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Relating anthropometric indicators to brain structure in 2-month-old Bangladeshi infants growing up in poverty: A
Ted Turesky1, Wanze Xie1, Swapna Kumar2
1Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
Insights
Infant stunting and underweight correlate with reduced white matter brain volume. This study in Bangladesh links poor physical growth to brain development in low-resource settings.
Area of Science:
- Developmental neuroscience
- Pediatric neuroimaging
- Global child health
Background:
- Anthropometric indicators like stunting, underweight, and wasting are linked to neurocognitive deficits.
- Malnutrition and infection impact brain structure, as suggested by animal models.
- The relationship between anthropometry and brain structure is understudied, especially in low-resource settings.
Purpose of the Study:
- To investigate the association between anthropometric indicators and brain structural measures in infants.
- To explore links between poverty, anthropometry, and brain structure in a low-resource environment.
- To establish the first connection between diminished growth and infant brain development.
Main Methods:
- MRI scans (3T, T1 sequences) were performed on 54 infants (2-3 months old) in Dhaka, Bangladesh.
- Structural images were segmented into gray and white matter, with quality assessed by a pediatric neuroradiologist.
- Semi-partial correlations analyzed brain volumes against height-for-age (HAZ), weight-for-age (WAZ), and weight-for-height (WHZ) scores in 29 infants.
Main Results:
- Positive correlations were found between white matter volume and HAZ and WAZ scores.
- Weight-for-height (WHZ) showed no correlation with any brain volume measure.
- No associations were observed between income-to-needs or maternal education and brain volumetric measures.
Conclusions:
- This study provides the first evidence linking diminished anthropometric growth (stunting and underweight) with reduced white matter volume in infancy.
- Poverty measures were not associated with total brain tissue volume in this cohort.
- The study highlights challenges and feasibility of developmental neuroimaging in low-resource settings.
Abstract:
Anthropometric indicators, including stunting, underweight, and wasting, have previously been associated with poor neurocognitive outcomes. This link may exist because malnutrition and infection, which are known to affect height and weight, also impact brain structure according to animal models. However, a relationship between anthropometric indicators and brain structural measures has not been tested yet, perhaps because stunting, underweight, and wasting are uncommon in higher-resource settings. Further, with diminished anthropometric growth prevalent in low-resource settings, where biological and psychosocial hazards are most severe, one might expect additional links between measures of poverty, anthropometry, and brain structure. To begin to examine these relationships, we conducted an MRI study in 2-3-month-old infants growing up in the extremely impoverished urban setting of Dhaka, Bangladesh. The sample size was relatively small because the challenges of investigating infant brain structure in a low-resource setting needed to be realized and resolved before introducing a larger cohort. Initially, fifty-four infants underwent T1 sequences using 3T MRI, and resulting structural images were segmented into gray and white matter maps, which were carefully evaluated for accurate tissue labeling by a pediatric neuroradiologist. Gray and white matter volumes from 29 infants (79 ± 10 days-of-age; F/M = 12/17), whose segmentations were of relatively high quality, were submitted to semi-partial correlation analyses with stunting, underweight, and wasting, which were measured using height-for-age (HAZ), weight-for-age (WAZ), and weight-for-height (WHZ) scores. Positive semi-partial correlations (after adjusting for chronological age and sex and correcting for multiple comparisons) were observed between white matter volume and HAZ and WAZ; however, WHZ was not correlated with any measure of brain volume. No associations were observed between income-to-needs or maternal education and brain volumetric measures, suggesting that measures of poverty were not associated with total brain tissue volume in this sample. Overall, these results provide the first link between diminished anthropometric growth and white matter volume in infancy. Challenges of conducting a developmental neuroimaging study in a low-resource country are also described.
