Reduced Cortical Excitability, Neuroplasticity, and Salivary Cortisol in 11–13-Year-Old Children Born to Women with Gestational Diabetes Mellitus
| Autor: | Julia B. Pitcher, Suzette Coat, Janet Rowan, Amy J. Garrett, Nicolette A. Hodyl, Mitchell R. Goldsworthy, William M. Hague, Jago M Van Dam, Luke A. Schneider |
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| Přispěvatelé: | Van Dam, Jago M, Garrett, Amy J, Schneider, Luke A, Hodyl, Nicolette A, Goldsworthy, Mitchell R, Coat, Suzette, Rowan, Janet A, Hague, William M, Pitcher, Julia B |
| Rok vydání: | 2018 |
| Předmět: |
Male
0301 basic medicine Hydrocortisone endocrine system diseases medicine.medical_treatment Neurodevelopment lcsh:Medicine Physiology 0302 clinical medicine IR insulin resistance Pregnancy transcranial magnetic stimulation Hyperglycaemia Insulin NMDAR N-methyl-d-aspartate receptor Child Cerebral Cortex lcsh:R5-920 Neuronal Plasticity neurodevelopment nmol/L nano-moles per litre Gestational age RMT resting motor threshold General Medicine Transcranial Magnetic Stimulation cTBS continuous theta burst stimulation Metformin Gestational diabetes Medicine Research & Experimental Hypothalamic-pituitary-adrenal axis Female lcsh:Medicine (General) MiG Metformin in Gestational diabetes trial Research Paper medicine.drug Cortisol secretion insulin Adolescent HOMA-IR homeostatic model assessment for insulin resistance AMT active motor threshold hypothalamic-pituitary-adrenal axis General Biochemistry Genetics and Molecular Biology 03 medical and health sciences Medicine General & Internal Insulin resistance General & Internal Medicine LTD long term depression medicine Humans Autistic Disorder Saliva SI1mV stimulus intensity to evoke 1 mV response HPA hypothalamic-pituitary-adrenal GDM gestational diabetes mellitus business.industry TMS transcranial magnetic stimulation lcsh:R nutritional and metabolic diseases medicine.disease Diabetes Gestational EMG electromyogram 030104 developmental biology Neurodevelopmental Disorders MEP motor evoked potential metformin business GA gestational age hyperglycaemia 030217 neurology & neurosurgery |
| Zdroj: | EBioMedicine, Vol 31, Iss, Pp 143-149 (2018) EBioMedicine |
| ISSN: | 2352-3964 |
| Popis: | Background Children exposed to gestational diabetes mellitus (GDM) in utero are at increased risk of neurodevelopmental difficulties, including autism and impaired motor control. However, the underlying neurophysiology is unknown. Methods Using transcranial magnetic stimulation, we assessed cortical excitability, long-term depression (LTD)-like neuroplasticity in 45 GDM-exposed and 12 control children aged 11–13 years. Data were analysed against salivary cortisol and maternal diabetes severity and treatment (insulin [N = 22] or metformin [N = 23]) during pregnancy. Findings GDM-exposed children had reduced cortical excitability (p = .003), LTD-like neuroplasticity (p = .005), and salivary cortisol (p Highlights • Children exposed to gestational diabetes (GDM) had lower cortical excitability, measured as higher resting motor thresholds. • The GDM group also exhibited smaller LTD-like neuroplastic responses to repetitive brain stimulation. • These were associated with lower salivary cortisol and with maternal diabetes severity, especially insulin resistance. Our results suggest that gestational diabetes, even when detected and treated as per clinical guidelines, has subtle effects on important neurophysiological processes persisting into early adolescence, including neuroplasticity and possibly cortisol secretion. The extent of these effects is related to the severity of maternal diabetes, particularly insulin resistance, during mid pregnancy. These results may aid in understanding how insulin resistance and hyperglycemia affect the developing brain. Further, our results indicate that earlier detection and pharmacologic treatment of gestational diabetes may attenuate or prevent these changes to neurodevelopment, and that maternal metformin treatment does not influence these aspects of development. |
| Databáze: | OpenAIRE |
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