Estimation of Serum Neurokinin A Level in Correlation to Visual Evoked Potentials and Morphological Brain Changes in Malnourished Children: A Follow-Up Case-Control Study

Title: Estimation of Serum Neurokinin A Level in Correlation to Visual Evoked Potentials and Morphological Brain Changes in Malnourished Children: A Follow-Up Case-Control Study

Authors: Enas Mahmoud Hassan, Laila Elmorsi Aboul-Fotoh Elmorsi, Doaa Mohamed Mahrous, Aliaa Monir Higazi, Gihan Mohamed Bebars, Mahmoud Mounir Higazi

DOI: https://dx.doi.org/10.18535/jmscr/v4i10.67

Abstract

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Corresponding Author

Abstract

Aim: To investigate the effects of protein energy malnutrition (PEM) on the developing brain and to show the association between these changes and neurokinin A (NKA) levels .Re-evaluation after treatment was done.

Methods: A prospective case control study including 30 children with PEM plus 30 healthy age and sex matched controls was planned. Clinical examination along with laboratory measurement of albumin, iron, ferritin and NKA levels were done for all participants. Visual evoked potential (VEPs) and brain MRI were performed. Investigations were repeated after treatment and compared with previous data.

Results: Significant reduction in serum NKA levels of malnourished children was reported. NKA levels were associated negatively with significant latencies in VEPs at P2-N2 in Oz and Cz but positively at P2-N2 amplitudes inO₁, Oz and Cz within PEM group compared to controls. Malnourished children mostly showed grade 2 brain atrophy, with significant negative correlation between NKA levels and degree of brain atrophy. Nutritional rehabilitation was associated with increased NKA levels and significant improvement in both VEPs and brain atrophy.

Conclusion: PEM during early infancy significantly affects the developing central nervous system (CNS) in the form of morphological brain atrophy and altered neurophysiological function. These PEM-induced brain changes seem to be reversible thus malnutrition should be detected and treated early to prevent permanent CNS damage. As well, we shed new lights on NKA deficiency within these patients that may play a potential role in the etiological basis for PEM-induced brain atrophy in addition to the resultant functional disorders. Further extended researches are required to validate this tachykinin as a new alarm in early screening for the development of brain harms in PEM children within poor districts. Also, this may be helpful in predicting the prognosis of such patients.

Keywords: protein energy malnutrition (PEM); neurokinin A (NKA); visual evoked potential (VEPs); brain magnetic resonance imaging (MRI).

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