Altered Neural Dynamics during a Flanker Attention Task in Patients with Type 1 Diabetes

Background: Patients with type 1 diabetes appear to have deficits in specific cognitive domains, particularly in attention and executive function (1). In this study, we used magnetoencephalography (MEG; 2), a noninvasive functional neuroimaging method, to identify neuronal changes in attention processing in otherwise healthy young adults with type 1 diabetes during euglycemia.

Methods: Adults with type 1 diabetes and no micro- or macro-vascular complications (N = 38) completed a visual selective attention task during MEG. A demographically-matched control group without type 1 diabetes was used for comparison. Each trial began with a fixation cross presented centrally, followed by a row of 5 arrows. Participants were asked to respond regarding the direction of the middle arrow (right index finger for left, right middle finger for right) and ignore the flanking arrows that were presented in either the same (congruent condition) or opposite direction (incongruent condition). All MEG data was processed following standard protocols (3), and the resulting images of functional brain activity were examined statistically.

Results: While no differences in reaction time or accuracy were found between groups, patients recruited a more widespread network of task relevant brain regions compared to controls, particularly the prefrontal cortex and anterior cingulate. Patients had a greater alpha increase from baseline in the anterior cingulate (p < .01), an important brain region in attention, and in the prefrontal cortex (p < .01) as compared to controls, likely reflecting compensatory mechanisms at play.

Conclusions: These results indicate that type 1 diabetes affects neural activity in attention networks of patients who are otherwise healthy and without major comorbidities, reflecting the recruitment of compensatory neural responses to complete task goals.