Aims: In this study, we used neuropsychological tests and neuroimaging to examine the cognitive functions and neuroimaging characteristics to explore the brain mechanism of cognitive deficits in patients with childhood-onset type 1 diabetes mellitus (T1DM).

Materials and methods: A total of 30 patients with childhood-onset T1DM and 28 healthy controls participated in the study. Neuropsychological tests were used to assess IQ, memory, and executive function. The VBM-DARTEL analysis and amplitude of low-frequent fluctuation (ALFF) were performed to evaluate the brain gray matter volume and neural spontaneous activity for each participant.

Results: Compared with healthy controls, patients with childhood-onset T1DM showed significant decline in verbal memory (p = 0.001) and visual memory (p = 0.002). Patients with T1DM had smaller gray matter volume at the midbrain, thalamus, and cerebellar culmen. They demonstrated an increased ALFF value in the left precentral gyrus, left postcentral gyrus, left insula, and left supramarginal gyrus and decreased ALFF value in the basal ganglia (putamen nucleus), right insula, right superior temporal gyrus, and cerebellar posterior lobe than the healthy control group. In the T1DM group, the ALFF value in the right insula was positively related to the verbal memory scores (r = 0.423, p = 0.025).

Conclusions: Childhood-onset T1DM was associated with cognitive deficits and changes in brain structure and function. These findings suggest that the brain structural and functional alterations in these regions may be the neuropathology of cognitive deficits in patients with T1DM. This article is protected by copyright. All rights reserved.