Brain and White Matter Hyperintensity Volumes After 10 Years of Random Assignment to Lifestyle Intervention.

TitleBrain and White Matter Hyperintensity Volumes After 10 Years of Random Assignment to Lifestyle Intervention.
Publication TypeJournal Article
Year of Publication2016
AuthorsEspeland MA, Erickson K, Neiberg RH, Jakicic JM, Wadden TA, Wing RR, Desiderio L, Erus G, Hsieh M-K, Davatzikos C, Maschak-Carey BJ, Laurienti PJ, Demos-McDermott K, R Bryan N
Corporate AuthorsAction for Health in Diabetes Brain Magnetic Resonance Imaging(Look AHEAD Brain) Ancillary Study Research Group
JournalDiabetes Care
Volume39
Issue5
Pagination764-71
Date Published2016 May
ISSN1935-5548
Abstract

OBJECTIVE: Type 2 diabetes increases the accumulation of brain white matter hyperintensities and loss of brain tissue. Behavioral interventions to promote weight loss through dietary changes and increased physical activity may delay these adverse consequences. We assessed whether participation in a successful 10-year lifestyle intervention was associated with better profiles of brain structure.

RESEARCH DESIGN AND METHODS: At enrollment in the Action for Health in Diabetes clinical trial, participants had type 2 diabetes, were overweight or obese, and were aged 45-76 years. They were randomly assigned to receive 10 years of lifestyle intervention, which included group and individual counseling, or to a control group receiving diabetes support and education through group sessions on diet, physical activity, and social support. Following this intervention, 319 participants from three sites underwent standardized structural brain magnetic resonance imaging and tests of cognitive function 10-12 years after randomization.

RESULTS: Total brain and hippocampus volumes were similar between intervention groups. The mean (SE) white matter hyperintensity volume was 28% lower among lifestyle intervention participants compared with those receiving diabetes support and education: 1.59 (1.11) vs. 2.21 (1.11) cc (P = 0.02). The mean ventricle volume was 9% lower: 28.93 (1.03) vs. 31.72 (1.03) cc (P = 0.04). Assignment to lifestyle intervention was not associated with consistent differences in cognitive function compared with diabetes support and education.

CONCLUSIONS: Long-term weight loss intervention may reduce the adverse impact of diabetes on brain structure. Determining whether this eventually delays cognitive decline and impairment requires further research.

DOI10.2337/dc15-2230
Alternate JournalDiabetes Care
PubMed ID27208378
PubMed Central IDPMC4839171
Grant ListP30 AG024827 / AG / NIA NIH HHS / United States
U01 DK057151 / DK / NIDDK NIH HHS / United States
K01 DK090445 / DK / NIDDK NIH HHS / United States
U01 DK057135 / DK / NIDDK NIH HHS / United States
UL1 RR024153 / RR / NCRR NIH HHS / United States
P30 DK046204 / DK / NIDDK NIH HHS / United States
M01 RR000056 / RR / NCRR NIH HHS / United States
U01 DK057219 / DK / NIDDK NIH HHS / United States
U01 DK057154 / DK / NIDDK NIH HHS / United States
U01 DK056992 / DK / NIDDK NIH HHS / United States
U01 DK057171 / DK / NIDDK NIH HHS / United States
R01 DK092237 / DK / NIDDK NIH HHS / United States
U01 DK057182 / DK / NIDDK NIH HHS / United States
U01 DK057136 / DK / NIDDK NIH HHS / United States
U01 DK057002 / DK / NIDDK NIH HHS / United States
U01 DK057177 / DK / NIDDK NIH HHS / United States
U01 DK057078 / DK / NIDDK NIH HHS / United States
U01 DK057131 / DK / NIDDK NIH HHS / United States
UL1 TR001120 / TR / NCATS NIH HHS / United States
U01 DK056990 / DK / NIDDK NIH HHS / United States
U01 DK057178 / DK / NIDDK NIH HHS / United States
U01 DK057008 / DK / NIDDK NIH HHS / United States
U01 DK057149 / DK / NIDDK NIH HHS / United States
M01 RR001346 / RR / NCRR NIH HHS / United States
Faculty Member Reference: 
Roberta Diaz Brinton, Ph.D