Strupp B J, Levitsky D A
Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853-6301, USA.
J Nutr. 1995 Aug;125(8 Suppl):2221S-2232S. doi: 10.1093/jn/125.suppl_8.2221S.
This article presents a reappraisal of the literature on the enduring cognitive effects of early malnutrition. In addition to summarizing the existing empirical literature, we present a theoretical framework for determining whether the processes likely to be most vulnerable to early malnutrition were adequately assessed. The two types of information used to make this determination are clinical and experimental behavioral data as well as reported neural changes. One point of clear consensus is that animals exposed to early malnutrition exhibit lasting changes in the realm of emotionality, motivation, and/or anxiety. Because these alterations profoundly affect all aspects of behavioral functioning, including cognition, it is suggested that future research focus on these changes, rather than control for them as many past studies have done. The functional integrity of specific cognitive processes is less clear. The only cognitive processes for which enduring cognitive changes were demonstrated in rehabilitated animals--outside of effects mediated by these affective changes--are cognitive flexibility and, possibly, susceptibility to proactive interference. However, the inference that these are the only processes affected does not appear to be warranted on the basis of the evidence that several cognitive processes likely to be affected have not been fully assessed. Examples include executive functions linked to the prefrontal cortex (for example, attention), transfer of learning, procedural learning and long-term memory. Future research focusing on these specific cognitive functions as well as on these unequivocal affective changes should allow a more definitive conclusion regarding the enduring functional consequences of early malnutrition.
本文对有关早期营养不良的持久认知影响的文献进行了重新评估。除了总结现有的实证文献外，我们还提出了一个理论框架，以确定那些可能最易受早期营养不良影响的过程是否得到了充分评估。用于做出这一判断的两类信息是临床和实验行为数据以及所报道的神经变化。一个明确的共识点是，遭受早期营养不良的动物在情绪、动机和/或焦虑领域表现出持久的变化。由于这些改变深刻影响包括认知在内的行为功能的各个方面，因此建议未来的研究关注这些变化，而不是像许多过去的研究那样对其进行控制。特定认知过程的功能完整性尚不清楚。在康复动物中，除了这些情感变化介导的影响外，唯一被证明存在持久认知变化的认知过程是认知灵活性，可能还有对前摄干扰的易感性。然而，基于一些可能受到影响的认知过程尚未得到充分评估的证据，认为这些是唯一受影响的过程这一推断似乎没有依据。例子包括与前额叶皮层相关的执行功能（例如注意力）、学习迁移、程序学习和长期记忆。未来针对这些特定认知功能以及这些明确的情感变化的研究，应该能够就早期营养不良的持久功能后果得出更明确的结论。
