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Mostek AMB, Bell EF, Feldman HA, Josephson CD, Georgieff MK, Nopoulos P, Patel RM, Stowell SR, Sola-Visner M, Conrad AL. Sex differences in the association of pretransfusion haemoglobin and cognition in preterm infants. BMJ Paediatr Open 2024; 8:e002541. [PMID: 38851221 PMCID: PMC11163603 DOI: 10.1136/bmjpo-2024-002541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/05/2024] [Indexed: 06/10/2024] Open
Abstract
OBJECTIVES To assess sex-specific differences in the association between pre-transfusion haemoglobin values and early neurodevelopmental function. DESIGN Observational follow-up of infants with birth weights <1000 g and gestational ages 22-28 weeks who were enrolled in the NICHD Neonatal Research Network Transfusion of Prematures (TOP) Trial at 19 U.S. sites, 2012-2017. MAIN OUTCOME MEASURES Pretransfusion haemoglobin values were obtained longitudinally through 36 weeks' postmenstrual age. The infant's mean pretransfusion haemoglobin was used as a marker of degree of anaemia (n=1655 measures). Measures of brain function were obtained at 22-26 months' corrected age using the Bayley Scales of Infant & Toddler Development, third edition (BSID-III) (n=1290 BSID-III scores). Sex-specific estimates for the linear relation between pretransfusion haemoglobin and BSID-III scores were obtained from repeated-measures regression analysis, adjusted for gestational age, birth weight, study site, clinical characteristics, and demographic covariates. RESULTS The relation of pretransfusion haemoglobin with 24-month BSID-III scores showed significant, independent interactions with both (1) sex (p=0.046) and (2) retinopathy of prematurity (ROP; p=0.004). In 614 males, BSID-III scores were higher by 1.07 points per g/dL (95% CI 1.58 to 4.33; p=0.008), not differing significantly among the three subscales (cognitive, language and motor; p=0.94). In 247 infants with ROP, BSID-III scores were higher by 2.95 points per g/dL (95% CI 0.28 to 1.87; p<0.0001), uniformly across subscales (p=0.73). These associations were non-significant in 676 females (p=0.96) and 1043 infants without ROP (p=0.81). CONCLUSIONS This study demonstrates sex-specific associations between mean pretransfusion haemoglobin (a marker of the severity of anaemia throughout the neonatal intensive care unit [NICU] hospitalisation) and early neurodevelopmental function at 22-26 months' corrected age.
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Affiliation(s)
- Amanda M Benavides Mostek
- Department of Psychiatry, University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA
| | - Edward F Bell
- Stead Family Department of Pediatrics, University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA
| | - Henry A Feldman
- Department of Pediatrics, Division of Newborn Medicine, Boston Children's Hospital, Harvard Medical School, Cambridge, Massachusetts, USA
| | - Cassandra D Josephson
- Cancer and Blood Disorders Institute, Blood Bank and Transfusion Medicine, Johns Hopkins All Children's Hospital, St Petersburg, Florida, USA
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michael K Georgieff
- Department of Pediatrics, Division of Neonatology, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA
| | - Peg Nopoulos
- Department of Psychiatry, University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA
- Stead Family Department of Pediatrics, University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA
- Department of Neurology, University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA
| | - Ravi Mangal Patel
- Department of Pediatrics, Division of Neonatology, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Sean R Stowell
- Department of Pathology, Joint Program in Transfusion Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Martha Sola-Visner
- Department of Pediatrics, Division of Newborn Medicine, Boston Children's Hospital, Harvard Medical School, Cambridge, Massachusetts, USA
| | - Amy L Conrad
- Stead Family Department of Pediatrics, University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA
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Cabral L, Calabro FJ, Foran W, Parr AC, Ojha A, Rasmussen J, Ceschin R, Panigrahy A, Luna B. Multivariate and regional age-related change in basal ganglia iron in neonates. Cereb Cortex 2024; 34:bhad456. [PMID: 38059685 DOI: 10.1093/cercor/bhad456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 12/08/2023] Open
Abstract
In the perinatal period, reward and cognitive systems begin trajectories, influencing later psychiatric risk. The basal ganglia is important for reward and cognitive processing but early development has not been fully characterized. To assess age-related development, we used a measure of basal ganglia physiology, specifically brain tissue iron, obtained from nT2* signal in resting-state functional magnetic resonance imaging (rsfMRI), associated with dopaminergic processing. We used data from the Developing Human Connectome Project (n = 464) to assess how moving from the prenatal to the postnatal environment affects rsfMRI nT2*, modeling gestational and postnatal age separately for basal ganglia subregions in linear models. We did not find associations with tissue iron and gestational age [range: 24.29-42.29] but found positive associations with postnatal age [range:0-17.14] in the pallidum and putamen, but not the caudate. We tested if there was an interaction between preterm birth and postnatal age, finding early preterm infants (GA < 35 wk) had higher iron levels and changed less over time. To assess multivariate change, we used support vector regression to predict age from voxel-wise-nT2* maps. We could predict postnatal but not gestational age when maps were residualized for the other age term. This provides evidence subregions differentially change with postnatal experience and preterm birth may disrupt trajectories.
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Affiliation(s)
- Laura Cabral
- Department of Radiology University of Pittsburgh, Pittsburgh, PA 15224, United States
| | - Finnegan J Calabro
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, United States
- Department of Bioengineering, University of Pittsburgh, 15213, United States
| | - Will Foran
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, United States
| | - Ashley C Parr
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, United States
| | - Amar Ojha
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA 15213, United States
- Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA 15213, United States
| | - Jerod Rasmussen
- Development, Health and Disease Research Program, University of California, Irvine, CA 92697, United States
- Department of Pediatrics, University of California, Irvine, CA 92697, United States
| | - Rafael Ceschin
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA 15224, United States
| | - Ashok Panigrahy
- Department of Radiology University of Pittsburgh, Pittsburgh, PA 15224, United States
| | - Beatriz Luna
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, United States
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Bulgarelli C, Blasi A, McCann S, Milosavljevic B, Ghillia G, Mbye E, Touray E, Fadera T, Acolatse L, Moore SE, Lloyd-Fox S, Elwell CE, Eggebrecht AT. Growth in early infancy drives optimal brain functional connectivity which predicts cognitive flexibility in later childhood. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.02.573930. [PMID: 38260280 PMCID: PMC10802370 DOI: 10.1101/2024.01.02.573930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Functional brain network organization, measured by functional connectivity (FC), reflects key neurodevelopmental processes for healthy development. Early exposure to adversity, e.g. undernutrition, affects neurodevelopment, observable via disrupted FC, and leads to poorer outcomes from preschool age onward. We assessed longitudinally the impact of early growth trajectories on developmental FC in a rural Gambian population from age 5 to 24 months. To investigate how these early trajectories relate to later childhood outcomes, we assessed cognitive flexibility at 3-5 years. We observed that early physical growth before the fifth month of life drove optimal developmental trajectories of FC that in turn predicted cognitive flexibility at pre-school age. In contrast to previously studied developmental populations, this Gambian sample exhibited long-range interhemispheric FC that decreased with age. Our results highlight the measurable effects that poor growth in early infancy has on brain development and the subsequent impact on pre-school age cognitive development, underscoring the need for early life interventions throughout global settings of adversity.
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Affiliation(s)
- Chiara Bulgarelli
- Centre for Brain and Cognitive Development, Birkbeck, University of London, UK
- Department of Medical Physics and Biomedical Engineering, University College London, UK
| | - Anna Blasi
- Department of Medical Physics and Biomedical Engineering, University College London, UK
| | - Samantha McCann
- Department of Women and Children’s Health, King’s College London, UK
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, The Gambia
| | - Bosiljka Milosavljevic
- Department of Psychology, University of Cambridge, UK
- School of Biological and Experimental Psychology, Queen Mary University of London, UK
| | - Giulia Ghillia
- Department of Women and Children’s Health, King’s College London, UK
| | - Ebrima Mbye
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, The Gambia
| | - Ebou Touray
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, The Gambia
| | - Tijan Fadera
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, The Gambia
| | - Lena Acolatse
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, The Gambia
- Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Ireland
| | - Sophie E. Moore
- Department of Women and Children’s Health, King’s College London, UK
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, The Gambia
| | | | - Clare E. Elwell
- Department of Medical Physics and Biomedical Engineering, University College London, UK
| | - Adam T. Eggebrecht
- Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, USA
| | - BRIGHT Study Team
- The BRIGHT team are (in alphabetic order): Muhammed Ceesay, Kassa Kora, Fabakary Njai, Andrew Prentice, Mariama Saidykhan
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Noh B, Blasco‐Conesa MP, Rahman SM, Monga S, Ritzel R, Guzman G, Lai Y, Ganesh BP, Urayama A, McCullough LD, Moruno‐Manchon JF. Iron overload induces cerebral endothelial senescence in aged mice and in primary culture in a sex-dependent manner. Aging Cell 2023; 22:e13977. [PMID: 37675802 PMCID: PMC10652299 DOI: 10.1111/acel.13977] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 08/13/2023] [Accepted: 08/16/2023] [Indexed: 09/08/2023] Open
Abstract
Iron imbalance in the brain negatively affects brain function. With aging, iron levels increase in the brain and contribute to brain damage and neurological disorders. Changes in the cerebral vasculature with aging may enhance iron entry into the brain parenchyma, leading to iron overload and its deleterious consequences. Endothelial senescence has emerged as an important contributor to age-related changes in the cerebral vasculature. Evidence indicates that iron overload may induce senescence in cultured cell lines. Importantly, cells derived from female human and mice generally show enhanced senescence-associated phenotype, compared with males. Thus, we hypothesize that cerebral endothelial cells (CEC) derived from aged female mice are more susceptible to iron-induced senescence, compared with CEC from aged males. We found that aged female mice, but not males, showed cognitive deficits when chronically treated with ferric citrate (FC), and their brains and the brain vasculature showed senescence-associated phenotype. We also found that primary culture of CEC derived from aged female mice, but not male-derived CEC, exhibited senescence-associated phenotype when treated with FC. We identified that the transmembrane receptor Robo4 was downregulated in the brain vasculature and in cultured primary CEC derived from aged female mice, compared with those from male mice. We discovered that Robo4 downregulation contributed to enhanced vulnerability to FC-induced senescence. Thus, our study identifies Robo4 downregulation as a driver of senescence induced by iron overload in primary culture of CEC and a potential risk factor of brain vasculature impairment and brain dysfunction.
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Affiliation(s)
- Brian Noh
- Department of NeurologyMcGovern Medical School at the University of Texas Health Science Center at HoustonHoustonTexasUSA
| | - Maria Pilar Blasco‐Conesa
- Department of NeurologyMcGovern Medical School at the University of Texas Health Science Center at HoustonHoustonTexasUSA
| | - Syed Mushfiqur Rahman
- Department of NeurologyMcGovern Medical School at the University of Texas Health Science Center at HoustonHoustonTexasUSA
| | - Sheelu Monga
- Department of NeurologyMcGovern Medical School at the University of Texas Health Science Center at HoustonHoustonTexasUSA
| | - Rodney Ritzel
- Department of NeurologyMcGovern Medical School at the University of Texas Health Science Center at HoustonHoustonTexasUSA
| | - Gary Guzman
- Department of NeurologyMcGovern Medical School at the University of Texas Health Science Center at HoustonHoustonTexasUSA
| | - Yun‐Ju Lai
- Department of NeurologyMcGovern Medical School at the University of Texas Health Science Center at HoustonHoustonTexasUSA
- Solomont School of NursingZuckerberg College of Health SciencesUniversity of Massachusetts LowellLowellMassachusettsUSA
| | - Bhanu Priya Ganesh
- Department of NeurologyMcGovern Medical School at the University of Texas Health Science Center at HoustonHoustonTexasUSA
| | - Akihiko Urayama
- Department of NeurologyMcGovern Medical School at the University of Texas Health Science Center at HoustonHoustonTexasUSA
| | - Louise D. McCullough
- Department of NeurologyMcGovern Medical School at the University of Texas Health Science Center at HoustonHoustonTexasUSA
| | - Jose Felix Moruno‐Manchon
- Department of NeurologyMcGovern Medical School at the University of Texas Health Science Center at HoustonHoustonTexasUSA
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5
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Hua M, Shi D, Xu W, Zhu L, Hao X, Zhu B, Shu Q, Lozoff B, Geng F, Shao J. Differentiation between fetal and postnatal iron deficiency in altering brain substrates of cognitive control in pre-adolescence. BMC Med 2023; 21:167. [PMID: 37143078 PMCID: PMC10161450 DOI: 10.1186/s12916-023-02850-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 03/27/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Early iron deficiency (ID) is a common risk factor for poorer neurodevelopment, limiting children's potential and contributing to global burden. However, it is unclear how early ID alters the substrate of brain functions supporting high-order cognitive abilities and whether the timing of early ID matters in terms of long-term brain development. This study aimed to examine the effects of ID during fetal or early postnatal periods on brain activities supporting proactive and reactive cognitive control in pre-adolescent children. METHODS Participants were part of a longitudinal cohort enrolled at birth in southeastern China between December 2008 and November 2011. Between July 2019 and October 2021, 115 children aged 8-11 years were invited to participate in this neuroimaging study. Final analyses included 71 children: 20 with fetal ID, 24 with ID at 9 months (postnatal ID), and 27 iron-sufficient at birth and 9 months. Participants performed a computer-based behavioral task in a Magnetic Resonance Imaging scanner to measure proactive and reactive cognitive control. Outcome measures included accuracy, reaction times, and brain activity. Linear mixed modeling and the 3dlme command in Analysis of Functional NeuroImages (AFNI) were separately used to analyze behavioral performance and neuroimaging data. RESULTS Faster responses in proactive vs. reactive conditions indicated that all groups could use proactive or reactive cognitive control according to contextual demands. However, the fetal ID group was lower in general accuracy than the other 2 groups. Per the demands of cues and targets, the iron-sufficient group showed greater activation of wide brain regions in proactive vs. reactive conditions. In contrast, such condition differences were reversed in the postnatal ID group. Condition differences in brain activation, shown in postnatal ID and iron-sufficient groups, were not found in the fetal ID group. This group specifically showed greater activation of brain regions in the reward pathway in proactive vs. reactive conditions. CONCLUSIONS Early ID was associated with altered brain functions supporting proactive and reactive cognitive control in childhood. Alterations differed between fetal and postnatal ID groups. The findings imply that iron supplement alone is insufficient to prevent persisting brain alterations associated with early ID. Intervention strategies in addition to the iron supplement should consider ID timing.
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Affiliation(s)
- Mengdi Hua
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Donglin Shi
- Department of Curriculum and Learning Sciences, Zhejiang University, Hangzhou, China
| | - Wenwen Xu
- Department of Curriculum and Learning Sciences, Zhejiang University, Hangzhou, China
| | - Liuyan Zhu
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoxin Hao
- Department of Curriculum and Learning Sciences, Zhejiang University, Hangzhou, China
| | - Bingquan Zhu
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qiang Shu
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- National Clinical Research Center for Child Health, Hangzhou, China
| | - Betsy Lozoff
- Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Fengji Geng
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
- Department of Curriculum and Learning Sciences, Zhejiang University, Hangzhou, China.
- National Clinical Research Center for Child Health, Hangzhou, China.
| | - Jie Shao
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
- National Clinical Research Center for Child Health, Hangzhou, China.
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East PL, Doom JR, Blanco E, Burrows R, Lozoff B, Gahagan S. Iron Deficiency in Infancy and Sluggish Cognitive Tempo and ADHD Symptoms in Childhood and Adolescence. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023; 52:259-270. [PMID: 34519599 PMCID: PMC8918441 DOI: 10.1080/15374416.2021.1969653] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To determine whether iron deficiency in infancy is associated with sluggish cognitive tempo (SCT) or attention-deficit/hyperactive-impulsive (AD-HI) symptoms in childhood and adolescence, and whether such behaviors contribute concurrently and predictively to lower verbal and mathematical abilities. METHOD Chilean children (N = 959; 50% male, of Spanish or indigenous descent from working-class backgrounds) were rated by mothers for SCT or AD-HI symptoms at ages 5, 10, and 16 years. Children completed standardized tests assessing verbal and mathematical abilities at ages 5, 10, and 16. At ages 12 and 18 months, children were assessed for iron deficiency. RESULTS Adjusting for a comprehensive panel of covariates, greater severity of iron deficiency in infancy was associated with more frequent SCT and AD-HI symptoms at all ages studied. Most effects of iron deficiency on children's verbal and math skills were indirect, mediated through AD-HI behaviors. Children's AD-HI symptoms related to lower verbal and math test scores within age and across age. CONCLUSIONS The long-term associations found between infant iron deficiency and SCT and AD-HI behaviors suggest that the neurodevelopmental alterations that stem from postnatal iron deficiency might play an etiological role in the development of ADHD. Screening for early-life nutritional deficiencies among children with SCT or ADHD symptoms might prove useful, and behavioral screening of children with a history of iron deficiency seems warranted. Interventions that support brain development after early nutritional deprivation also would be beneficial.
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Affiliation(s)
- Patricia L East
- Department of Pediatrics, University of California, San Diego
| | | | - Estela Blanco
- Department of Pediatrics, University of California, San Diego
- Department of Public Health, Pontifical Catholic University of Chile
| | - Raquel Burrows
- Institute of Nutrition and Food Technology, University of Chile
| | - Betsy Lozoff
- Department of Pediatrics, University of Michigan
| | - Sheila Gahagan
- Department of Pediatrics, University of California, San Diego
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7
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Abstract
Growing evidence indicates that a suboptimal intrauterine environment confers risk for schizophrenia. The developmental model of schizophrenia posits that aberrant brain growth during early brain development and adolescence may interact to contribute to this psychiatric disease in adulthood. Although a variety of factors may perturb the environment of the developing fetus and predispose for schizophrenia later, a common mechanism has yet to be elucidated. Micronutrient deficiencies during the perinatal period are known to induce potent effects on brain development by altering neurodevelopmental processes. Iron is an important candidate nutrient to consider because of its role in energy metabolism, monoamine synthesis, synaptogenesis, myelination, and the high prevalence of iron deficiency (ID) in the mother-infant dyad. Understanding the current state of science regarding perinatal ID as an early risk factor for schizophrenia is imperative to inform empirical work investigating the etiology of schizophrenia and develop prevention and intervention programs. In this narrative review, we focus on perinatal ID as a common mechanism underlying the fetal programming of schizophrenia. First, we review the neural aberrations associated with perinatal ID that indicate risk for schizophrenia in adulthood, including disruptions in dopaminergic neurotransmission, hippocampal-dependent learning and memory, and sensorimotor gating. Second, we review the pathophysiology of perinatal ID as a function of maternal ID during pregnancy and use epidemiological and cohort studies to link perinatal ID with risk of schizophrenia. Finally, we review potential confounding phenotypes, including nonanemic causes of perinatal brain ID and future risk of schizophrenia.
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Affiliation(s)
- Andrea M. Maxwell
- Medical Scientist Training Program, University of Minnesota, Minneapolis, MN 55455 (USA)
| | - Raghavendra B. Rao
- Department of Pediatrics, Division of Neonatology, University of Minnesota Medical School, Minneapolis, MN 55455 (USA)
- Center for Neurobehavioral Development, University of Minnesota, Minneapolis, MN 55455 (USA)
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8
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Cecilia A, Patricio P, Donna C, Rakibul H, Sussanne R, Betsy L, Bharat B. Cognitive control inhibition networks in adulthood are impaired by early iron deficiency in infancy. Neuroimage Clin 2022; 35:103089. [PMID: 35753235 PMCID: PMC9249946 DOI: 10.1016/j.nicl.2022.103089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 12/26/2022]
Abstract
Iron deficiency, a common form of micronutrient deficiency, primarily affects children and women. The principal cause of iron deficiency is undernutrition in low-income countries and malnutrition in middle to upper income regions. Iron is a key element for myelin production, neuronal metabolism, and dopamine functions. Iron deficiency in early life can alter brain development and exert long-lasting effects. Control inhibition is an executive function that involves several brain regions, including the prefrontal cortex and caudate and sub-thalamic nuclei. Dopamine is the prevalent neurotransmitter underlying cognitive inhibition. We followed cohort study participants who had iron deficiency anemia in infancy as well non-anemic controls. At 22 years of age, the participants were subjected to functional magnetic resonance imaging (fMRI) to evaluate the correlation between functional connectivity and performance on an inhibitory cognitive task (Go/No-Go). We hypothesized that former iron deficient anemic (FIDA) participants demonstrate less strength in functional connectivity compared with controls (C). There were not significant group differences in the behavioral results in terms of accuracy and response time. A continuous covariate interaction analysis of functional connectivity and the Go/No-Go scores demonstrated significant differences between the FIDA and C groups. The FIDA participants demonstrated less strength in connectivity in brain regions related to control inhibition, including the medial temporal lobe, impairment in the integration of the default mode network (indicating decreased attention and alertness), and an increase in connectivity in posterior brain areas, all of which suggest slower circuitry maturation. The results support the hypothesis that FIDA young adults show differences in the connectivity of networks related to executive functions. These differences could increase their vulnerability to develop cognitive dysfunctions or mental disorders in adulthood.
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Affiliation(s)
- Algarín Cecilia
- Sleep and Functional Neurobiology Laboratory, Institute of Nutrition and Food Technology, University of Chile, Chile,Corresponding author at: El Líbano 5524, Macul 7830490, Región Metropolitana, Santiago, Chile.
| | - Peirano Patricio
- Sleep and Functional Neurobiology Laboratory, Institute of Nutrition and Food Technology, University of Chile, Chile
| | - Chen Donna
- Department of Biomedical Engineering, New Jersey Institute of Technology, University Heights, Newark, NJ, United States
| | - Hafiz Rakibul
- Department of Biomedical Engineering, New Jersey Institute of Technology, University Heights, Newark, NJ, United States
| | - Reyes Sussanne
- Sleep and Functional Neurobiology Laboratory, Institute of Nutrition and Food Technology, University of Chile, Chile
| | - Lozoff Betsy
- Department of Pediatrics and Environmental Health Sciences, University of Michigan, Ann Arbor, MI, United States
| | - Biswal Bharat
- Department of Biomedical Engineering, New Jersey Institute of Technology, University Heights, Newark, NJ, United States
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9
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The Influence of Intensive Nutritional Education on the Iron Status in Infants. Nutrients 2022; 14:nu14122453. [PMID: 35745183 PMCID: PMC9229227 DOI: 10.3390/nu14122453] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 06/09/2022] [Accepted: 06/12/2022] [Indexed: 02/06/2023] Open
Abstract
Iron is an essential nutrient for a child’s proper development at every growth stage. It is crucial for the production of red blood and muscle cells, DNA replication, and the development of the brain, nervous and immune systems. Iron deficiency is the most common micronutrient deficiency in children worldwide. Despite widespread access to nutritional information for children, parents continue to make many feeding mistakes. This study aimed to assess whether any nutritional intervention would affect the iron status in children. The parents of 203 children were randomly assigned to one of two groups: the study group received intensive mobile nutritional education for a year, while the control group received no intervention. Blood tests were performed on both groups at the beginning of the study and one year later. The educational intervention resulted in statistically significantly higher levels of RBC (red blood cells; p = 0.020), HGB (haemoglobin; p = 0.039), HCT (haematocrit; p = 0.036), MCV (mean cell volume; p = 0.018) parameters and iron dietary intake (p ≤ 0.001). Even a non-targeted dietary intervention improves the iron status in children. As iron management is insufficient in most children, an iron-targeted nutritional intervention appears necessary.
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10
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Sandri BJ, Kim J, Lubach GR, Lock EF, Guerrero C, Higgins L, Markowski TW, Kling PJ, Georgieff MK, Coe CL, Rao RB. Multiomic Profiling of Iron Deficient Infant Monkeys Reveals Alterations in Neurologically Important Biochemicals in Serum and CSF Prior to the Onset of Anemia. Am J Physiol Regul Integr Comp Physiol 2022; 322:R486-R500. [PMID: 35271351 DOI: 10.1152/ajpregu.00235.2021] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND The effects of iron deficiency (ID) during infancy extend beyond the hematologic compartment and include short- and long-term adverse effects on many tissues including the brain. However, sensitive biomarkers of iron-dependent brain health are lacking in humans. OBJECTIVE To determine whether serum and CSF biomarkers of ID-induced metabolic dysfunction are concordant in the pre/early anemic stage of ID prior to anemia in a nonhuman primate model of infantile IDA. METHODS Paired serum and CSF specimens were collected from iron-sufficient (IS; n = 12) and ID (n = 7) rhesus infants at 4-months (pre-anemic period) and 6-months of age (anemic). Hematological, metabolomic, and proteomic profiles were generated via HPLC/MS at both time points to discriminate serum bio markers of ID-induced brain metabolic dysfunction. RESULTS We identified 227 metabolites and 205 proteins in serum. Abnormalities indicating altered liver function, lipid dysregulation, and increased acute phase reactants were present in ID. In CSF, we measured 210 metabolites and 1,560 proteins with changes in ID infants indicative of metabolomic and proteomic differences indexing disrupted synaptogenesis. Systemic and CSF proteomic and metabolomic changes were present and concurrent in the pre-anemic and anemic periods. CONCLUSIONS Multiomic serum and CSF profiling uncovered pathways disrupted by ID in both the pre-anemic and anemic stages of infantile IDA, including evidence for hepatic dysfunction and activation of acute phase response. Parallel changes observed in serum and CSF potentially provide measurable serum biomarkers of ID that reflect at-risk brain processes prior to progression to clinical anemia.
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Affiliation(s)
- Brian J Sandri
- Division of Neonatology, Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States.,Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, MN, United States
| | - Jonathan Kim
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Gabriele R Lubach
- Harlow Center for Biological Psychology, University of Wisconsin, Madison, WI, United States
| | - Eric F Lock
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Candace Guerrero
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN, United States
| | - LeeAnn Higgins
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN, United States
| | - Todd W Markowski
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN, United States
| | - Pamela J Kling
- Division of Neonatology, Department of Pediatrics, University of Wisconsin, Madison, WI, United States
| | - Michael K Georgieff
- Division of Neonatology, Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States.,Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, MN, United States
| | - Christopher L Coe
- Harlow Center for Biological Psychology, University of Wisconsin, Madison, WI, United States
| | - Raghavendra B Rao
- Division of Neonatology, Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States.,Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, MN, United States
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11
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Reyes S, Rimkus CDM, Lozoff B, Algarin C, Peirano P. Nighttime Sleep Characteristics and White Matter Integrity in Young Adults. Nat Sci Sleep 2022; 14:1363-1373. [PMID: 35965887 PMCID: PMC9364986 DOI: 10.2147/nss.s360311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 07/07/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Sleep is essential for life and plays a key role for optimal physiology, brain functioning, and health. Evidence suggests a relation between sleep and cerebral white matter integrity. Human studies report that sleep duration shows a U-shaped association with brain functioning. We hypothesized that participants with longer or shorter sleep time in the nighttime period show altered microstructural white matter integrity. PARTICIPANTS AND METHODS Seventy-three young adult participants were evaluated. Sleep-wake cycle parameters were assessed objectively using actigraphy. Diffusion tensor imaging studies were performed to assess white matter integrity using fractional anisotropy and mean, axial, and radial diffusivities. Relations between white matter microstructure indexes and sleep parameters were investigated through tract-based spatial statistics. Participants were grouped according to their nocturnal total sleep time: 27 in the Reference sleep group (6.5-8.0 h), 23 in the Short sleep group (<6.5 h) and 23 in the Long sleep group (>8.0 h). RESULTS Compared with the Reference sleep group, participants in the Long sleep group showed lower fractional anisotropy (p < 0.05) and higher radial diffusivity (p < 0.05) values in white matter tracts linked to sleep regulation (corona radiata, body of the corpus callosum, superior longitudinal fasciculus, and anterior thalamic radiation). CONCLUSION This pattern of reduced fractional anisotropy and increased radial diffusivity in the Long sleep group indicates an association between sleep duration and lower integrity of myelin sheaths. Because myelin is continuously remodeled in the brain, nighttime sleep characteristics appear to be a key player for its quality and maintenance.
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Affiliation(s)
- Sussanne Reyes
- Laboratory of Sleep and Functional Neurobiology, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Carolina de Medeiros Rimkus
- Laboratory of Medical Investigation (LIM-44), Department of Radiology and Oncology, Faculty of Medicine, University of Sao Paulo, São Paulo, São Paulo, Brazil
| | - Betsy Lozoff
- Department of Pediatrics and Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Cecilia Algarin
- Laboratory of Sleep and Functional Neurobiology, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Patricio Peirano
- Laboratory of Sleep and Functional Neurobiology, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
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12
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East P, Doom JR, Blanco E, Burrows R, Lozoff B, Gahagan S. Iron deficiency in infancy and neurocognitive and educational outcomes in young adulthood. Dev Psychol 2021; 57:962-975. [PMID: 34424013 PMCID: PMC8386013 DOI: 10.1037/dev0001030] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
This study examines the extent to which iron deficiency in infancy contributes to adverse neurocognitive and educational outcomes in young adulthood directly and indirectly, through its influence on verbal cognition and attention problems in childhood. Young adults (N = 1,000, M age = 21.3 years, 52% female; of Spanish or indigenous descent) from working-class families in Santiago, Chile, completed instruments assessing memory, processing speed, mental flexibility, and educational attainment. Iron status was assessed at ages 6, 12, and 18 months, and verbal intelligence, inattention, and sluggish cognitive tempo (SCT) symptoms were assessed at age 10. Results indicated that young adults who had iron-deficiency in infancy had poor executive control at age 21. Severity of iron deficiency during infancy was associated with lower verbal IQ and more frequent inattention and SCT symptoms in childhood, and with lower educational attainment in young adulthood through its effect on inattention. No additional indirect effects were found. Interventions directed toward improving cognitive and attention deficits linked to early-life iron deficiency appear warranted and could alter the course to adult functioning. Further research on the impact of such interventions would be helpful. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Patricia East
- Department of Pediatrics, University of California, San Diego
| | | | - Estela Blanco
- Department of Pediatrics, University of California, San Diego
| | - Raquel Burrows
- Institute of Nutrition and Food Technology, University of Chile
| | - Betsy Lozoff
- Department of Pediatrics, University of Michigan
| | - Sheila Gahagan
- Department of Pediatrics, University of California, San Diego
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13
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Berglund SK, Domellöf M. Iron deficiency in infancy: current insights. Curr Opin Clin Nutr Metab Care 2021; 24:240-245. [PMID: 33656466 DOI: 10.1097/mco.0000000000000749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE OF REVIEW Iron deficiency is the most common micronutrient deficiency and infants are at particular risk. The purpose of this review is to summarize recent studies that explored the metabolism of iron in infants as well as the risks and benefits of iron supplementation in different populations. RECENT FINDINGS The ability of infants to regulate iron homeostasis is not fully known but most likely different from adults. Reducing iron deficiency has beneficial effects on neurodevelopment but iron overload may have adverse functional effects including diarrhea and even poor neurodevelopment. Recent studies have confirmed benefits of delayed cord clamping and supplementation of infants in risk groups while iron supplementation to pregnant women has shown limited effect in the offspring with regard to iron status and neurodevelopment. Further support is given to the recommendation that exclusive breast feeding, without supplementation, is safe for normal birth weight infants until 6 months whereafter an iron-rich diet should be given. SUMMARY Iron deficiency negatively impacts global health but efforts to identify optimal interventions are progressing. Yet, questions remain, particularly regarding long-term risks, benefits and optimal interventions for low birth weight infants as well as the level of iron fortification in infant formula.
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Affiliation(s)
- Staffan K Berglund
- Department of Clinical Sciences, Pediatrics
- Wallenberg Centre for Molecular Medicine (WCMM), Umeå University, Umeå, Sweden
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14
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Vlasova RM, Wang Q, Willette A, Styner MA, Lubach GR, Kling PJ, Georgieff MK, Rao RB, Coe CL. Infantile Iron Deficiency Affects Brain Development in Monkeys Even After Treatment of Anemia. Front Hum Neurosci 2021; 15:624107. [PMID: 33716694 PMCID: PMC7947927 DOI: 10.3389/fnhum.2021.624107] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 01/25/2021] [Indexed: 12/26/2022] Open
Abstract
A high percent of oxidative energy metabolism is needed to support brain growth during infancy. Unhealthy diets and limited nutrition, as well as other environmental insults, can compromise these essential developmental processes. In particular, iron deficiency anemia (IDA) has been found to undermine both normal brain growth and neurobehavioral development. Even moderate ID may affect neural maturation because when iron is limited, it is prioritized first to red blood cells over the brain. A primate model was used to investigate the neural effects of a transient ID and if deficits would persist after iron treatment. The large size and postnatal growth of the monkey brain makes the findings relevant to the metabolic and iron needs of human infants, and initiating treatment upon diagnosis of anemia reflects clinical practice. Specifically, this analysis determined whether brain maturation would still be compromised at 1 year of age if an anemic infant was treated promptly once diagnosed. The hematology and iron status of 41 infant rhesus monkeys was screened at 2-month intervals. Fifteen became ID; 12 met clinical criteria for anemia and were administered iron dextran and B vitamins for 1-2 months. MRI scans were acquired at 1 year. The volumetric and diffusion tensor imaging (DTI) measures from the ID infants were compared with monkeys who remained continuously iron sufficient (IS). A prior history of ID was associated with smaller total brain volumes, driven primarily by significantly less total gray matter (GM) and smaller GM volumes in several cortical regions. At the macrostructual level, the effect on white matter volumes (WM) was not as overt. However, DTI analyses of WM microstructure indicated two later-maturating anterior tracts were negatively affected. The findings reaffirm the importance of iron for normal brain development. Given that brain differences were still evident even after iron treatment and following recovery of iron-dependent hematological indices, the results highlight the importance of early detection and preemptive supplementation to limit the neural consequences of ID.
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Affiliation(s)
- Roza M. Vlasova
- Department of Psychiatry, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Qian Wang
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, United States
| | - Auriel Willette
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, United States
| | - Martin A. Styner
- Department of Psychiatry, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Gabriele R. Lubach
- Harlow Center for Biological Psychology, University of Wisconsin-Madison, Madison, WI, United States
| | - Pamela J. Kling
- Department of Pediatrics, University of Wisconsin-Madison, Madison, WI, United States
| | - Michael K. Georgieff
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States
| | - Raghavendra B. Rao
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States
| | - Christopher L. Coe
- Harlow Center for Biological Psychology, University of Wisconsin-Madison, Madison, WI, United States
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15
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McCann S, Perapoch Amadó M, Moore SE. The Role of Iron in Brain Development: A Systematic Review. Nutrients 2020; 12:E2001. [PMID: 32635675 PMCID: PMC7400887 DOI: 10.3390/nu12072001] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 01/12/2023] Open
Abstract
One-third of children falter in cognitive development by pre-school age. Iron plays an important role in many neurodevelopmental processes, and animal studies suggest that iron sufficiency in pregnancy and infancy is particularly important for neurodevelopment. However, it is not clear whether iron deficiency directly impacts developmental outcomes, and, if so, whether impact differs by timing of exposure or developmental domain. We searched four databases for studies on iron deficiency or iron supplementation in pregnancy, or at 0-6 months, 6-24 months, or 2-4 years of age. All studies included neurodevelopmental assessments in infants or children up to 4 years old. We then qualitatively synthesized the literature. There was no clear relationship between iron status and developmental outcomes across any of the time windows or domains included. We identified a large quantity of low-quality studies, significant heterogeneity in study design and a lack of research focused on pregnancy and early infancy. In summary, despite good mechanistic evidence for the role of iron in brain development, evidence for the impact of iron deficiency or iron supplementation on early development is inconsistent. Further high-quality research is needed, particularly within pregnancy and early infancy, which has previously been neglected.
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Affiliation(s)
- Samantha McCann
- Department of Women and Children’s Health, King’s College London, London SE1 7EH, UK;
- Medical Research Council Unit, The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, P.O. Box 273, Banjul, The Gambia
| | - Marta Perapoch Amadó
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK;
| | - Sophie E. Moore
- Department of Women and Children’s Health, King’s College London, London SE1 7EH, UK;
- Medical Research Council Unit, The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, P.O. Box 273, Banjul, The Gambia
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16
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Reyes S, Rimkus CDM, Lozoff B, Biswal BB, Peirano P, Algarin C. Assessing cognitive control and the reward system in overweight young adults using sensitivity to incentives and white matter integrity. PLoS One 2020; 15:e0233915. [PMID: 32484819 PMCID: PMC7266313 DOI: 10.1371/journal.pone.0233915] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 05/14/2020] [Indexed: 11/18/2022] Open
Abstract
Cognitive control and incentive sensitivity are related to overeating and obesity. Optimal white matter integrity is relevant for an efficient interaction among reward-related brain regions. However, its relationship with sensitivity to incentives remains controversial. The aim of this study was to assess the incentive sensitivity and its relationship to white matter integrity in normal-weight and overweight groups. Seventy-six young adults participated in this study: 31 were normal-weight (body mass index [BMI] 18.5 to < 25.0 kg/m2, 14 females) and 45 were overweight (BMI ≥ 25.0 kg/m2, 22 females). Incentive sensitivity was assessed using an antisaccade task that evaluates the effect of incentives (neutral, reward, and loss avoidance) on cognitive control performance. Diffusion tensor imaging studies were performed to assess white matter integrity. The relationship between white matter microstructure and incentive sensitivity was investigated through tract-based spatial statistics. Behavioral antisaccade results showed that normal-weight participants presented higher accuracy (78.0 vs. 66.7%, p = 0.01) for loss avoidance incentive compared to overweight participants. Diffusion tensor imaging analysis revealed a positive relationship between fractional anisotropy and loss avoidance accuracy in the normal-weight group (p < 0.05). No relationship reached significance in the overweight group. These results support the hypothesis that white matter integrity is relevant for performance in an incentivized antisaccade task.
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Affiliation(s)
- Sussanne Reyes
- Laboratory of Sleep and Functional Neurobiology, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Carolina de Medeiros Rimkus
- Department of Radiology and Oncology, Laboratory of Medical Investigation (LIM-44), Faculty of Medicine, University of Sao Paulo, São Paulo, São Paulo, Brasil
| | - Betsy Lozoff
- Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Bharat B. Biswal
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, United States of America
| | - Patricio Peirano
- Laboratory of Sleep and Functional Neurobiology, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Cecilia Algarin
- Laboratory of Sleep and Functional Neurobiology, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
- * E-mail:
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17
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Morton SU, Vyas R, Gagoski B, Vu C, Litt J, Larsen RJ, Kuchan MJ, Lasekan JB, Sutton BP, Grant PE, Ou Y. Maternal Dietary Intake of Omega-3 Fatty Acids Correlates Positively with Regional Brain Volumes in 1-Month-Old Term Infants. Cereb Cortex 2020; 30:2057-2069. [PMID: 31711132 PMCID: PMC8355466 DOI: 10.1093/cercor/bhz222] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 07/31/2019] [Accepted: 08/22/2019] [Indexed: 01/05/2023] Open
Abstract
Maternal nutrition is an important factor for infant neurodevelopment. However, prior magnetic resonance imaging (MRI) studies on maternal nutrients and infant brain have focused mostly on preterm infants or on few specific nutrients and few specific brain regions. We present a first study in term-born infants, comprehensively correlating 73 maternal nutrients with infant brain morphometry at the regional (61 regions) and voxel (over 300 000 voxel) levels. Both maternal nutrition intake diaries and infant MRI were collected at 1 month of life (0.9 ± 0.5 months) for 92 term-born infants (among them, 54 infants were purely breastfed and 19 were breastfed most of the time). Intake of nutrients was assessed via standardized food frequency questionnaire. No nutrient was significantly correlated with any of the volumes of the 61 autosegmented brain regions. However, increased volumes within subregions of the frontal cortex and corpus callosum at the voxel level were positively correlated with maternal intake of omega-3 fatty acids, retinol (vitamin A) and vitamin B12, both with and without correction for postmenstrual age and sex (P < 0.05, q < 0.05 after false discovery rate correction). Omega-3 fatty acids remained significantly correlated with infant brain volumes after subsetting to the 54 infants who were exclusively breastfed, but retinol and vitamin B12 did not. This provides an impetus for future larger studies to better characterize the effect size of dietary variation and correlation with neurodevelopmental outcomes, which can lead to improved nutritional guidance during pregnancy and lactation.
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Affiliation(s)
- Sarah U Morton
- Division of Newborn Medicine, Boston Children’s Hospital, Boston, MA 02115, USA
| | - Rutvi Vyas
- Division of Newborn Medicine, Boston Children’s Hospital, Boston, MA 02115, USA
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children’s Hospital, Boston, MA 02115, USA
| | - Borjan Gagoski
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children’s Hospital, Boston, MA 02115, USA
- Department of Radiology, Boston Children’s Hospital, Boston, MA 02115, USA
| | - Catherine Vu
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children’s Hospital, Boston, MA 02115, USA
| | - Jonathan Litt
- Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Ryan J Larsen
- Beckman Institute, University of Illinois at Urbana—Champaign, Urbana, IL 61801, USA
| | | | | | - Brad P Sutton
- Beckman Institute, University of Illinois at Urbana—Champaign, Urbana, IL 61801, USA
- Department of Bioengineering, University of Illinois at Urbana—Champaign, Urbana, IL 61801, USA
| | - P Ellen Grant
- Division of Newborn Medicine, Boston Children’s Hospital, Boston, MA 02115, USA
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children’s Hospital, Boston, MA 02115, USA
- Department of Radiology, Boston Children’s Hospital, Boston, MA 02115, USA
| | - Yangming Ou
- Division of Newborn Medicine, Boston Children’s Hospital, Boston, MA 02115, USA
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children’s Hospital, Boston, MA 02115, USA
- Department of Radiology, Boston Children’s Hospital, Boston, MA 02115, USA
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18
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DelRosso LM, Yi T, Chan JHM, Wrede JE, Lockhart CT, Ferri R. Determinants of ferritin response to oral iron supplementation in children with sleep movement disorders. Sleep 2020; 43:5575974. [PMID: 31563958 DOI: 10.1093/sleep/zsz234] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 08/18/2019] [Indexed: 12/29/2022] Open
Abstract
STUDY OBJECTIVES To identify children who respond to oral iron supplementation as evidenced by increased ferritin levels and to identify factors that correlate with improvement in ferritin levels in those who respond. METHODS A retrospective chart review of the PLMS/RLS/RSD database at Seattle Children's Hospital was carried out. Data collected included nocturnal polysomnography parameters, age, sex, initial and follow-up ferritin level and date of collection, and presence of restless legs syndrome (RLS), periodic limb movements of sleep (PLMS)/PLM disorder (PLMD), restless sleep disorder (RSD), obstructive sleep apnea (OSA), neurologic, psychiatric, neurodevelopmental, or medical comorbidity. Oral iron therapy was evaluated by side effects (none; constipation; bad taste/nausea), subjective outcome in symptoms (resolved, improved, no change), and adherence to therapy (poor, fair, good). RESULTS Seventy-seven children were included in this study of whom 42 were classified as responders (increase in ferritin of ≥10 µg/L) and 35 were nonresponders. Age and sex were not different between groups. Adherence was the only significant predictor of an increase in ferritin of ≥10 µg/L. Constipation was seen in 7.1% of responders vs. 45.8% of nonresponders. No change in symptoms was reported in 26.2% of responders vs. 71.4% in nonresponders. A significant correlation was found between treatment duration and ferritin level change in responders but not in nonresponders. CONCLUSIONS Side effects hinders adherence to oral iron supplementation in children. Responders to oral iron show improvement in ferritin levels and symptoms, while nonresponders show no improvement in ferritin levels despite a long-lasting treatment, at least in part of them.
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Affiliation(s)
- Lourdes M DelRosso
- Seattle Children's Hospital, Seattle, WA.,University of Washington, Seattle, WA
| | - Troy Yi
- University of Washington, Seattle, WA
| | | | - Joanna E Wrede
- Seattle Children's Hospital, Seattle, WA.,University of Washington, Seattle, WA
| | - Carey T Lockhart
- Seattle Children's Hospital, Seattle, WA.,University of Washington, Seattle, WA
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19
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Nelson CA, Gabard-Durnam LJ. Early Adversity and Critical Periods: Neurodevelopmental Consequences of Violating the Expectable Environment. Trends Neurosci 2020; 43:133-143. [PMID: 32101708 PMCID: PMC8092448 DOI: 10.1016/j.tins.2020.01.002] [Citation(s) in RCA: 205] [Impact Index Per Article: 51.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 12/30/2019] [Accepted: 01/12/2020] [Indexed: 12/12/2022]
Abstract
It is now widely recognized that children exposed to adverse life events in the first years of life are at increased risk for a variety of neural, behavioral, and psychological sequelae. As we discuss in this paper, adverse events represent a violation of the expectable environment. If such violations occur during a critical period of brain development, the detrimental effects of early adversity are likely to be long lasting. Here we discuss the various ways adversity becomes neurobiologically embedded, and how the timing of such adversity plays an important role in determining outcomes. We conclude our paper by offering recommendations for how to elucidate the neural mechanisms responsible for the behavioral sequelae and how best to model the effects of early adversity.
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Affiliation(s)
- Charles A Nelson
- Harvard Medical School, Harvard University, Boston, MA 02115, USA; Harvard Graduate School of Education, Harvard University, Cambridge, MA 02138, USA; Department of Pediatrics, Boston Children's Hospital, Boston, MA 02115, USA; Laboratories of Cognitive Neuroscience, Boston Children's Hospital, Boston, MA 02215, USA.
| | - Laurel J Gabard-Durnam
- Harvard Medical School, Harvard University, Boston, MA 02115, USA; Department of Pediatrics, Boston Children's Hospital, Boston, MA 02115, USA
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20
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Rafiee A, Delgado-Saborit JM, Sly PD, Quémerais B, Hashemi F, Akbari S, Hoseini M. Environmental chronic exposure to metals and effects on attention and executive function in the general population. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 705:135911. [PMID: 31838411 DOI: 10.1016/j.scitotenv.2019.135911] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 10/16/2019] [Accepted: 12/01/2019] [Indexed: 05/19/2023]
Abstract
Heavy metals are neurotoxic, associated with brain dysfunction, and have been linked with cognitive decline in adults. This study was aimed to characterize chronic exposure to metals (Cd, Be, Co, Hg, Sn, V, Al, Ba, Cr, Cu, Fe, Li, Mn, Ni, Pb, and Zn) and metalloids (As, B, Sb) and assess its impact on cognitive performance of Tehran's residents, capital of Iran. Scalp hair samples gathered from 200 volunteered participants (110 men and 90 women), aged 14-70 years and quantified by inductively coupled plasma atomic emission spectroscopy (ICP-OES). Attention and executive function, two measures of cognitive performance, were characterized using the trail making test (TMT) part A and B, respectively. Mental flexibility was characterized as the Delta TMT B-A scores and cognitive efficiency or dissimulation as the ration between TMT B and A scores. A comprehensive questionnaire was used to gather information on demographic and socioeconomic as well as lifestyle and health status. The highest and lowest mean concentrations were observed for B (325 μg/g) and As (0.29 μg/g), respectively. Results indicated that chronic metal exposure measured in hair changed significantly based on gender and age (p < 0.05). The levels of Cr, Fe, Ni, Si, Hg, Pb and B were significantly higher in males' hair, whereas those of Ag and Ba were greater in females' hair (p < 0.05). The results of the cognitive TMT test were significantly different between gender and age groups (p < 0.05). Moreover, results revealed that As, Hg, Mn, and Pb levels in hair were significantly associated with poorer participants' performance scores in the TMT test (p < 0.05). Age, gender, cigarette smoking, water-pipe smoking, traffic density in the area of residence, and dental amalgam filling were significant factors affecting the TMT test scores. The results suggest that chronic exposure to metals has detrimental effects on attention, executive function, mental flexibility and cognitive efficiency.
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Affiliation(s)
- Ata Rafiee
- Department of Medicine, University of Alberta, Edmonton, AB, Canada.
| | - Juana Maria Delgado-Saborit
- ISGlobal Barcelona Institute for Global Health, Barcelona Biomedical Research Park, Barcelona, Spain; Population Health and Environmental Sciences, Analytical Environmental and Forensic Sciences, King's College London, United Kingdom; Division of Environmental Health & Risk Management, School of Geography, Earth & Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Peter D Sly
- Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, South Brisbane, Australia
| | | | - Fallah Hashemi
- Department of Environmental Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sadaf Akbari
- Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hoseini
- Research Center for Health Sciences, Institute of Health, Department of Environmental Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
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21
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Chiou B, Neely EB, Mcdevitt DS, Simpson IA, Connor JR. Transferrin and H-ferritin involvement in brain iron acquisition during postnatal development: impact of sex and genotype. J Neurochem 2020; 152:381-396. [PMID: 31339576 PMCID: PMC6980902 DOI: 10.1111/jnc.14834] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 07/06/2019] [Accepted: 07/16/2019] [Indexed: 12/23/2022]
Abstract
Iron delivery to the developing brain is essential for energy and metabolic support needed for processes such as myelination and neuronal development. Iron deficiency, especially in the developing brain, can result in a number of long-term neurological deficits that persist into adulthood. There is considerable debate that excess access to iron during development may result in iron overload in the brain and subsequently predispose individuals to age-related neurodegenerative diseases. There is a significant gap in knowledge regarding how the brain acquires iron during development and how biological variables such as development, genetics, and sex impact brain iron status. In this study, we used a mouse model expressing a mutant form of the iron homeostatic regulator protein HFE, (Hfe H63D), the most common gene variant in Caucasians, to determine impact of the mutation on brain iron uptake. Iron uptake was assessed using 59 Fe bound to either transferrin or H-ferritin as the iron carrier proteins. We demonstrate that at postnatal day 22, mutant mice brains take up greater amounts of iron compared with wildtype. Moreover, we introduce H-ferritin as a key protein in brain iron transport during development and identify a sex and genotype effect demonstrating female mutant mice take up more iron by transferrin, whereas male mutant mice take up more iron from H-ferritin at PND22. Furthermore, we begin to elucidate the mechanism for uptake using immunohistochemistry to profile the regional distribution and temporal expression of transferrin receptor and T-cell immunoglobulin and mucin domain 2, the latter is the receptor for H-ferritin. These data demonstrate that sex and genotype have significant effects on iron uptake and that regional receptor expression may play a large role in the uptake patterns during development. Open Science: This manuscript was awarded with the Open Materials Badge For more information see: https://cos.io/our-services/open-science-badges/ Cover Image for this issue: doi: 10.1111/jnc.14731.
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Affiliation(s)
- Brian Chiou
- Department of Neurosurgery, Penn State College of Medicine, Hershey, PA, USA
| | - Elizabeth B. Neely
- Department of Neurosurgery, Penn State College of Medicine, Hershey, PA, USA
| | - Dillon S. Mcdevitt
- Department of Neurosurgery, Penn State College of Medicine, Hershey, PA, USA
| | - Ian A. Simpson
- Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - James R. Connor
- Department of Neurosurgery, Penn State College of Medicine, Hershey, PA, USA
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Alam MA, Richard SA, Fahim SM, Mahfuz M, Nahar B, Das S, Shrestha B, Koshy B, Mduma E, Seidman JC, Murray-Kolb LE, Caulfield LE, Ahmed T. Impact of early-onset persistent stunting on cognitive development at 5 years of age: Results from a multi-country cohort study. PLoS One 2020; 15:e0227839. [PMID: 31978156 PMCID: PMC6980491 DOI: 10.1371/journal.pone.0227839] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 12/30/2019] [Indexed: 01/01/2023] Open
Abstract
Background Globally more than 150 million children under age 5 years were stunted in 2018, primarily in low- and middle-income countries (LMICs), and the impact of early-onset, persistent stunting has not been well explored. To explore the association between early-onset persistent stunting in children and cognitive development at 5 years of age, and to identify the factors associated with early-onset stunting. Methods and findings Children from the MAL-ED cohort study were followed from birth to 5 years of age in six LMICs. The Wechsler Preschool Primary Scales of Intelligence (WPPSI) was used to assess cognitive abilities (fluid reasoning) at 5 years and was adapted for each culture. Stunting was categorized as early-onset persistent (first stunted at 1–6 months and persisting at 60 months), early-onset recovered (first stunted at 1–6 months and not stunted at 60 months), late-onset persistent (first stunted at 7–24 months and persisting at 60 months), late-onset recovered (first stunted at 7–24 months and not stunted at 60 months), and never (never stunted). Mixed effects linear models were used to estimate the relationship between stunting status and cognitive development. Children with early-onset persistent stunting had significantly lower cognitive scores (-2.10 (95% CI: -3.85, -0.35)) compared with those who were never stunted. Transferrin receptor (TfR) was also negatively associated with cognitive development (-0.31 (95% CI: -0.49, -0.13)), while the HOME inventory, an index of quality of the home environment (0.46 (95% CI: 0.21, 0.72)) and socio-economic status (1.50 (95% CI: 1.03, 1.98)) were positively associated with cognitive development. Conclusions Early-onset persistent stunting was associated with lower cognitive development in children at 5 years of age in this cohort of children.
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Affiliation(s)
- Md Ashraful Alam
- icddr,b, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, Bangladesh
| | - Stephanie A. Richard
- Fogarty International Center/National Institutes of Health, Bethesda, MD, United States of America
| | | | - Mustafa Mahfuz
- icddr,b, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, Bangladesh
- * E-mail:
| | - Baitun Nahar
- icddr,b, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, Bangladesh
| | - Subhasish Das
- icddr,b, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, Bangladesh
| | - Binod Shrestha
- Water Reed/AFRIMS Research Unit Nepal (WARUN), Kathmandu, Nepal
| | | | | | - Jessica C. Seidman
- Fogarty International Center/National Institutes of Health, Bethesda, MD, United States of America
| | - Laura E. Murray-Kolb
- The Pennsylvania State University, University Park, PA, United States of America
| | | | - Tahmeed Ahmed
- icddr,b, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, Bangladesh
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23
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Adan RAH, van der Beek EM, Buitelaar JK, Cryan JF, Hebebrand J, Higgs S, Schellekens H, Dickson SL. Nutritional psychiatry: Towards improving mental health by what you eat. Eur Neuropsychopharmacol 2019; 29:1321-1332. [PMID: 31735529 DOI: 10.1016/j.euroneuro.2019.10.011] [Citation(s) in RCA: 158] [Impact Index Per Article: 31.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 08/08/2019] [Accepted: 10/29/2019] [Indexed: 12/26/2022]
Abstract
Does it matter what we eat for our mental health? Accumulating data suggests that this may indeed be the case and that diet and nutrition are not only critical for human physiology and body composition, but also have significant effects on mood and mental wellbeing. While the determining factors of mental health are complex, increasing evidence indicates a strong association between a poor diet and the exacerbation of mood disorders, including anxiety and depression, as well as other neuropsychiatric conditions. There are common beliefs about the health effects of certain foods that are not supported by solid evidence and the scientific evidence demonstrating the unequivocal link between nutrition and mental health is only beginning to emerge. Current epidemiological data on nutrition and mental health do not provide information about causality or underlying mechanisms. Future studies should focus on elucidating mechanism. Randomized controlled trials should be of high quality, adequately powered and geared towards the advancement of knowledge from population-based observations towards personalized nutrition. Here, we provide an overview of the emerging field of nutritional psychiatry, exploring the scientific evidence exemplifying the importance of a well-balanced diet for mental health. We conclude that an experimental medicine approach and a mechanistic understanding is required to provide solid evidence on which future policies on diet and nutrition for mental health can be based.
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Affiliation(s)
- Roger A H Adan
- Department of Translational Neurosciences, University Medical Center Utrecht, Universiteitsweg 100, 3584 CG Utrecht, the Netherlands; Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Medicinaregatan 11, SE-405 30 Gothenburg, Sweden.
| | - Eline M van der Beek
- Danone Nutricia Research, Utrecht, the Netherlands; Department of Pediatrics, University Medical Centre Groningen, Groningen, the Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Karakter Child and Adolescent Psychiatry, Nijmegen, the Netherlands
| | - John F Cryan
- Department of Anatomy & Neuroscience and APC Microbiome Ireland, University College Cork, Ireland
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Suzanne Higgs
- Suzanne Higgs School of Psychology, University of Birmingham, Birmingham, UK
| | - Harriet Schellekens
- Department of Anatomy & Neuroscience and APC Microbiome Ireland, University College Cork, Ireland
| | - Suzanne L Dickson
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Medicinaregatan 11, SE-405 30 Gothenburg, Sweden.
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24
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Vandenplas Y, Rakhecha A, Edris A, Shaaban B, Tawfik E, Bashiri FA, AlAql F, Alsabea H, Haddad J, El Barbary M, Salah M, Abouelyazid M, Kumar M, Alsaad S. Physicians' Understanding of Nutritional Factors Determining Brain Development and Cognition in the Middle East and Africa. Pediatr Gastroenterol Hepatol Nutr 2019; 22:536-544. [PMID: 31777719 PMCID: PMC6856510 DOI: 10.5223/pghn.2019.22.6.536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 07/20/2019] [Indexed: 01/24/2023] Open
Abstract
PURPOSE Proper nutrition is essential for brain development during infancy, contributing to the continued development of cognitive, motor, and socio-emotional skills throughout life. Considering the insufficient published data in the Middle East and North Africa, experts drafted a questionnaire to assess the opinions and knowledge of physicians on the impact of nutrition on brain development and cognition in early life. METHODS The questionnaire consisted of two parts: The first focused on the responders' demographic and professional characteristics and the second questioned the role of nutrition in brain development and cognition. Descriptive statistics were used to summarize respondents' characteristics and their responses to questions. RESULTS A total of 1,500 questionnaires were distributed; 994 physicians responded. The majority of the surveyed physicians (64.4%) felt that nutrition impacts brain development in early childhood (0-4 years), with almost 90% of physicians agreeing/strongly agreeing that preventing iron, zinc, and iodine deficiency would improve global intelligence quotient. The majority of physicians (83%) agreed that head circumference was the most important measure of brain development. The majority of physicians (68.9%) responded that the period from the last trimester until 18 months postdelivery was crucial for brain growth and neurodevelopment, with 76.8% believing that infants breast-fed by vegan mothers have an increased risk of impaired brain development. CONCLUSION The results of this study show that practicing physicians significantly agree that nutrition plays an important role in brain and cognitive development and function in early childhood, particularly during the last trimester until 18 months postdelivery.
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Affiliation(s)
- Yvan Vandenplas
- KidZ Health Castle, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Amira Edris
- Department of Pediatrics, Kasr Al Ainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Bassel Shaaban
- Departments of Pediatric and NICU, Mediclinic Airport Road Hospital, Abu Dhabi, UAE
| | - Eslam Tawfik
- Department of Pediatric, Sheikh Khalifa Medical City, Abu Dhabi, UAE
| | - Fahad A Bashiri
- Division of Neurology, Department of Pediatrics, College of Medicine & King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Fahd AlAql
- King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
| | | | - Joseph Haddad
- Department of Pediatrics, Saint George Hospital, University Medical Center, Balamand University, Beirut, Lebanon
| | - Mohammed El Barbary
- Department of Pediatrics and Neonatology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | | | - Mudit Kumar
- Consultant Pediatrician, Mediclinic Parkview Hospital, Dubai, UAE
| | - Sulaiman Alsaad
- Department of Pediatrics, Neonatal Intensive Care Unit, Kuwait Oil Company Hospital, Al Ahmadi City, Kuwait
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25
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Markova V, Holm C, Pinborg AB, Thomsen LL, Moos T. Impairment of the Developing Human Brain in Iron Deficiency: Correlations to Findings in Experimental Animals and Prospects for Early Intervention Therapy. Pharmaceuticals (Basel) 2019; 12:ph12030120. [PMID: 31416268 PMCID: PMC6789712 DOI: 10.3390/ph12030120] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 08/12/2019] [Accepted: 08/13/2019] [Indexed: 02/06/2023] Open
Abstract
Due to the necessity of iron for a variety of cellular functions, the developing mammalian organism is vulnerable to iron deficiency, hence causing structural abnormalities and physiological malfunctioning in organs, which are particularly dependent on adequate iron stores, such as the brain. In early embryonic life, iron is already needed for proper development of the brain with the proliferation, migration, and differentiation of neuro-progenitor cells. This is underpinned by the widespread expression of transferrin receptors in the developing brain, which, in later life, is restricted to cells of the blood–brain and blood–cerebrospinal fluid barriers and neuronal cells, hence ensuring a sustained iron supply to the brain, even in the fully developed brain. In embryonic human life, iron deficiency is thought to result in a lower brain weight, with the impaired formation of myelin. Studies of fully developed infants that have experienced iron deficiency during development reveal the chronic and irreversible impairment of cognitive, memory, and motor skills, indicating widespread effects on the human brain. This review highlights the major findings of recent decades on the effects of gestational and lactational iron deficiency on the developing human brain. The findings are correlated to findings of experimental animals ranging from rodents to domestic pigs and non-human primates. The results point towards significant effects of iron deficiency on the developing brain. Evidence would be stronger with more studies addressing the human brain in real-time and the development of blood biomarkers of cerebral disturbance in iron deficiency. Cerebral iron deficiency is expected to be curable with iron substitution therapy, as the brain, privileged by the cerebral vascular transferrin receptor expression, is expected to facilitate iron extraction from the circulation and enable transport further into the brain.
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Affiliation(s)
- Veronika Markova
- Department of Obstetrics and Gynaecology, Hvidovre Hospital, Copenhagen University Hospital, 2650 Hvidovre, Denmark
- Pharmacosmos A/S, 4300 Holbæk, Denmark
- Laboratory of Neurobiology, Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark
| | - Charlotte Holm
- Laboratory of Neurobiology, Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark
| | - Anja Bisgaard Pinborg
- Fertility Clinic, Juliane Marie Centre, Rigshospitalet, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Lars Lykke Thomsen
- Pharmacosmos A/S, 4300 Holbæk, Denmark
- Laboratory of Neurobiology, Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark
| | - Torben Moos
- Laboratory of Neurobiology, Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark.
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26
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McCormick BJJ, Richard SA, Caulfield LE, Pendergast LL, Seidman JC, Koshy B, Roshan R, Shrestha R, Svensen E, Blacy L, Rasmussen Z, Maphula A, Scharf R, Nahar B, Haque S, Rasheed M, Oria R, Rogawski ET, Murray-Kolb LE. Early Life Child Micronutrient Status, Maternal Reasoning, and a Nurturing Household Environment have Persistent Influences on Child Cognitive Development at Age 5 years: Results from MAL-ED. J Nutr 2019; 149:1460-1469. [PMID: 31162601 PMCID: PMC6686051 DOI: 10.1093/jn/nxz055] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 01/17/2019] [Accepted: 03/04/2019] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Child cognitive development is influenced by early-life insults and protective factors. To what extent these factors have a long-term legacy on child development and hence fulfillment of cognitive potential is unknown. OBJECTIVE The aim of this study was to examine the relation between early-life factors (birth to 2 y) and cognitive development at 5 y. METHODS Observational follow-up visits were made of children at 5 y, previously enrolled in the community-based MAL-ED longitudinal cohort. The burden of enteropathogens, prevalence of illness, complementary diet intake, micronutrient status, and household and maternal factors from birth to 2 y were extensively measured and their relation with the Wechsler Preschool Primary Scales of Intelligence at 5 y was examined through use of linear regression. RESULTS Cognitive T-scores from 813 of 1198 (68%) children were examined and 5 variables had significant associations in multivariable models: mean child plasma transferrin receptor concentration (β: -1.81, 95% CI: -2.75, -0.86), number of years of maternal education (β: 0.27, 95% CI: 0.08, 0.45), maternal cognitive reasoning score (β: 0.09, 95% CI: 0.03, 0.15), household assets score (β: 0.64, 95% CI: 0.24, 1.04), and HOME child cleanliness factor (β: 0.60, 95% CI: 0.05, 1.15). In multivariable models, the mean rate of enteropathogen detections, burden of illness, and complementary food intakes between birth and 2 y were not significantly related to 5-y cognition. CONCLUSIONS A nurturing home context in terms of a healthy/clean environment and household wealth, provision of adequate micronutrients, maternal education, and cognitive reasoning have a strong and persistent influence on child cognitive development. Efforts addressing aspects of poverty around micronutrient status, nurturing caregiving, and enabling home environments are likely to have lasting positive impacts on child cognitive development.
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Affiliation(s)
| | | | | | | | - Jessica C Seidman
- Fogarty International Center/National Institutes of Health, Bethesda, MD
| | | | | | | | | | | | - Zeba Rasmussen
- Fogarty International Center/National Institutes of Health, Bethesda, MD
| | | | | | | | | | | | | | | | - Laura E Murray-Kolb
- The Pennsylvania State University, University Park, PA,Address correspondence to LEM-K (e-mail: )
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27
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Abnormal spontaneous brain activity in patients with generalized anxiety disorder revealed by resting-state functional MRI. Neuroreport 2019; 29:397-401. [PMID: 29406370 DOI: 10.1097/wnr.0000000000000982] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This study aimed to examine the spontaneous hemodynamic fluctuations and the dysfunctional brain regions in patients with generalized anxiety disorder (GAD) using resting-state functional MRI. Previous studies have demonstrated some neural networks that are different in this patient group compared with healthy controls. However, there is still a need for precise anatomical localization of the aberrantly operating networks. We used resting-state functional MRI to measure the hemodynamic fluctuations in 31 GAD patients and 31 control participants matched for sex, age, and education. On the basis of the hemodynamic fluctuations, we calculated regional homogeneity (ReHo) for our comparisons as this measure reflects coherent fluctuations in adjacently located brain regions. The Hamilton Anxiety Rating Scale was used to assess symptom severity of the GAD patients. There were no significant differences with respect to age, sex, handedness, and education. However, compared with controls, GAD patients showed higher Hamilton Anxiety Rating Scale scores (16.90±1.94, P<0.05). We identified decreased ReHo measures in the right inferior frontal gyrus and the left caudate nucleus in the GAD group compared with the healthy controls. In addition, we found increased ReHo measures within the left cingulate gyrus. This study further complements the network characteristics in anxiety patients and presents new and more accurate anatomical positioning about GAD patients.
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29
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Iron as a model nutrient for understanding the nutritional origins of neuropsychiatric disease. Pediatr Res 2019; 85:176-182. [PMID: 30341413 PMCID: PMC6353667 DOI: 10.1038/s41390-018-0204-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 10/04/2018] [Accepted: 10/04/2018] [Indexed: 12/19/2022]
Abstract
Adequate nutrition during the pre- and early-postnatal periods plays a critical role in programming early neurodevelopment. Disruption of neurodevelopment by nutritional deficiencies can result not only in lasting functional deficits, but increased risk of neuropsychiatric disease in adulthood. Historical periods of famine such as the Dutch Hunger Winter and the Chinese Famine have provided foundational evidence for the long-term effects of developmental malnutrition on neuropsychiatric outcomes. Because neurodevelopment is a complex process that consists of many nutrient- and brain-region-specific critical periods, subsequent clinical and pre-clinical studies have aimed to elucidate the specific roles of individual macro- and micronutrient deficiencies in neurodevelopment and neuropsychiatric pathologies. This review will discuss developmental iron deficiency (ID), the most common micronutrient deficiency worldwide, as a paradigm for understanding the role of early-life nutrition in neurodevelopment and risk of neuropsychiatric disease. We will review the epidemiologic data linking ID to neuropsychiatric dysfunction, as well as the underlying structural, cellular, and molecular mechanisms that are thought to underlie these lasting effects. Understanding the mechanisms driving lasting dysfunction and disease risk is critical for development and implementation of nutritional policies aimed at preventing nutritional deficiencies and their long-term sequelae.
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30
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Fu XY, Xie XT. [Association between iron deficiency and brain developmental disorder in children]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2018; 20:964-967. [PMID: 30477632 PMCID: PMC7389029 DOI: 10.7499/j.issn.1008-8830.2018.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 10/02/2018] [Indexed: 06/09/2023]
Abstract
Iron deficiency (ID) is the most common trace element deficiency in childhood. Recent studies have shown that late fetus period, neonatal period, and infancy are important periods for brain development, and ID during these periods may cause irreversible damage to brain development, including abnormal emotion and behavior, cognitive decline, and attention deficit, which may still be present in adulthood. Therefore, it should be taken seriously. This article summarizes the research advances in major mechanisms involved in brain developmental disorder due to ID in the early stage of life and related intervention measures.
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Affiliation(s)
- Xiao-Yan Fu
- Department of Pediatrics, Shanghai Luodian Hospital, Shanghai 201908, China.
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31
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Georgieff MK, Ramel SE, Cusick SE. Nutritional influences on brain development. Acta Paediatr 2018; 107:1310-1321. [PMID: 29468731 PMCID: PMC6045434 DOI: 10.1111/apa.14287] [Citation(s) in RCA: 121] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 02/12/2018] [Accepted: 02/16/2018] [Indexed: 12/19/2022]
Abstract
There is increasing evidence from preclinical and human studies that nutrition in the late foetal and early neonatal period has a significant impact on neurodevelopment across the lifespan. Certain nutrients have particularly large effects in this time period, and their deficits cause greater long-term risk. The mechanisms by which nutrients influence early brain growth and the sensitive periods for when certain nutrients should be provided are being elucidated. Assessments of nutritional status that index brain growth and predict long-term development are important to assess the efficacy of early life nutritional therapies. CONCLUSION Optimizing nutrition during foetal and early postnatal life is a golden opportunity to impact neurodevelopment and brain function across the lifespan.
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Affiliation(s)
- Michael K. Georgieff
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN
| | - Sara E. Ramel
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN
| | - Sarah E. Cusick
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN
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32
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Georgieff MK, Tran PV, Carlson ES. Atypical fetal development: Fetal alcohol syndrome, nutritional deprivation, teratogens, and risk for neurodevelopmental disorders and psychopathology. Dev Psychopathol 2018; 30:1063-1086. [PMID: 30068419 PMCID: PMC6074054 DOI: 10.1017/s0954579418000500] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Accumulating evidence indicates that the fetal environment plays an important role in brain development and sets the brain on a trajectory across the life span. An abnormal fetal environment results when factors that should be present during a critical period of development are absent or when factors that should not be in the developing brain are present. While these factors may acutely disrupt brain function, the real cost to society resides in the long-term effects, which include important mental health issues. We review the effects of three factors, fetal alcohol exposure, teratogen exposure, and nutrient deficiencies, on the developing brain and the consequent risk for developmental psychopathology. Each is reviewed with respect to the evidence found in epidemiological and clinical studies in humans as well as preclinical molecular and cellular studies that explicate mechanisms of action.
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Affiliation(s)
| | - Phu V Tran
- University of Minnesota School of Medicine
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33
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Marchitelli R, Aiello M, Cachia A, Quarantelli M, Cavaliere C, Postiglione A, Tedeschi G, Montella P, Milan G, Salvatore M, Salvatore E, Baron JC, Pappatà S. Simultaneous resting-state FDG-PET/fMRI in Alzheimer Disease: Relationship between glucose metabolism and intrinsic activity. Neuroimage 2018; 176:246-258. [PMID: 29709628 DOI: 10.1016/j.neuroimage.2018.04.048] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 04/18/2018] [Accepted: 04/20/2018] [Indexed: 12/31/2022] Open
Abstract
Simultaneously evaluating resting-state brain glucose metabolism and intrinsic functional activity has potential to impact the clinical neurosciences of Alzheimer Disease (AD). Indeed, integrating such combined information obtained in the same physiological setting may clarify how impairments in neuroenergetic and neuronal function interact and contribute to the mechanisms underlying AD. The present study used this multimodality approach to investigate, by means of a hybrid PET/MR scanner, the coupling between glucose consumption and intrinsic functional activity in 23 patients with AD-related cognitive impairment ranging from amnestic mild cognitive impairment (MCI) to mild-moderate AD (aMCI/AD), in comparison with a group of 23 healthy elderly controls. Between-group (Controls > Patients) comparisons were conducted on data from both imaging modalities using voxelwise 2-sample t-tests, corrected for partial-volume effects, head motion, age, gender and multiple tests. FDG-PET/fMRI relationships were assessed within and across subjects using Spearman partial correlations for three different resting-state fMRI (rs-fMRI) metrics sensitive to AD: fractional amplitude of low frequency fluctuations (fALFF), regional homogeneity (ReHo) and group independent component analysis with dual regression (gICA-DR). FDG and rs-fMRI metrics distinguished aMCI/AD from controls according to spatial patterns analogous to those found in stand-alone studies. Within-subject correlations were comparable across the three rs-fMRI metrics. Correlations were overall high in healthy controls (ρ = 0.80 ± 0.04), but showed a significant 17% reduction (p < 0.05) in aMCI/AD patients (ρ = 0.67 ± 0.05). Positive across-subject correlations were overall moderate (ρ = 0.33 ± 0.07) and consistent across rs-fMRI metrics. These were confined around AD-target posterior regions for metrics of functional connectivity (ReHo and gICA-DR). In contrast, FDG/fALFF correlations were distributed in the frontal gyrus, thalami and caudate nuclei. Taken together, these results support the presence of bioenergetic coupling between glucose utilization and rapid transmission of neural information in healthy ageing, which is substantially reduced in aMCI/AD, suggesting that abnormal glucose utilization is in some way linked to communication breakdown among brain regions impacted by the underlying pathological process.
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Affiliation(s)
- Rocco Marchitelli
- IRCCS SDN, Institute of Nuclear and Diagnostic Research, Via E. Gianturco 113, 80143, Naples, Italy
| | - Marco Aiello
- IRCCS SDN, Institute of Nuclear and Diagnostic Research, Via E. Gianturco 113, 80143, Naples, Italy.
| | - Arnaud Cachia
- INSERM U894, Université Paris Descartes, Centre Hospitalier Sainte-Anne, Sorbonne Paris Cité, Paris, France; CNRS U8240, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Institut Universitaire de France, Paris, France
| | - Mario Quarantelli
- Institute of Biostructure and Bioimaging, National Research Council, Naples, Italy
| | - Carlo Cavaliere
- IRCCS SDN, Institute of Nuclear and Diagnostic Research, Via E. Gianturco 113, 80143, Naples, Italy
| | - Alfredo Postiglione
- Department of Clinical Medicine & Surgery, University of Naples "Federico II", Naples, Italy
| | - Gioacchino Tedeschi
- Dept of Medical, Surgical Neurological Metabolic and Aging Sciences. University of Campania "L. Vanvitelli", Italy
| | - Patrizia Montella
- Dept of Medical, Surgical Neurological Metabolic and Aging Sciences. University of Campania "L. Vanvitelli", Italy
| | - Graziella Milan
- Centro Geriatrico Frullone, ASL Napoli 1 Centro, Naples, Italy
| | - Marco Salvatore
- IRCCS SDN, Institute of Nuclear and Diagnostic Research, Via E. Gianturco 113, 80143, Naples, Italy
| | - Elena Salvatore
- Department of Neuroscience Reproductive Sciences and Odontostomatology, Federico II University, Naples, Italy
| | - Jean Claude Baron
- Dept of Neurology, Centre Hospitalier Sainte-Anne, Université Paris Descartes, INSERM U894, Paris, France
| | - Sabina Pappatà
- Institute of Biostructure and Bioimaging, National Research Council, Naples, Italy
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34
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Cerami C. Iron Nutriture of the Fetus, Neonate, Infant, and Child. ANNALS OF NUTRITION & METABOLISM 2017; 71 Suppl 3:8-14. [PMID: 29268254 PMCID: PMC6143763 DOI: 10.1159/000481447] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Iron is a key nutrient and is essential for the developing fetus, neonate, infant, and child. Iron requirements are high during early stages of life because it is critically important for the production of new red blood cells and muscle cells as well as brain development. Neonates, infants, and children obtain iron from dietary sources including breast milk (lactoferrin) and heme- and non-heme-containing foods. Iron deficiency (ID) is the most common micronutrient deficiency in children and pregnant women worldwide. ID and iron deficiency anemia (IDA) can affect growth and energy levels as well as motor and cognitive performance in the developing child. The fetus is completely dependent on maternal iron crossing through the placenta and, although it is generally well protected against deficiency at birth, ID in mothers can increase the risk of ID and IDA in their children as early as 4 months. This review will discuss the uses of iron, iron requirements, and the sources of iron from conception through childhood. In addition, it will describe the prevalence and clinical manifestations of ID and IDA in children and discuss recommendations for iron supplementation of children and pregnant women.
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Affiliation(s)
- Carla Cerami
- MRC Unit The Gambia, MRC International Nutrition Group, Fajara, The Gambia
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Forbes TA, Gallo V. All Wrapped Up: Environmental Effects on Myelination. Trends Neurosci 2017; 40:572-587. [PMID: 28844283 PMCID: PMC5671205 DOI: 10.1016/j.tins.2017.06.009] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 06/26/2017] [Indexed: 12/16/2022]
Abstract
To date, studies have demonstrated the dynamic influence of exogenous environmental stimuli on multiple regions of the brain. This environmental influence positively and negatively impacts programs governing myelination, and acts on myelinating oligodendrocyte (OL) cells across the human lifespan. Developmentally, environmental manipulation of OL progenitor cells (OPCs) has profound effects on the establishment of functional cognitive, sensory, and motor programs. Furthermore, central nervous system (CNS) myelin remains an adaptive entity in adulthood, sensitive to environmentally induced structural changes. Here, we discuss the role of environmental stimuli on mechanisms governing programs of CNS myelination under normal and pathological conditions. Importantly, we highlight how these extrinsic cues can influence the intrinsic power of myelin plasticity to promote functional recovery.
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Affiliation(s)
- Thomas A Forbes
- Center for Neuroscience Research, Children's Research Institute, Children's National Medical Center, Washington, DC 20010, USA; The George Washington University School of Medicine and Health Sciences, Washington, DC 20037, USA.
| | - Vittorio Gallo
- Center for Neuroscience Research, Children's Research Institute, Children's National Medical Center, Washington, DC 20010, USA; The George Washington University School of Medicine and Health Sciences, Washington, DC 20037, USA.
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Fischer MDQ, Molz P, Hermes L, Santos CD, Limberger LB, Schlickmann DDS, Horta JA, Renner JDP, Prá D, Franke SIR. Neuropsychomotor development and genomic stability associated to folate and blood iron levels in preschool children. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2017. [DOI: 10.1590/1806-93042017000300006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: to evaluate the neuropsychomotor development and the genomic stability associated to folate and blood iron levels in preschool children. Methods: a cross-sectional study in which evaluated the biochemical exams (complete hemogram, serum ferritin, iron and folate), neuropsychomotor development (Denver II Test) and genotoxicity (micronuclei cytome in buccal mucosa cells) of 55 children aging 36-59 months old. Student´s T test, Kruskal-Wallis and Pearson's or Spearman's correlation tests were applied with a significance level of p<0.05 for data analysis. Results: the prevalence of anemia was 1.8%. The Denver II test classified 32.7% of the children as normal and 67.3% were suspected of having a delay. The children suspected of having a delay presented a slight reduction on hemoglobin and hematocrit (p=0.05 and p=0.14), intermediate reduction on iron and folate (p=0.29 and p=0.23) and a notable reduction on ferritin (p=0.03). Folate and iron were significantly associated to the frequency of cells with DNA damages (p<0.05). The frequency of binucleated cells was positively associated to the Red Cell Distribution Width (RDW) (r=0.56; p=0.02) in children without a delay and negatively with folate (r=-0.334; p=0.047) in children with a delay. Conclusions: this study showed a low prevalence of anemia, but a high rate of children suspected of having a neuropsychomotor, possibly associated to low ferritin levels. Additionally, iron and folate were associated to DNA damage which may have contributed to the psychomotor development delay.
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Affiliation(s)
| | - Patrícia Molz
- Pontifícia Universidade Católica do Rio Grande do Sul, Brazil
| | | | | | | | | | | | | | - Daniel Prá
- Universidade de Santa Cruz do Sul, Brazil
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