Abstract
INTRODUCTION: Neuroimaging studies have shown activation of a network during executive control tasks that usually includes the anterior cingulate area, prefrontal cortex, and the basal ganglia. Since dopamine levels are higher in the striatum, and the caudate nucleus is strongly involved in the connections between the prefrontal cortex and the caudate nucleus, it is conceivable that alterations in dopaminergic systems would affect executive functions. Given the well-established links between iron-deficiency anemia (IDA) and impaired dopaminergic function in animal models, added to the evidence that IDA during early infancy is associated with lasting neurofunctional, sensory and cognitive effects, we evaluated the potential effects of early IDA on executive functions in childhood. The performance of the Stroop test, a task that usually explores the networks of executive functions, was assessed in a group of former IDA children. The Stroop–like test adapted for children was applied to a group of healthy 5 year-old Chilean children who had been treated for IDA (former IDA: FIDA, n=19) or were nonanemic (nonFIDA, n=19) in infancy. The task requires memorizing two instructions and inhibiting the usual, everyday responses to them. Two sets of 16 cards were used and subjects were instructed to say “day” when shown the night card and “night” when shown the day one (conflict condition), or to give the logical response (no-conflict condition). The second set of cards suggested neither day nor night, and children were instructed to say “day” for one and “night” for the other (control condition). RESULTS: Performance was similar in both the no-conflict and control condition tasks regardless of FIDA or nonFIDA history (90% and 91%, respectively). However, the accuracy of FIDA children in the conflict condition (85%) was significantly lower compared to nonFIDA (91%) (p<0.0007). CONCLUSIONS: These results indicate that FIDA children have lower scores in executive functions as assessed through the Stroop test, and emphasize the lasting effects of early IDA on cognitive development. Since the networks involved in these processes are important not only for cognition but also for the regulation of social behavior, we suggest that delayed development in executive functions may well represent a contributing factor to altered developmental outcome in formerly IDA children.
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Algarñn, C., Peirano, P., Regeasse, M. et al. Iron Deficiency Anemia in Infancy Affects the Performance of Executive Functions in Childhood. Pediatr Res 53, 872 (2003). https://doi.org/10.1203/00006450-200305000-00047
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DOI: https://doi.org/10.1203/00006450-200305000-00047