Pediatr Gastroenterol Hepatol Nutr.  2019 Mar;22(2):171-180. 10.5223/pghn.2019.22.2.171.

Neurocognitive Functions in Infants with Malnutrition; Relation with Long-chain Polyunsaturated Fatty Acids, Micronutrients Levels and Magnetic Resonance Spectroscopy

• Cakir M
• Senyuva S
• Kul S
• Sag E
• Cansu A
• Yucesan FB
• Yaman SO
• Orem A

• KMID: 2440591
• DOI: http://doi.org/10.5223/pghn.2019.22.2.171

Abstract

PURPOSE
Malnutrition may influence neurocognitive development in children by directly affecting the brain structural development, or indirectly by affecting the children's cognition experience. Malnutrition alters the cell numbers, cell migration, synaptogenesis, and neurotransmission due to inadequate availability of necessary micronutrients to support cell growth. We aimed to analyze neurocognitive development in infants with malnutrition and its association with long chain polyunsaturated fatty acids (LC-PUFA), micronutrients levels and magnetic resonance spectroscopy (MRS) findings.
METHODS
The study included two groups; group 1, infants with malnutrition (n=24), group 2; healthy infants (n=21). Peripheral blood was obtained from the participants for studying micronutrients and LC-PUFA levels. The neurocognitive development was analyzed by the use of an Ankara Developmental Screening Inventory test. MRS were performed on all infants.
RESULTS
All parameters of neurocognitive development and serum calcium (9.6±0.9 mg/dL vs. 10.4±0.3 mg/dL, p < 0.05) and magnesium (2.02±0.27 mg/dL vs. 2.2±0.14 mg/dL, p < 0.05) levels were noted as being low in infants with marked malnutrition. No difference was found in LC-PUFA levels between healthy and malnourished infants. Thalamic choline/creatine levels were significantly high in infants with malnutrition (1.33±0.22 vs. 1.18±0.22, p < 0.05). Total neurocognitive development in infants was positively correlated with serum calcium levels (p < 0.05, r=0.381).
CONCLUSION
Calcium supplementation may improve neurocognitive development in malnourished infants.

Keyword

Malnutrition; Neurocognitive; Calcium; Fatty acids, unsaturated; Spectroscopy

MeSH Terms

Brain
Calcium
Cell Count
Cell Movement
Child
Cognition
Fatty Acids, Unsaturated*
Humans
Infant*
Magnesium
Magnetic Resonance Spectroscopy*
Malnutrition*
Mass Screening
Micronutrients*
Spectrum Analysis
Synaptic Transmission
Calcium
Fatty Acids, Unsaturated
Magnesium
Micronutrients

Figure

• 

  Fig. 1 MRS findings of malnourished and healthy infants. Note thalamic Cho/Cr ratio was higher in infants with malnutrition (1.33±0.22 vs. 1.18±0.22). MRS: magnetic resonance spectroscopy, Cho: choline, Cr: creatine, NAA: N-acetylaspartate. *p<0.05.

• 

  Fig. 2 MRS image of thalamic Cho/Cr ratio of a patient (A) and an infant in the control group (B). MRS: magnetic resonance spectroscopy, Cho: choline, Cr: creatine.

• 

  Fig. 3 Correlation of serum Ca levels with T points (p<0.05, r=0.381). Ca: calcium, T points: total points.

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