Ventral Striatum, but Not Cortical Volume Loss, Is Related to Cognitive Dysfunction in Type 1 Diabetic Patients With and Without Microangiopathy

OBJECTIVE Patients with longstanding type 1 diabetes may develop microangiopathy due to high cumulative glucose exposure. Also, chronic hyperglycemia is related to cerebral alterations and cognitive dysfunction. Whether the presence of microangiopathy is conditional to the development of hyperglycemia-related cerebral compromise is unclear. Since subcortical, rather than cortical, volume loss was previously related to cognitive dysfunction in other populations, we measured these brain correlates and cognitive functions in patients with longstanding type 1 diabetes with and without microangiopathy. RESEARCH DESIGN AND METHODS We evaluated differences in subcortical volume and cortical thickness and volume in type 1 diabetic patients with ( n = 51) and without ( n = 53) proliferative retinopathy and 49 control subjects and related volume differences to cognitive dysfunction. Analyses were corrected for age, sex, systolic blood pressure, and A1C. RESULTS Putamen and right thalamic volume loss was noted in both patients with and without proliferative retinopathy compared with control subjects (all P P P CONCLUSIONS This study shows subcortical, but not cortical, volume loss in relation to cognitive dysfunction in patients with long-standing type 1 diabetes, irrespective of microangiopathy. The time-course, pathophysiology, and clinical relevance of these findings need to be established in longitudinal and mechanistic studies.