THE EFFECT OF HYPOGLYCEMIA ON BRAIN FUNCTION

低血糖对脑功能的影响

• 批准号: 7718977
• 负责人: ALAN M JACOBSON
• 金额: $ 0.19万
• 依托单位: BETH ISRAEL DEACONESS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-01 至 2008-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7718977
• 关键词: Area; Blood Glucose; Brain; Brain region; Caring; Clinical; Cognition; Cognitive; Computer Retrieval of Information on Scientific Projects Database; Defect; Event; Functional Magnetic Resonance Imaging; Funding; Glucose; Goals; Grant; Hormones; Hypoglycemia; Hypoglycemic Agents; Hypothalamic structure; Impaired cognition; Institution; Insulin-Dependent Diabetes Mellitus; Neural Pathways; Patients; Performance; Recurrence; Research; Research Personnel; Resources; Risk; Source; Symptoms; Therapeutic; United States National Institutes of Health; design; diabetic; glycemic control; hypoglycemia unawareness; non-diabetic; programs; relating to nervous system; response; volunteer

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Hypoglycemia is a critical factor limiting optimal care in Type 1 diabetes patient (T1DM). Recurrent hypoglycemia can led to hypoglycemia unawareness (HU). However, little is know about the neural pathways underlying the changes in glucose sensing, cortical activity, and cognition associate with HU. The proposed studies will use fMRI to examine brain activation, cognitive performance, counter regulatory hormone secretion, and symptom recognition in three carefully selected contrast groups (N=60). T1DM patients without HU, T1DM patients with HU and non-diabetic volunteers to determine whether the counter regulatory defect present in unaware patients occurs due to an abnormal hypothalamic response. We will further explore whether other brain regions are activated in response to hypoglycemia and whether these regions differ in aware T1DM patients and control subjects as compared with the unaware patients. We will also investigate cortical activation in areas that support cognition. This research program will allow us to identify the brain regions involved in glucose sensing as well as cortical regions most susceptible to hypoglycemia. Due to the therapeutic goal of maintaining blood glucose levels as near normal, there is an elevated risk for mild recurrent hypoglycemia in T1DM. We need to better understand the long-term sequelae of this phenomenon to design approaches to clinical care to help patients achieve tighter glycemic control. Further a better understanding of the neural underpinnings of hypoglycemia associated cognitive impairments could provide important guidance on how to anticipate, avoid, and adapt to specific cognitive limitation that may be caused by an unanticipated hypoglycemic event. A major aim of our study is to determine whether patients with hypoglycemia unawareness activate the glucose sensing region (hypothalamus) less strongly and a t a lower blood glucose than aware diabetic patients and control subjects and whether they respond differently to cognitive challenges during hypoglycemia.

该子项目是利用该技术的众多研究子项目之一 资源由 NIH/NCRR 资助的中心拨款提供。子项目和 研究者 (PI) 可能已从 NIH 的另一个来源获得主要资金， 因此可以在其他 CRISP 条目中表示。列出的机构是 对于中心来说，它不一定是研究者的机构。 低血糖是限制 1 型糖尿病患者 (T1DM) 最佳护理的关键因素。反复发生低血糖可导致低血糖无意识（HU）。然而，人们对与 HU 相关的葡萄糖感知、皮质活动和认知变化背后的神经通路知之甚少。拟议的研究将使用功能磁共振成像来检查三个精心挑选的对比组（N = 60）的大脑激活、认知表现、反调节激素分泌和症状识别。没有 HU 的 T1DM 患者、患有 HU 的 T1DM 患者和非糖尿病志愿者，以确定不知情患者中存在的反调节缺陷是否由于异常下丘脑反应而发生。我们将进一步探讨其他大脑区域是否因低血糖而被激活，以及与不知情的患者相比，这些区域在有意识的 T1DM 患者和对照受试者中是否存在差异。 我们还将研究支持认知的区域的皮质激活。这项研究计划将使我们能够识别参与葡萄糖传感的大脑区域以及最容易发生低血糖的皮质区域。由于治疗目标是将血糖水平维持在接近正常水平，因此 T1DM 患者出现轻度复发性低血糖的风险较高。我们需要更好地了解这种现象的长期后遗症，以设计临床护理方法，帮助患者实现更严格的血糖控制。进一步更好地了解低血糖相关认知障碍的神经基础可以为如何预测、避免和适应可能由意外低血糖事件引起的特定认知限制提供重要指导。 我们研究的一个主要目的是确定无意识低血糖患者是否比有意识的糖尿病患者和对照受试者激活葡萄糖传感区域（下丘脑）的强度更低，血糖也更低，以及他们在低血糖期间对认知挑战的反应是否不同。