Event related potentials in anemic school – going girls of age group 8 to 10 years.

In the present study the effects of anemia on cognitive functions were studied in school going girls aged 8-10 years. The cognitive functions were assessed by Event Related Potentials (P300) and by the psychometric tests, i.e., Raven’s progressive matrices test and Digit span attention test. The girls with Hb < 12 g/dl were classified into anemic and Hb > 12 g/dl into control group. Hematological values of the control group were significantly better than anemic group. P300 latency in the anemic girls was delayed as compared to control group but, no statistically significant difference was observed for P300 latency and P300 amplitude between the control group and the anemic group. The psychometric test scores for intelligence quotient and transformed quotient were also better but not statistically significant in control group of girls as compared to anemic girls. However, the hematocrit values showed a significant correlation with the P300 wave latency showing that the hematological status is associated with some effects on cognition.

Effects of iron therapy on cognition in anemic school going boys.

The present study was conducted on 18 anemic and 34 control subjects (mean age 9.26 +/- 0.26 years) to observe the effect of anemia on cognition and to see effect of 3 months of iron therapy on it. Anemia was defined on the basis of hematological values and peripheral smear examinations. Cognitive data consisted of the recording of the P300 wave of Auditory Event Related Potentials (AERP), Ravens Progressive Matrices Test (RPMT), and Digit Span Attention Test (DSAT) under standard test conditions. RPMT scores were then converted to the intelligence quotient (IQ) scores for comparison. Both anemic and control boys were dewormed after recording pretreatment values and then anemic boys were given iron therapy for 3 months, after which the recordings were taken again. Pretreatment, anemic boys showed significantly lower hematological values, delayed P300 latency, and lower RPMT scores as compared to controls. Post therapy the hematological profile of anemic boys though significantly improved as compared to the pretreatment values, was still significantly lower than that of control boys. The P300 latency values of anemic boys showed improvement but were still significantly delayed than the control group. RPMT values and derived IQ scores of anemic boys were similar to control boys after therapy suggesting that though the 3 months iron therapy regime resulted in improvement in psychometric cognitive tests in anemic boys, the basic P300 defects persisted. This suggests that the P300 component of AERP in anemic children is relatively refractory to 3 months of iron therapy.

Effect of iron on growth in iron deficient anemic school going children.

Iron deficiency anemia (IDA) in children has been associated with retardation in growth and the cognitive development. In the ongoing study on the effects of IDA in school going children, the effects on anthropometric parameters such as height (Ht), Weight (Wt), head circumference (HC), body mass index (BMI) and the mid arm circumference (MAC) were studied along with the hematological parameters such as hemoglobin (Hb), hematocrit (Hct), MCV, MCH, serum iron (SI), total iron binding capacity (TIBC) and % saturation. The pre-supplementation values of all these parameters were taken in anemic and control groups of girls and boys. After deworming all the children with albendazole (400 mg), the anemic group was put on iron supplementation (Ferrous iron 3-4 mg/kg body weight/day) along with vitamin C (100 mg OD) and the control children were given vitamin C (100 mg OD), for 90 days. Pre-supplementation values of IDA children were significantly lower for MAC and HC in girls and for Ht and MAC in boys, when compared to the control group. After the therapy both the groups of girls showed improvement in the hematological parameters though it was greater in the anemic girls. Ht and Wt of both groups also improved significantly but the anemic girls showed increase in BMI also. Both the control and anemic boys showed gain in weight. Post therapy, improvement in hematological parameters for both the anemic girls and boys were greater than their respective control groups. The MAC value for anemic girls were in the control range but those of anemic boys remained lesser than the control boys. So, it can be concluded from the present study that the IDA children lagged behind the control children in terms of anthropometric parameters and they benefited relatively more in terms of anthropometric improvement and hematological improvement after iron supplementation.

Brainstem auditory evoked potential responses in iron-deficient anemic children.

Iron deficiency is a major health problem in developing countries manifesting not only as overt anemia but also involving the CNS resulting in cognitive and behavioral deficits. Iron is an important nutrient and essential element involved in myelin formation and neurotransmitter synthesis and thus contributes to normal neurological activity. Hypomyelination has been reported in iron deficient states with possible neural conduction defects. The brainstem auditory evoked potential response is used extensively to identify lesions associated with various demyelinating diseases and hence has been used in the present study to observe the effect of iron deficiency on sensory brain function. A trend of increased absolute and interpeak latencies and reduced amplitudes of the waves leading to a definite linear correlation between the severity of anemia and the degree of neurophysiological deficit suggests a subclinical involvement of the auditory pathway in the brainstem of iron deficient children.