Psychoorganic syndrome in type 1 diabetes mellitus: a concomitant disease or a complication of diabetes? (Review)

Psychoorganic syndrome (POS), also known as organic brain syndrome, or encephalopathy, is characterized by cognitive decline, emotional incontinence (emotional lability), and asthenic symptoms. It can develop due to a number of exogenous and endogenous factors, and despite the use of the term «diabetic encephalopathy», the evidence for a specific diabetic etiology of POS remains limited. The review provides a detailed history of the term POS and its definition, components and possible causes, pros and cons of the existence of POS of diabetic origin. The potential influence of dysglycemia on the development of POS and brain abnormalities in Type 1 diabetic patients (T1D) found at neuroimaging, as well as their associations between each other and with other clinical parameters, including the age at diabetes manifestation, disease duration, acute diabetic complications, and diabetic retinopathy as a marker of a long-term exposure to hyperglycemia, are discussed. In young adults with T1DM, cognitive function parameters fall within the age-related reference ranges, and their associations with the degree of hyperglycemia or severe hypoglycemia are not reproducible in larger samples. The analysis of neuroimaging and histological data also does not provide convincing evidence that brain abnormalities are unique to T1DM. Thus, the issue of POS (encephalopathy) in T1DM remains insufficiently studied and controversial. Current data does not allow to unequivocally accept the specific diabetic nature of POS/encephalopathy in T1D. Further studies are necessary to identify the contribution of diabetes and associated factors to the development of POS, including histological data.

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