Evidence map›Paper›PMID 29709497›Full record

Trial reportEBioMedicine2018

Reduced Cortical Excitability, Neuroplasticity, and Salivary Cortisol in 11-13-Year-Old Children Born to Women with Gestational Diabetes Mellitus.

Jago M Van Dam, Amy J Garrett, Luke A Schneider, Nicolette A Hodyl, Mitchell R Goldsworthy, Suzette Coat, Janet A Rowan, William M Hague, Julia B Pitcher

Abstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in EBioMedicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Review
  5. Review
  6. Article
  7. Gestational Diabetes: An Update 60 Years After O'Sullivan and Mahan.The Journal of clinical endocrinology and metabolism · 2024
    Review
  8. Article
  9. Article
  10. Article
  11. Review
  12. Article
  13. Review
  14. Article
  15. Review
  16. Review
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Jago M Van DamRobinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, South Australia 5006, Australia.
Amy J GarrettRobinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, South Australia 5006, Australia.
Luke A SchneiderRobinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, South Australia 5006, Australia.
Nicolette A HodylRobinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, South Australia 5006, Australia.
Mitchell R GoldsworthyRobinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, South Australia 5006, Australia.
Suzette CoatRobinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, South Australia 5006, Australia.
Janet A RowanDepartment of Obstetrics, National Women's Health at Auckland City Hospital, Auckland, New Zealand.
William M HagueRobinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, South Australia 5006, Australia; Obstetric Medicine, Women's and Children's Hospital Network, North Adelaide, South Australia 5006, Australia.
Julia B PitcherRobinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, South Australia 5006, Australia. Electronic address: julia.pitcher@adelaide.edu.au.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChildren exposed to gestational diabetes mellitus (GDM) in utero are at increased risk of neurodevelopmental difficulties, including autism and impaired motor control. However, the underlying neurophysiology is unknown.

methodsUsing transcranial magnetic stimulation, we assessed cortical excitability, long-term depression (LTD)-like neuroplasticity in 45 GDM-exposed and 12 control children aged 11-13 years. Data were analysed against salivary cortisol and maternal diabetes severity and treatment (insulin [N = 22] or metformin [N = 23]) during pregnancy.

findingsGDM-exposed children had reduced cortical excitability (p = .003), LTD-like neuroplasticity (p = .005), and salivary cortisol (p < .001) when compared with control children. Higher maternal insulin resistance (IR) before and during GDM treatment was associated with a blunted neuroplastic response in children (p = .014) and this was not accounted for by maternal BMI. Additional maternal and neonatal measures, including fasting plasma glucose and inflammatory markers, predicted neurophysiological outcomes. The metformin and insulin treatment groups had similar outcomes.

interpretationThese results suggest that GDM can contribute to subtle differences in child neurophysiology, and possibly cortisol secretion, persisting into early adolescence. Importantly, these effects appear to occur during second trimester, before pharmacologic treatment typically commences, and can be predicted by maternal insulin resistance. Therefore, earlier detection and treatment of GDM may be warranted. Metformin appears to be safe for these aspects of neurodevelopment.

Indexed as

Autistic DisorderDiabetes, GestationalNeuronal PlasticityTranscranial Magnetic StimulationAdolescentCerebral CortexChildFemaleHumansHydrocortisoneMaleNeurodevelopmental DisordersPregnancySalivaHydrocortisoneHyperglycaemiaHypothalamic-pituitary-adrenal axisInsulinMetforminNeurodevelopmentTranscranial magnetic stimulation

Identifiers

PMID29709497
PMCPMC6014572

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.