Working Memory Impairment in Type 2 Diabetes: A Neurocognitive and Pathophysiological Review
Subject Areas : psychologyAmir Reza Majidi 1 , صغری ابراهیمی قوام 2 , Ehsan Rezayat 3 *
1 - Allameh Tabataba’i University
2 - Allameh Tabataba’i University
3 - Department of Cognitive Sciences, Faculty of Psychology and Education, University of Tehran, Tehran, Iran.
Keywords: Type 2 Diabetes Mellitus (T2DM), Working Memory, Insulin Resistance, Neuroinflammation, Cognition,
Abstract :
Abstract: Type 2 diabetes mellitus (T2DM) extends beyond a simple metabolic disorder and is associated with a range of neural and cognitive alterations that can impact executive functions, including working memory. This review aims to comprehensively elucidate the pathophysiological mechanisms and evaluate behavioral and neuroimaging evidence related to working memory impairment in patients with T2DM. By analyzing studies published over the past two decades, data from cognitive tests (e.g., n-back, Stroop) and neuro imaging techniques (e.g., fMRI, MEG) were reviewed. Behavioral evidence indicates that diabetic patients exhibit poorer performance in working memory tasks compared to healthy individuals, with this decline linked to factors such as age, disease duration, and glycated hemoglobin (HbA1c) levels. From a neuro biological perspective, central insulin resistance, neuro inflammation, oxidative stress, reduced cerebro-vascular reactivity, and neurotransmitter dysfunction are identified as key contributors to these impairments. fMRI and MEG data further support disruptions in activity and connectivity within working memory networks, particularly in the anterior cingulate cortex (ACC), dorsolateral prefrontal cortex (DLPFC), and hippocampus. Understanding the neural mechanisms underlying working memory decline in T2DM may facilitate early identification of at-risk patients and inform targeted clinical interventions to prevent cognitive deterioration.
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