Could anemia be the reason for dysfunctional cognition???

Pranali S. Kharat, Pradnya P. Waghmare

Abstract


Background: Studies claim that anemia at any time in life can hamper the metabolic processes and subsequently affect the cognitive and behavioral domain of an individual. Late-adolescent girls are one of the most vulnerable groups due to commencement of menstrual cycles, hormonal changes, nutritional deficits etc. It is also the time period where adolescents enter their professional careers in our country where cognition forms the basis of all the learning. This study was focused on seeing whether anemia affects the P300 wave which is a cognitive evoked potential.  

Methods: 74 girls of first and second year MBBS were chosen for this study. They were divided into two groups on basis of hemoglobin estimation by cyanmethemoglobin method. A comparative study was done of P300 latency and P300 amplitude between the two groups.

Results: Comparison between the anemic group to the control group revealed: Latency of P300 was significantly delayed in the anemic group and amplitude was significantly higher in the control group.

Conclusion: The results suggested a better cognitive performance of those having normal hemoglobin levels.


Keywords


Anemia, Late-adolescent, P300 latency, P300 amplitude

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References


Goodin DS. Event-related potentials. In: Pioli SF, eds. Electrodiagnosis in Clinical Neurology. 5th ed. London: Elsevier Churchill Livingstone; 2005: 609-625.

Polich J. Neuropsychology of P300. In: Polich J, eds. Oxford Handbook of Event-Related Potential Components. 4th ed. California, CA: Oxford University Press; 2010: 159-188.

Smith DBD, Donchin E, Cohen L, Starr A. Auditory averaged evoked potentials in man during selective binaural listening. Electroenceph Clin Neurophysiol. 1970;28:146-52.

Ritter W, Vaughan HG Jr, Costa LD. Orienting and habituation to auditory stimuli: a study of short-term changes in average evoked responses. Electroenceph Clin Neurophysiol.1968;25:550-6.

McCarthy G, Donchin E. A metric for thought: a comparison of P300 latency and reaction time. Science. 1981;211(4477):77-80.

Burden MJ, Westerlund AJ, Armony-Sivan R, Nelson CA, Jacobson SW, Lozoff B, et al. An event-related potential study of attention and recognition memory in infants with iron-deficiency anemia. Pediatrics. 2007;120(2):336-45.

Singh NP, Sahni V, Wadhwa A, Garg S, Bajaj SK, Kohli R, et al. Effect of improvement in anemia on electroneurophysiological markers (P300) of cognitive dysfunction in chronic kidney disease. Hemodial Int. 2006;10(3):267-73.

Biradar SS, Biradar SP, Alatagi AC, Wantamutte AS, Malur PR. Prevalence of anaemia among adolescent girls: a one year cross-sectional study. J Clin Diagn Res. 2012;6(3):372-7.

Yadav A, Tandon OP, Vaney N. Long latency auditory evoked responses in ovulatory and anovulatory menstrual cycle. Indian J Physiol Pharmacol. 2003;47(2):179-84.

Yucca Diagnostics. Manual: cyanmethemoglobin method, 2014. Available at: http://yucca.in/products/lab.

Van Kampen EJ, Zijlstra WG. Standardization of hemoglobinometry. II. The hemiglobincyanide method. Clin Chem Acta. 1961;6:538-44.

Misra UK, Kalita J. Cognitive evoked potential. In: Misra UK, Kalita J, eds. Clinical Neurophysiology. 2nd ed. New Delhi, India: Elsevier; 2008: 401-408.

Recorders & Medicare Systems, India. Installation & Service Manual RMS EMG. EP MARK II, 2014. Available at: www.rmsindia.com.

Kamble P. Comparative study of evoked potentials in athletes compared to healthy age-matched subjects. In: Kamble P, eds. MD Thesis. Solapur: Dr. Vishampayan Memorial Govt. Medical College; 2010.

Trivedi JK. Cognitive deficits in psychiatric disorders: current status. Indian J Psychiatry. 2006;48(1):10-20.

Hassaan MR. P300 amplitude verses latency: measures of post-remediation improvement in auditory processing disorders. Egypt J Ear Nose Throat Allied Sci. 2010;11:83-6.

Schochat E, Scheuer CI, Andrade ÊR de. ABR and auditory P300 findings in children with ADHD. Arquivos de Neuro-Psiquiatria. 2002;60(3B):742-7.

Nieuwenhuis S, Aston-Jones G, Cohen JD. Decision making, the P3, and the locus coeruleus-norepinephrine system. Psychol Bull. 2005;131(4):510-32.

Picton TW. The P300 wave of the human event-related potential. J Clin Neurophysiol. 1992;9:456-79.

Frodl BT, Bottlender R, Hegerl U. Neurochemical substrates and neuroanatomical generators of the event-related P300. Neuropsychobiology. 1999;40(2):86-94.

Kececi H, Degirmenci Y. Quantitative EEG and cognitive evoked potentials in anemia. Neurophysiologie Clinique/Clin Neurophysiol. 2008;38(2):137-43.

Otero GA, Pliego-Rivero FB, Contreras G, Ricardo J, Fernández T. Iron supplementation brings up a lacking P300 in iron deficient children. Clin Neurophysiol. 2004;115(10):2259-66.

Yehuda S, Mostofsky DI. Iron deficiency and overload. In: Yehuda S, Mostofsky DI, eds. Iron Deficiency and Excess in Brain: Implications for Cognitive Impairment and Neurodegeneration. 6th ed. New York: Humana Press; 2010: 95-125.

Youdim M B, Ben-Shachar D, Yehuda S. Putative biological mechanisms of the effect of iron deficiency on brain biochemistry and behavior. Am J Clin Nutr.1989;50(3):607-17.

Badaracco ME, Siri MV, Pasquini JM. Oligodendrogenesis: the role of iron. Biofactors. 2010;36(2):98-102.

Barth D, Hirschmann JV. Anemia. In: Tkachuk, Douglas C, Hirschmann JV, eds. Wintrobe’s Atlas of Clinical Hematology. 1st Online ed. Philadelphia: Lippincott Williams & Wilkins; 2007: 1-33.

Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes and its Panel on Folate, Other B Vitamins, and Choline. Dietary reference intakes for thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. In: NCBI, eds. NCBI Book. Washington (DC): National Academies Press (US); 1998.

Tang FI, Wei IL. Vitamin B-6 deficiency prolongs the time course of evoked dopamine release from rat striatum. J Nutr. 2004;134(12):3350-4.

Nevruz O, Ulas U, Cetin T, Kutukcu Y, Kurekci A. Cognitive dysfunction in β‐thalassemia minor. Am J Hematol. 2007;82(3):203-7.

Lachner C, Steinle NI, Regenold WT. The neuropsychiatry of vitamin B12 deficiency in elderly patients. J Neuropsychiatry Clin Neurosci. 2012;24:1.

Babior BM, Bunn HF. Megaloblastic anemias. In: Braunwald E, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL, eds. Harrison’s Principles of Internal Medicine. 15th ed. New-York: McGraw-Hill; 2001: 674-680.

Victor M, Ropper AH. Diseases of the nervous system due to nutritional deficiency. In: Victor M, Ropper AH, eds. Adams and Victor’s Principles of Neurology. 7th ed. New York: McGraw-Hill; 2001: 1218-1222.

Miller AL. The methylation, neurotransmitter, and antioxidant connections between folate and depression. Altern Med Rev. 2008;13(3):216-26.

Nieoullon A. Dopamine and the regulation of cognition and attention. Proq Neurobiol. 2002;67(1):53-83.