Hyperhomocysteinemia, Cognitive Deficits, and Delayed P300 Latencies in Malnourished Children from Northern India

Background: Malnutrition during childhood can adversely affect behaviour and cognitive performance. Vitamin B deficiencies in particular have been linked to cognitive impairment and hyperhomocysteinemia, a risk factor for cardiovascular and neurological disorders. The objective of this study was to assess the effects of malnourishment on cognition and plasma vitamin B12, folate, and homocysteine levels in children in Northern India. Methods: 825 school going children were screened following which 75 children were included in the malnourished group and 50 apparently healthy children in the control group. Attention span, long and short-term memory, and latenciesof the brain event related potential P300 were assessed as the cognitive measures. 1.0 ml blood (fasting) was collected from each subject in EDTA tubes and centrifuged (2000 rpm) at 4 °C for 20 minutes,separate the plasma. Fasting plasma levels of homocysteine, vitamin B12, and folate were also determined by ELISA. Results: Significantly lower scores in the attention span and memory tests were observed in the malnourished group as compared to the control group (P<0.001). These differences were further exemplified by delayed P300 latencies observed in the malnourished group as compared to controls (P<0.001). Elevated plasma homocysteine along with lower folate, and vitamin B12 levels were also observed in the malnourished group when compared to controls(P<0.001). Discussion: These results encourage pilot studies to establish whether interventions to treat vitamin B12 folate and iron deficiencies in the malnourished children studied here could help improve cognitive performance and ameliorate hyperhomocysteinemia.