{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:06:20Z","timestamp":1784073980958,"version":"3.55.0"},"reference-count":54,"publisher":"The Endocrine Society","issue":"8","license":[{"start":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T00:00:00Z","timestamp":1772841600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100020513","name":"Italian Ministry of Ecological Transition","doi-asserted-by":"publisher","award":["RF-2016-02364070"],"award-info":[{"award-number":["RF-2016-02364070"]}],"id":[{"id":"10.13039\/100020513","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>The developing brain is particularly vulnerable to glycemic extremes in early-onset type 1 diabetes (T1D). However, how treatment-specific modalities may influence long-term neurodevelopmental trajectories remains poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To characterize multimodal MRI neurodevelopmental profiles in pediatric T1D and evaluate treatment-related effects of multiple daily injections (MDI) vs continuous subcutaneous insulin infusion (CSII) on brain structure, function, and test whether glycated hemoglobin (HbA1c)-linked imaging features relate to executive\u2013working-memory performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Sixteen children with T1D (8 MDI and 8 CSII from diagnosis) and eight controls underwent structural MRI, diffusion MRI, and resting-state fMRI. Union Recursive Feature Elimination selected gray matter (GM), white matter (WM), and resting-state functional connectivity (rs-FC) features discriminating groups; regression related selected features to long-term age-adjusted mean HbA1c. NEPSY-II Word List Interference (WI) was administered; control-referenced WI outcomes were examined vs HbA1c and HbA1c-associated structural features, including mediation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Functional features outperformed structural features (balanced accuracy 0.83 vs 0.67). MDI showed reduced GM\/WM integrity and disrupted fronto-temporal and subcortical connectivity vs CSII and controls. Right inferior frontal gyrus (IFG) volume correlated with HbA1c (r = 0.71, P &amp;lt; .05) and predicted HbA1c (\u03b2 = 0.28, P = .015). Higher HbA1c related to poorer WI repetition (r = \u22120.60, P = .013), and right IFG volume related to poorer WI repetition (r = \u22120.70, P = .002). Mediation supported an indirect HbA1c effect via right IFG volume (a \u00d7 b = \u22120.676; Sobel z = \u22121.765, one-tailed P = .0388), explaining \u223c64% of the total association. CSII had 30% lower hyperglycemia exposure than MDI and higher WI repetition mean ranks (11.19 vs 5.81; P = .023).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pediatric T1D is associated with multimodal neuroimaging alterations influenced by insulin treatment modality. CSII may confer neuroprotective benefits by improving metabolic control and preserving functional connectivity. Right IFG volume is a candidate imaging marker linking metabolic regulation to interference-sensitive executive\u2013working-memory vulnerability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgag102","type":"journal-article","created":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T12:42:34Z","timestamp":1772800954000},"page":"2275-2292","source":"Crossref","is-referenced-by-count":0,"title":["Multimodal MRI neurodevelopmental profiling in type 1 diabetes: long-term effects of MDI vs CSII treatments"],"prefix":"10.1210","volume":"111","author":[{"given":"Pasquale Anthony","family":"Della Rosa","sequence":"first","affiliation":[{"name":"Department of Neuroradiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) , Milan 20132 ,","place":["Italy"]},{"name":"Department of Metacognition, \u201cbr-ing\u201d Primary and Lower Secondary Bilingual School, Via San Tommaso, snc, Castelvenere , Benevento 82037 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