Skip to main content
SpringerLink
Log in

Brain MRI and MR Spectroscopy Findings in Children with Nutritional Vitamin B12 Deficiency

  • Original Article
  • Published:
Clinical Neuroradiology Aims and scope Submit manuscript

Abstract

Introduction

Our aim in this study was to analyze the findings of brain magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) of children with vitamin B12 deficiency.

Methods

This study included 14 cases. The findings of brain MRI and MRS in all cases were investigated. Four patients had been followed up and mean follow-up time 71.8 (59–85) day.

Results

Eight patients of the cases (57 %) had at least one abnormal MRI finding. The most commonly found MRI findings were thinning of the corpus callosum and brain atrophy, respectively. The mean ratio of NAA/Cr and Cho/Cr were measured in MRS, with values of 1.31 ± 0.17 and 1.04 ± 0.27, respectively. In two of three patients with abnormal MRI studies at presentation, subsequent MRI showed improvement while one patient remained unchanged. An increase in the ratios of metabolites were found in one case with control MRS. There was no lactate peak.

Conclusion

Brain MRI was abnormal in more than half of the cases of children with vitamin B12 deficiency. Our radiologic findings similar with literature. There was no identifiable lactate peak. B12 deficiency could be the cause of the thinning of the corpus callosum and brain atrophy in the children that were given a brain MRI.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Black MM. Effects of vitamin B12 and folate deficiency on brain development in children. Food Nutr Bull. 2008;29(Suppl 2):S126–31.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Emadfa I, Singer I. Vitamin B-12 and homocysteine status among vegetarians: a global perspective. Am J Clin Nutr. 2009;89(Suppl):1693S–8S.

    Article  Google Scholar 

  3. Korenke GC, Hunneman DH, Eber S, Hanefeld F. Severe encephalopathy with epilepsy in an infant caused by subclinical maternal pernicious anaemia: case report and review of the literature. Eur J Pediatr. 2007;163:196–201.

    Article  Google Scholar 

  4. Taşkesen M, Yaramış A, Pirinçcioglu AG, Ekici F. Cranial magnetic resonance imaging findings of nutritional B(12) deficiency in 15 hypotonic infants. Eur J Paediatr Neurol. 2011;16:266–70.

    Article  PubMed  Google Scholar 

  5. Honzik T, Adamovicova M, Smolka V, Magner M, Hruba E, Zeman J. Clinical presentation and metabolic consequences in 40 breastfed infants with nutritional vitamin B12 deficiency—what have we learned? Eur J Paediatr Neurol. 2010;14:488–95.

    Article  PubMed  Google Scholar 

  6. Ertaş T, Koç A, Koçyiğit A, Baz T. Bebeklerin nöro-motor, sosyal ve fiziksel gelişmeleri üzerine B12 vitamini eksikliğinin etkileri. Çocuk Sağlığı ve Hastalıkları Derg. 2011;54:62–9.

    Google Scholar 

  7. Katar S, Nuri Ozbek M, Yaramis A, Ecer S. Nutritional megaloblastic anemia in young Turkish children is associated with Vitamin B-12 deficiency and psychomotor retardation. J Pediatr Hematol Oncol. 2006;28:559–62.

    Article  CAS  PubMed  Google Scholar 

  8. Von Schenck U, Gotze CB, Koletzko B. Persistence of neurological damage induced by dietary vitamin B12 deficiency in infancy. Arch Dis Child. 1997;77:137–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Hajek M, Dezortova M. Introduction to clinical in vivo MR spectroscopy. Eur J Radiol. 2008;67:185–93.

    Article  PubMed  Google Scholar 

  10. Kosucu P, Erdemli S, Sonmez M, Kul S, Aksoy A. MR spectroscopic evaluation of psychomotor delay of unknown cause in children. AJR Am J Roentgenol. 2010;94:1110–5.

    Article  Google Scholar 

  11. Horstmann M, Neumaier-Probst E, Lukacs Z, Steinfeld R, Ullrich K, Kohlschutter A. Infantile cobalamin deficiency with cerebral lactate accumulation and sustained choline depletion. Neuropediatrics. 2003;34:261–4.

    Article  CAS  PubMed  Google Scholar 

  12. Barkovich AJ, Kjos BO. Normal postnatal development of the corpus callosum as demonstrated by MR imaging. AJNR Am J Neuroradiol. 1998;9:487–91.

    Google Scholar 

  13. Barkovich AJ. Normal development of the neonatal and infant brain, skull and spine. In:Barkovich AJ, editor. Pediatric neuroimaging, 4th ed. Philadelphia: Lippincott Williams and Wilkins; 2005. pp. 17–75.

    Google Scholar 

  14. Lövblad K, Ramelli G, Remonda L, Nirkko AC, Ozdoba C, Schroth G. Retardation of myelination due to dietary vitamin B12 deficiency: cranial MRI findings. Pediatr Radiol. 1997;27:155–8.

    Article  PubMed  Google Scholar 

  15. Graham SM, Arvela OM, Wise GA. Long-term neurological consequences of nutritional VB12 deficiency in infants. J Pediatr. 1992;121:710–4.

    Article  CAS  PubMed  Google Scholar 

  16. Dror DK, Allen LH. Effect of vitamin B12 deficiency on neurodevelopment in infants: current knowledge and possible mechanisms. Nutr Rev. 2008;66:250–5.

    Article  PubMed  Google Scholar 

  17. Lam WW, Wang ZJ, Zhao H, Berry GT, Kaplan P, Gibson J, Kaplan BS, Bilaniuk LT, Hunter JV, Haselgrove JC, Zimmermann RA. 1H MR spectroscopy of the basal ganglia in childhood: a semiquantitative analysis. Neuroradiology. 1998;40:315–23.

    Article  CAS  PubMed  Google Scholar 

  18. Filippi CG, Ulug AM, Deck MD, Zimmerman RD, Heier LA. Developmental delay in children: assessment with proton MR spectroscopy. AJNR Am J Neuroradiol. 2002;23:882–8.

    PubMed  Google Scholar 

  19. Kreis R, Ernst T, Ross BD. Development of the human brain: in vivo quantification of metabolite and water content with proton magnetic resonance spectroscopy. Magn Reson Med. 1993;30:424–37.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, School of Medicine, Dicle University, Radyoloji AD, 21280, Diyarbakir, Turkey

    F. Ekici MD, G. Tekbas MD, S. Hattapoğlu MD, H. Önder MD & A. Bilici MD

  2. Department of Pediatric Neurology, School of Medicine, Dicle University, 21280, Diyarbakir, Turkey

    A. Yaramış MD

Authors
  1. F. Ekici MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. Tekbas MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. Hattapoğlu MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Yaramış MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. H. Önder MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A. Bilici MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to F. Ekici MD.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ekici, F., Tekbas, G., Hattapoğlu, S. et al. Brain MRI and MR Spectroscopy Findings in Children with Nutritional Vitamin B12 Deficiency. Clin Neuroradiol 26, 215–220 (2016). https://doi.org/10.1007/s00062-014-0351-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00062-014-0351-1

Keywords

Search

Navigation