Defective involuntary attention to novelty in type 1 diabetes and impaired awareness of hypoglycaemia

Aim: To determine if there are differences in terms of neurophysiology and neurocognitive functioning in a group of type 1 diabetes (T1D) patients regarding hypoglycaemia awareness. Methods: 27 patients with T1D were classified according to Clarke score as having impaired awareness of hypoglycaemia...

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Bibliographic Details
Authors: Stantonyonge, Nicole, Martínez-Horta, Saul|||0000-0003-0125-7249, Sampedro, Frederic|||0000-0002-3933-1355, Sánchez-Saudinós, María Belén|||0000-0003-1795-1833, Chico, Ana|||0000-0001-6498-3411
Format: article
Publication Date:2021
Country:España
Institution:Universitat Autònoma de Barcelona
Repository:Dipòsit Digital de Documents de la UAB
Language:English
OAI Identifier:oai:ddd.uab.cat:269692
Online Access:https://ddd.uab.cat/record/269692
https://dx.doi.org/urn:doi:10.1016/j.diabres.2021.108898
Access Level:Open access
Keyword:Type 1 diabetes
Hypoglycaemia
Impaired awareness
Neurophysiology
Description
Summary:Aim: To determine if there are differences in terms of neurophysiology and neurocognitive functioning in a group of type 1 diabetes (T1D) patients regarding hypoglycaemia awareness. Methods: 27 patients with T1D were classified according to Clarke score as having impaired awareness of hypoglycaemia (IAH; n = 11) or normal awareness to hypoglycaemia (NAH; n = 16). We measured several clinical and sociodemographic variables and cognitive performance using neuropsychological tests. Electroencephalography was assessed during an auditory oddball task. We compared the groups in terms of clinical/sociodemographic variables as well as two event-related brain potentials (ERPs): The P3a which is associated with automatic orientation of attention to novelty, and the P3b which is associated with target detection and processing. Results: The IAH group performed significantly worse on the Trail Making Test part A (TMT-A) (p = 0.05). Compared to the NAH group, P3a and P3b amplitudes in the frontal-central sites were significantly lower in the IAH group (p < 0.05). The P3a was strongly associated with worse performance on the TMT-A in the IAH group (r = 0.540; p < 0.005) Conclusion: IAH is accompanied by decreased neurophysiological activity in ERPs associated with information processing and with the automatic orientation of attention to novelty and environmental changes. These findings suggest a possible framework to better understand the cognitive origin of IAH in this patient population.