dopaminergic reward and saliency (interoceptive and error monitoring) circuits show a tight link with impaired metabolic trajectories and cognitive impulsivity in T1DM. Activity in parietal and posterior cingulate are associated with adaptive trajectories. This link between reward-saliency-inhibition circuits suggests novel strategies for patient management. | Descrição: | Published online: March 22, 2022 | URI: | https://hdl.handle.net/10316/99578 | ISSN: | 2233-6087 2233-6079 |
DOI: | 10.4093/dmj.2021.0307 | Direitos: | openAccess |
Aparece nas coleções: | I&D CES - Artigos em Revistas Internacionais |
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Abnormal Responses in Cognitive Impulsivity Circuits.pdf | 1.05 MB | Adobe PDF | Ver/Abrir |
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