In patients with Type 1 Diabetes Mellitus, worse metabolic control trajectories (increasing HbA1C) positively correlated with higher BOLD activity in the interoceptive saliency network.
Cross-Sectional (n=50)
No
Does neural activation during health and economic decision-making differ between Type 1 Diabetes patients and controls, and does it correlate with HbA1c trajectories?
Neural risk processing in the saliency interoceptive network correlates with metabolic control trajectories in Type 1 Diabetes, suggesting a neurobiological link between decision-making and long-term health outcomes.
p-value: p=<0.05
Experimental approaches in neuroeconomics generally involve monetary utility. Utility in the health domain is relevant in diabetes because constant daily life decisions are critical for self-consequential long-term outcomes. We used fMRI to investigate self-consequent decision-making in the health and economic domains in Type 1 Diabetes Mellitus and controls (N = 50). We focused on two critical phases of decision-making: Investment and Feedback (Positive or Negative). Patients showed larger BOLD activation of limbic, and reward/dopaminergic regions in particular in the health trust game. Importantly, the worse the trajectory of metabolic control (increasing HbA1C), the higher the BOLD activity in regions of the interoceptive saliency network. This was manifested by positive correlations between brain activity during investment in anterior cingulate cortex and insula and HbA1c blood level progression. We conclude that the neural correlates of health-consequent decision-making domain involve limbic and reward related dopaminergic regions in Type 1 Diabetes Mellitus. Furthermore, the temporal trajectory of HbA1C blood levels is correlated with neural risk processing in the saliency network. Evidence for differential risk processing in the health versus the neuroeconomic context, and the discovery of a role for the saliency interoceptive network in metabolic control trajectories suggests a new perspective on the development of personalized interventions.
Jorge et al. (Tue,) conducted a cross-sectional in Type 1 Diabetes Mellitus (n=50). Trust-based decision-making tasks (economic and health domains) vs. Healthy controls was evaluated on Correlation between BOLD activity in the interoceptive saliency network and HbA1c trajectories during decision-making (p=<0.05). In patients with Type 1 Diabetes Mellitus, worse metabolic control trajectories (increasing HbA1C) positively correlated with higher BOLD activity in the interoceptive saliency network.