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
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
DOI: 10.1016/j.ebiom.2018.04.011
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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