Division of Pediatric Gastroenterology and Nutrition, MassGeneral Hospital for Children, Boston MA, USA.
The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China; The Cuban Neurosciences Center, La Habana, Cuba.
Neuroimage. 2021 May 1;231:117828. doi: 10.1016/j.neuroimage.2021.117828. Epub 2021 Feb 5.
Approximately one in five children worldwide suffers from childhood malnutrition and its complications, including increased susceptibility to inflammation and infectious diseases. Due to improved early interventions, most of these children now survive early malnutrition, even in low-resource settings (LRS). However, many continue to exhibit neurodevelopmental deficits, including low IQ, poor school performance, and behavioral problems over their lifetimes. Most studies have relied on neuropsychological tests, school performance, and mental health and behavioral measures. Few studies, in contrast, have assessed brain structure and function, and to date, these have mainly relied on low-cost techniques, including electroencephalography (EEG) and evoked potentials (ERP). The use of more advanced methods of neuroimaging, including magnetic resonance imaging (MRI) and functional near-infrared spectroscopy (fNIRS), has been limited by cost factors and lack of availability of these technologies in developing countries, where malnutrition is nearly ubiquitous. This report summarizes the current state of knowledge and evidence gaps regarding childhood malnutrition and the study of its impact on neurodevelopment. It may help to inform the development of new strategies to improve the identification, classification, and treatment of neurodevelopmental disabilities in underserved populations at the highest risk for childhood malnutrition.
全世界大约五分之一的儿童患有儿童期营养不良及其并发症,包括更容易受到炎症和传染病的影响。由于早期干预措施的改善,现在这些儿童中的大多数即使在资源匮乏环境(LRS)中也能存活下来早期营养不良。然而,许多人在其一生中仍表现出神经发育缺陷,包括智商低、学业成绩差和行为问题。大多数研究都依赖于神经心理学测试、学业成绩以及心理健康和行为措施。相比之下,很少有研究评估大脑结构和功能,而且迄今为止,这些研究主要依赖于成本较低的技术,包括脑电图(EEG)和诱发电位(ERP)。神经影像学的更先进方法的使用,包括磁共振成像(MRI)和功能性近红外光谱(fNIRS),受到成本因素和发展中国家这些技术的可用性限制,这些国家几乎普遍存在营养不良。本报告总结了关于儿童期营养不良及其对神经发育影响的研究的现有知识和证据差距。它可能有助于为在儿童期营养不良风险最高的服务不足人群中改善神经发育障碍的识别、分类和治疗提供新的策略。