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Differentiation between fetal and postnatal iron deficiency in altering brain substrates of cognitive control in
Mengdi Hua1, Donglin Shi2, Wenwen Xu2
1Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Insights
Early iron deficiency (ID) impacts children's brain development, affecting cognitive control differently based on timing (fetal vs. postnatal). Interventions should consider when iron deficiency occurs for better outcomes.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatrics
Background:
- Early iron deficiency (ID) is a significant risk factor for impaired neurodevelopment in children.
- The precise impact of early ID on brain function and the importance of its timing (fetal vs. postnatal) on long-term cognitive development remain unclear.
Purpose of the Study:
- To investigate the effects of fetal or early postnatal iron deficiency on brain activity related to proactive and reactive cognitive control in pre-adolescent children.
- To determine if the timing of early iron deficiency influences long-term brain development and cognitive functions.
Main Methods:
- A longitudinal cohort study involving 71 children aged 8-11 years, categorized into fetal ID, postnatal ID (at 9 months), and iron-sufficient groups.
- Neuroimaging using Magnetic Resonance Imaging (MRI) during a cognitive control task to assess brain activity, accuracy, and reaction times.
- Statistical analyses included linear mixed modeling for behavioral data and AFNI for neuroimaging data.
Main Results:
- All groups demonstrated the ability to switch between proactive and reactive cognitive control, but the fetal ID group showed lower overall accuracy.
- Iron-sufficient and postnatal ID groups exhibited condition-dependent brain activation differences, which were reversed in the postnatal ID group.
- The fetal ID group displayed unique activation patterns in the reward pathway and lacked condition-specific brain activation differences.
Conclusions:
- Early iron deficiency is linked to altered brain functions supporting cognitive control in children, with distinct effects depending on whether the deficiency occurred during the fetal or postnatal period.
- Iron supplementation alone may not fully reverse persistent brain alterations caused by early iron deficiency.
- Future interventions should consider the timing of iron deficiency to effectively address long-term brain development and cognitive deficits.
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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