Differential Effects of Insulin Resistance on Frontal Lobe Related Cognitive Function in Adolescents and Adults
American Journal of Psychiatry and Neuroscience
Volume 6, Issue 4, December 2018, Pages: 108-115
Received: Nov. 13, 2018;
Accepted: Nov. 28, 2018;
Published: Dec. 21, 2018
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Stephanie London, Department of Psychiatry, New York University School of Medicine, New York, USA
Kathy Yates, Department of Psychiatry, New York University School of Medicine, New York, USA; Nathan Kline Institute for Psychiatric Research, Orangeburg, New York, USA
Antonio Convit, Department of Psychiatry, New York University School of Medicine, New York, USA; Department of Medicine, New York University School of Medicine, New York, USA; Department of Radiology, New York University School of Medicine, New York, USA; Nathan Kline Institute for Psychiatric Research, Orangeburg, New York, USA
The aim of this study was to determine whether effects of insulin resistance (IR) on frontal lobe mediated abilities differ between adolescents and middle-aged adults. These analyses included 118 adolescents aged 16-21 and 118 adults aged 45-60. IR was defined as having a homeostasis model assessment of insulin resistance (HOMA-IR) > 3.99. These analyses focused on higher-order frontal lobe-mediated function and assessed the differential effects of IR by age group on eight targeted cognitive/functional measures. There were significant differences between adolescents who were insulin sensitive (IS) and those with IR on the Stroop interference score (Cohen’s d = 0.61) and Frontal Systems Behavior Scale (FrSBe) executive dysfunction (Cohen’s d = -1.00). Adults with and without IR did not differ on any of the selected measures. There were significant interactions between age group and IR status for the Stroop interference score (partial eta2 = 0.029) and FrSBe executive dysfunction scale (partial eta2 = 0.045). Compared to their IS peers, adolescents with IR performed significantly worse on 2/8 indices of frontal lobe function, while no frontal lobe related cognitive differences existed in the adult population. As anticipated, there was a significant age group by IR status interaction for these higher-order frontal abilities. Poor performance in these measures indicates difficulties in planning, organization and self-regulation, skills that are crucial for life-long learning and achievement of future goals. These data suggest that the still-developing brains of adolescents may render them more vulnerable to the negative effects of metabolic dysregulation than do equivalent metabolic abnormalities in adults.
Differential Effects of Insulin Resistance on Frontal Lobe Related Cognitive Function in Adolescents and Adults, American Journal of Psychiatry and Neuroscience.
Vol. 6, No. 4,
2018, pp. 108-115.
Jolliffe, D., Extent of overweight among US children and adolescents from 1971 to 2000. Int J Obes Relat Metab Disord, 2004. 28(1): p. 4-9.
Skinner, A. C., et al., Prevalence of Obesity and Severe Obesity in US Children, 1999-2016. Pediatrics, 2018.
Gold, S. M., et al., Hippocampal damage and memory impairments as possible early brain complications of type 2 diabetes. Diabetologia, 2007. 50(4): p. 711-9.
Stewart, R. and D. Liolitsa, Type 2 diabetes mellitus, cognitive impairment and dementia. Diabet Med, 1999. 16(2): p. 93-112.
Cervos-Navarro, J. and N. H. Diemer, Selective vulnerability in brain hypoxia. Crit Rev Neurobiol, 1991. 6(3): p. 149-82.
Chalmers, J., et al., Severe amnesia after hypoglycemia. Clinical, psychometric, and magnetic resonance imaging correlations. Diabetes Care, 1991. 14(10): p. 922-5.
Vanhanen, M., et al., Risk for non-insulin-dependent diabetes in the normoglycaemic elderly is associated with impaired cognitive function. Neuroreport, 1997. 8(6): p. 1527-30.
Bruehl, H., et al., Cognitive impairment in nondiabetic middle-aged and older adults is associated with insulin resistance. J Clin Exp Neuropsychol, 2010. 32(5): p. 487-93.
Willette, A. A., et al., Insulin resistance, brain atrophy, and cognitive performance in late middle-aged adults. Diabetes Care, 2013. 36(2): p. 443-9.
Muniyappa, R., M. Iantorno, and M. J. Quon, An integrated view of insulin resistance and endothelial dysfunction. Endocrinol Metab Clin North Am, 2008. 37(3): p. 685-711, ix-x.
Willette, A. A., et al., Association of Insulin Resistance With Cerebral Glucose Uptake in Late Middle-Aged Adults at Risk for Alzheimer Disease. JAMA Neurol, 2015. 72(9): p. 1013-20.
Sweat, V., et al., Obese Adolescents Show Reduced Cognitive Processing Speed Compared with Healthy Weight Peers. Child Obes, 2017. 13(3): p. 190-196.
Yau, P. L., et al., Preliminary evidence of cognitive and brain abnormalities in uncomplicated adolescent obesity. Obesity (Silver Spring), 2014. 22(8): p. 1865-71.
Li, Y., et al., Overweight is associated with decreased cognitive functioning among school-age children and adolescents. Obesity (Silver Spring), 2008. 16(8): p. 1809-15.
Roberts, C. K., B. Freed, and W. J. McCarthy, Low aerobic fitness and obesity are associated with lower standardized test scores in children. J Pediatr, 2010. 156(5): p. 711-8, 718.e1.
Mangone, A., et al., Cognitive functions among predominantly minority urban adolescents with metabolic syndrome. Appl Neuropsychol Child, 2018. 7(2): p. 157-163.
Andersen, S. L., Trajectories of brain development: point of vulnerability or window of opportunity? Neurosci Biobehav Rev, 2003. 27(1-2): p. 3-18.
Lupien, S. J., et al., Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nature Reviews Neuroscience, 2009. 10: p. 434.
McCrimmon, R. J., C. M. Ryan, and B. M. Frier, Diabetes and cognitive dysfunction. Lancet, 2012. 379(9833): p. 2291-9.
Romine, C. B. and C. R. Reynolds, A model of the development of frontal lobe functioning: findings from a meta-analysis. Appl Neuropsychol, 2005. 12(4): p. 190-201.
Yau, P. L., et al., Preliminary evidence for brain complications in obese adolescents with type 2 diabetes mellitus. Diabetologia, 2010. 53(11): p. 2298-306.
Yau, P. L., et al., Obesity and metabolic syndrome and functional and structural brain impairments in adolescence. Pediatrics, 2012. 130(4): p. e856-64.
Anderson, P., Assessment and development of executive function (EF) during childhood. Child Neuropsychol, 2002. 8(2): p. 71-82.
Henry, J. D. and J. R. Crawford, A meta-analytic review of verbal fluency performance following focal cortical lesions. Neuropsychology, 2004. 18(2): p. 284-95.
Tang, Q., et al., Optimal cut-off values for the homeostasis model assessment of insulin resistance (HOMA-IR) and pre-diabetes screening: Developments in research and prospects for the future. Drug Discov Ther, 2015. 9(6): p. 380-5.
Rosenbaum, M., et al., Racial/ethnic differences in clinical and biochemical type 2 diabetes mellitus risk factors in children. Obesity (Silver Spring), 2013. 21(10): p. 2081-90.
Flynn, J. T., et al., Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Pediatrics, 2017. 140(3).
Fink, R. I., et al., The role of the glucose transport system in the postreceptor defect in insulin action associated with human aging. J Clin Endocrinol Metab, 1984. 58(4): p. 721-5.
Falkner, B., Hypertension in children and adolescents: epidemiology and natural history. Pediatr Nephrol, 2010. 25(7): p. 1219-24.
McNiece, K. L., et al., Prevalence of hypertension and pre-hypertension among adolescents. J Pediatr, 2007. 150(6): p. 640-4, 644.e1.
Carroll, M. D., C. D. Fryar, and B. K. Kit, Total and High-density Lipoprotein Cholesterol in Adults: United States, 2011-2014. NCHS Data Brief, 2015(226): p. 1-8.
Nguyen, D., B. Kit, and M. Carroll, Abnormal Cholesterol Among Children and Adolescents in the United States, 2011-2014. NCHS Data Brief, 2015(228): p. 1-8.
Dabelea, D., et al., Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. Jama, 2014. 311(17): p. 1778-86.
Novak, V. and I. Hajjar, The relationship between blood pressure and cognitive function. Nat Rev Cardiol, 2010. 7(12): p. 686-98.
Wolf, P. A., et al., Relation of obesity to cognitive function: importance of central obesity and synergistic influence of concomitant hypertension. The Framingham Heart Study. Curr Alzheimer Res, 2007. 4(2): p. 111-6.
Alvarez, J. A. and E. Emory, Executive function and the frontal lobes: a meta-analytic review. Neuropsychol Rev, 2006. 16(1): p. 17-42.
Perret, E., The left frontal lobe of man and the suppression of habitual responses in verbal categorical behaviour. Neuropsychologia, 1974. 12(3): p. 323-30.
Blair, C. and R. P. Razza, Relating effortful control, executive function, and false belief understanding to emerging math and literacy ability in kindergarten. Child Dev, 2007. 78(2): p. 647-63.
Best, J. R., P. H. Miller, and J. A. Naglieri, Relations between Executive Function and Academic Achievement from Ages 5 to 17 in a Large, Representative National Sample. Learn Individ Differ, 2011. 21(4): p. 327-336.
Maayan, L., et al., Disinhibited eating in obese adolescents is associated with orbitofrontal volume reductions and executive dysfunction. Obesity (Silver Spring), 2011. 19(7): p. 1382-7.
Pathan, A. R., et al., Rosiglitazone attenuates the cognitive deficits induced by high fat diet feeding in rats. Eur J Pharmacol, 2008. 589(1-3): p. 176-9.
Alosco, M. L., et al., Cognitive function after bariatric surgery: evidence for improvement 3 years after surgery. Am J Surg, 2014. 207(6): p. 870-6.
Gunstad, J., et al., Improved memory function 12 weeks after bariatric surgery. Surg Obes Relat Dis, 2011. 7(4): p. 465-72.
Mingrone, G., et al., Bariatric surgery versus conventional medical therapy for type 2 diabetes. N Engl J Med, 2012. 366(17): p. 1577-85.
Sultan, S., et al., Five-year outcomes of patients with type 2 diabetes who underwent laparoscopic adjustable gastric banding. Surg Obes Relat Dis, 2010. 6(4): p. 373-6.