vitamin-b-12 and Child-Behavior-Disorders

Previous studies have suggested that prenatal maternal folate deficiency is associated with reduced prenatal brain growth and psychological problems in offspring. However, little is known about the longer-term impact. The aims of this study were to investigate whether prenatal maternal folate insufficiency, high total homocysteine levels and low vitamin B12 levels are associated with altered brain morphology, cognitive and/or psychological problems in school-aged children. This study was embedded in Generation R, a prospective population-based cohort study. The study sample consisted of 256 Dutch children aged between 6 and 8 years from whom structural brain scans were collected using MRI. The mothers of sixty-two children had insufficient (<8 nmol/l) plasma folate concentrations in early pregnancy. Cognitive development was assessed by the Snijders-Oomen Niet-verbale intelligentietest - Revisie and the NEPSY-II-NL. Psychological problems were assessed at age 6 years using the parent report of the Child Behavior Checklist. Low prenatal folate levels were associated with a smaller total brain volume (B -33·34; 95 % CI -66·7, 0·02; P=050) and predicted poorer performance on the language (B -0·28; 95 % CI -0·52, -0·04; P=0·020) and visuo-spatial domains (B -0·27; 95 % CI -0·50, -0·04; P=0·021). High homocysteine levels (>9·1 µmol/l) predicted poorer performance on the language (B -0·31; 95 % CI -0·56, -0·06; P=0·014) and visuo-spatial domains (B -0·36; 95 % CI -0·60, -0·11; P=0·004). No associations with psychological problems were found. Our findings suggest that folate insufficiency in early pregnancy has a long-lasting, global effect on brain development and is, together with homocysteine levels, associated with poorer cognitive performance.

Topics: Brain; Child; Child Behavior Disorders; Cognition Disorders; Cohort Studies; Female; Folic Acid; Folic Acid Deficiency; Homocysteine; Humans; Language Development Disorders; Magnetic Resonance Imaging; Male; Netherlands; Pregnancy; Pregnancy Complications; Prenatal Exposure Delayed Effects; Prospective Studies; Vitamin B 12; Vitamin B 12 Deficiency

Cobalamin C (cblC) disease, an inborn error of vitamin B(12) metabolism, results in neurometabolic, neurochemical and neuroanatomical changes. Little is known of the long-term effects of the disorder on cognition and behaviour in children. Here, the complete neuropsychological profiles of two 12-year-old girls with cblC disease are presented. The two girls were tested longitudinally with standardized neuropsychological tests including intellectual ability, attention and memory, as well as executive, adaptive and behavioural function. The results indicate the presence of intellectual dysfunction, attention problems, and concerns with behavioural aspects of executive function. Both patients demonstrated a pattern of decreasing intellectual function over time, which may reflect a growing developmental gap in comparison with their same age peers. These impairments are in contrast to the relatively spared verbal expression and comprehension abilities, as well as strengths in sociability. The findings highlight a pattern of neuropsychological strengths and weaknesses that may distinguish cblC disease from other inborn errors of metabolism. Overt sociability such as observed in these two patients may actually mask underlying cognitive deficits because the patients appear to function at a more advanced level than that reflected by quantitative assessment of intellectual and cognitive functioning. This is of clinical and functional importance and suggests that accurate determination of cognitive, adaptive and social abilities necessitates an in-depth and broad evaluation. The presence of significant intellectual and cognitive deficits also underscores the need to document and monitor cognitive development in children with cblC disease and to consider remediative and adaptive learning strategies.

Topics: Adaptation, Psychological; Child; Child Behavior; Child Behavior Disorders; Child, Preschool; Cognition; Cognition Disorders; Female; Humans; Infant; Metabolism, Inborn Errors; Neuropsychological Tests; Social Behavior; Vitamin B 12

Topics: Child; Child Behavior Disorders; Female; Humans; Psychotic Disorders; Vitamin B 12

Topics: Anemia, Pernicious; Child; Child Behavior Disorders; Child, Preschool; Cobalt Isotopes; Humans; Infant; Male; Schilling Test; Spinal Cord Diseases; Vitamin B 12

Topics: Adolescent; Child; Child Behavior Disorders; Child Psychiatry; Corrinoids; Hematinics; Humans; Psychology, Educational; Vitamin B 12