The virtual Morris water maze for cognitive function assessment in adolescents with type 1 diabetes

Q: What was the main aim of the virtual Morris water maze study in adolescents with type 1 diabetes?

To investigate how diabetes-related factors influence spatial navigation performance in adolescents with type 1 diabetes.

Q: How were participants assessed in the virtual Morris water maze task?

Spatial navigation performance on the vMWMT was evaluated in adolescents with type 1 diabetes and compared with healthy controls. Outcomes included time to first move, time to platform, and path length across visible and hidden platform stages.

Q: Which diabetes-related factors independently predicted worse performance?

Diabetes duration independently predicted longer time to platform, and nocturnal time spent in marked hypoglycaemia predicted longer path length.

Sep 30, 2026

Uploaded by Aria

Neuropsychological assessments and neuroimaging findings suggest impaired spatial working memory in adolescents with type 1 diabetes. The study evaluates how diabetes-related factors influence spatial navigation using the virtual Morris water maze task. Participants with type 1 diabetes are compared with age- and sex-matched healthy controls. Visible-stage motor-related outcomes show sex-specific group differences, while hidden-stage learning and memory outcomes are comparable. Regression analyses indicate diabetes duration and recent nocturnal glycaemic control independently affect performance.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Abstract

Methods

Study design and participants

Introduction

Methods

Spatial navigation task and outcomes

Results

Conclusions/interpretation

Keywords

Abbreviations

Diabetologia (2025) 69:491–503 [https://doi.org/10.1007/s00125-025-06598-x](https://doi.org/10.1007/s00125-025-06598-x) The virtual Morris water maze for cognitive function assessment in adolescents with type 1 diabetes Hussein Zaitoon1,2 · Liat Perl1,2 · Eyal Cohen‑Sela1,2 · Asaf Oren1,2 · Yael Lebenthal1,2 · Avivit Brener1,2 Received: 26 June 2025 / Accepted: 10 September 2025 / Published online: 17 November 2025 © The Author(s) 2025 Abstract Aims/hypothesis Neuropsychological assessments and neuroimaging techniques have indicated impaired spatial working memory in adolescents with type 1 diabetes. We investigated the influence of diabetes-related factors on their spatial navigation performance. Methods Spatial navigation performance on the virtual Morris water maze task (vMWMT) was evaluated in adolescents with type 1 diabetes and compared with that of healthy control adolescents of similar age and sex. Collected data on diabetesrelated variables included disease duration, diabetic ketoacidosis (DKA) at diagnosis and continuous glucose monitoring (CGM) metrics during the 2 weeks preceding the assessment, with focus upon nocturnal values measured during the night before testing. Time to first move, time to platform and path length were measured in visible and hidden platform vMWMT stages. Results The 74 study participants (age 15.6 ± 3.1 years, 45 boys) with type 1 diabetes demonstrated sex-specific patterns of spatial navigation, comparable with those observed in the healthy control group. Both the boys and girls had longer time to first move than the control groups in the visible platform stage, which assessed motor control (p=0.036 and p=0.002, respectively). Test outcomes did not differ between the participants with and without type 1 diabetes in the hidden platform stages, which assessed spatial learning and memory. However, linear regression models adjusted for sex, age and DKA at diagnosis found that diabetes duration (β=0 .464, p<0 .001) independently predicted longer time to platform (R2=0 .396, p=0 .003), while nocturnal time spent in marked hypoglycaemia (β=0 .397, p=0 .002) predicted longer path length (R2=0 .206, p=0 .017) . Conclusions/interpretation Spatial navigation performance in adolescents with type 1 diabetes is influenced by both disease duration and recent glycaemic control. Glycaemic excursions, especially during the night, were shown to impair performance. Keywords Cognitive function · Glycaemic management · Spatial navigation · Type 1 diabetes · Virtual Morris water maze Abbreviations AID Automated insulin delivery CGM Continuous glucose monitoring DKA Diabetic ketoacidosis GMI Glucose management indicator MDI Multiple daily injections SEP Socioeconomic position vMWMT Virtual Morris water maze task * Avivit Brener [avivitbrener@tauex.tau.ac.il](avivitbrener@tauex.tau.ac.il); [avivitb@tlvmc.gov.il](avivitb@tlvmc.gov.il) 1 Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel 2 The Institute of Pediatric Endocrinology, Diabetes and Metabolism,‘Dana-Dwek’ Children’s Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel Introduction Accumulating evidence points to mild-to-moderate cognitive deficits and compromised academic achievement in adolescents with type 1 diabetes [1, 2] . In individuals with type 1 diabetes, extreme glycaemic fluctuations, particularly hypoglycaemia and, to a lesser extent, hyperglycaemia, may be associated with declines in cognitive functions [3, 4]. Distinct central neuropathic alterations in the hippocampus, a region critical for memory formation, attention and spatial navigation, were reported in individuals with type 1 diabetes [5]. Rodent models of diabetes revealed hippocampal electrophysiological abnormalities and related deficits in learning, memory and cognition [6] . These findings include impaired synaptic plasticity, deficits in long-term potentiation and long-term depression [7, 8],

FAQs

What was the main aim of the virtual Morris water maze study in adolescents with type 1 diabetes?

To investigate how diabetes-related factors influence spatial navigation performance in adolescents with type 1 diabetes.

How were participants assessed in the virtual Morris water maze task?

Spatial navigation performance on the vMWMT was evaluated in adolescents with type 1 diabetes and compared with healthy controls. Outcomes included time to first move, time to platform, and path length across visible and hidden platform stages.

Which diabetes-related factors independently predicted worse performance?

Diabetes duration independently predicted longer time to platform, and nocturnal time spent in marked hypoglycaemia predicted longer path length.

Sep 30, 2026

Uploaded by Aria