# Exposure to gestational diabetes mellitus in utero impacts hippocampal functional connectivity in response to food cues in children

## TL;DR

Children exposed to gestational diabetes in the womb show stronger brain connections related to food rewards, which may increase obesity risk.

## Contribution

The study reveals novel neural mechanisms linking gestational diabetes exposure to altered brain connectivity in children related to food cues.

## Key findings

- Children with gestational diabetes exposure showed stronger hippocampal connectivity to the insula and striatum during high-calorie food cues.
- This increased connectivity suggests heightened reward processing in response to food cues in GDM-exposed children.
- The findings imply potential long-term metabolic disease risks linked to altered brain connectivity.

## Abstract

Intrauterine exposure to gestational diabetes mellitus (GDM) increases the risk of obesity in the offspring, but little is known about the underlying neural mechanisms. The hippocampus is crucial for food intake regulation and is vulnerable to the effects of obesity. The purpose of the study was to investigate whether GDM exposure affects hippocampal functional connectivity during exposure to food cues using functional magnetic resonance imaging.

Participants were 90 children age 7–11 years (53 females) who underwent an fMRI-based visual food cue task in the fasted state. Hippocampal functional connectivity (FC) was examined using generalized psychophysiological interaction in response to high-calorie food versus non-food cues. Food-cue induced hippocampal FC was compared between children with and without GDM exposure, while controlling for possible confounding effects of age, sex and waist-to-hip ratio.

Children with GDM exposure exhibited stronger hippocampal FC to the insula and striatum (i.e., putamen, pallidum and nucleus accumbens) compared to unexposed children, while viewing high caloric food cues.

Intrauterine exposure to GDM was associated with higher food-cue induced hippocampal FC to reward processing regions. Future studies with longitudinal measurements are needed to clarify whether increased hippocampal FC to reward processing regions may raise the risk of the development of metabolic diseases later in life.