Characterization of brain microstructural changes in children with infantile vitamin B12 deficiency using diffusion...

Area of Science:

• Pediatric Neurology
• Neuroimaging
• Nutritional Neuroscience

Background:

• Infantile Vitamin B12 deficiency, or Infantile Tremor Syndrome (ITS), affects exclusively breastfed infants of vegetarian mothers.
• Known structural neuroimaging findings include cerebral and corpus callosal atrophy.
• Microstructural brain changes in ITS are not well understood.

Purpose of the Study:

• To investigate brain microstructural changes in Infantile Vitamin B12 deficiency using Diffusion Tensor Imaging (DTI).
• To correlate these microstructural changes with neurodevelopmental outcomes after Vitamin B12 supplementation.

Main Methods:

• Thirty infants with Infantile Vitamin B12 deficiency underwent clinical, neurodevelopmental, and DTI assessments.
• DTI metrics (FA, MD, RD, AD) were analyzed using region-of-interest and voxel-based methods.
• Correlations between DTI metrics and developmental scores were evaluated post-treatment.

Main Results:

• Vitamin B12 supplementation improved serum B12, hemoglobin, neurodevelopmental scores, and normalized homocysteine.
• DTI revealed increased FA and reduced diffusivity, indicating remyelination and axonal recovery.
• Significant improvements were observed in the corpus callosum, corona radiata, internal capsule, thalamus, and pre-central gyrus.

Conclusions:

• Infantile Vitamin B12 deficiency presents with global brain microstructural abnormalities.
• These abnormalities significantly improve with Vitamin B12 therapy.
• DTI metrics correlate with neurodevelopmental recovery, highlighting B12's role in brain myelination.