Regional brain activation during hypoglycemia in type 1 diabetes.
Regional brain activation during hypoglycemia in type 1 diabetes.
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DOI：
10.1210/jc.2007-2007
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发表时间：
2008-04
期刊：
影响因子：
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通讯作者：
G. Musen;D. Simonson;N. Bolo;Amy E. Driscoll;K. Weinger;Annaswamy Raji;J. Théberge;P. Renshaw
中科院分区：
文献类型：
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作者：
G. Musen;D. Simonson;N. Bolo;Amy E. Driscoll;K. Weinger;Annaswamy Raji;J. Théberge;P. Renshaw
CONTEXT Mechanisms underlying the brain response to hypoglycemia are not well understood. OBJECTIVE Our objective was to determine the blood glucose level at which the hypothalamus and other brain regions are activated in response to hypoglycemia in type 1 diabetic patients and control subjects. DESIGN This was a cross-sectional study evaluating brain activity using functional magnetic resonance imaging in conjunction with a hyperinsulinemic hypoglycemic clamp to lower glucose from euglycemia (90 mg/dl) to hypoglycemia (50 mg/dl). SETTING The study was performed at the Brain Imaging Center in the McLean Hospital. STUDY PARTICIPANTS Seven type 1 diabetic patients between 18 and 50 yr old and six matched control subjects were included in the study. INTERVENTION Hyperinsulinemic hypoglycemic clamp was performed. MAIN OUTCOME MEASURES Blood glucose level at peak hypothalamic activation, amount of regional brain activity during hypoglycemia in both groups, and difference in regional brain activation between groups were calculated. RESULTS The hypothalamic region activates at 68 +/- 9 mg/dl in control subjects and 76 +/- 8 mg/dl in diabetic patients during hypoglycemia induction. Brainstem, anterior cingulate cortex, uncus, and putamen were activated in both groups (P < 0.001). Each group also activated unique brain areas not active in the other group. CONCLUSIONS This application of functional magnetic resonance imaging can be used to identify the glucose level at which the hypothalamus is triggered in response to hypoglycemia and whether this threshold differs across patient populations. This study suggests that a core network of brain regions is recruited during hypoglycemia in both diabetic patients and control subjects.
