Neurological, Psychiatric, and Biochemical Aspects of Thiamine Deficiency in Children and Adults

Abstract

Thiamine (vitamin B1) is an essential nutrient that serves as a cofactor for a number of enzymes, mostly with mitochondrial localization. Some thiamine-dependent enzymes are involved in energy metabolism and biosynthesis of nucleic acids whereas others are part of the antioxidant machinery. The brain is highly vulnerable to thiamine deficiency due to its heavy reliance on mitochondrial ATP production. This is more evident during rapid growth (i.e., perinatal periods and children) in which thiamine deficiency is commonly associated with either malnutrition or genetic defects. Thiamine deficiency contributes to a number of conditions spanning from mild neurological and psychiatric symptoms (confusion, reduced memory, and sleep disturbances) to severe encephalopathy, ataxia, congestive heart failure, muscle atrophy, and even death. This review discusses the current knowledge on thiamine deficiency and associated morbidity of neurological and psychiatric disorders, with special emphasis on the pediatric population, as well as the putative beneficial effect of thiamine supplementation in autism spectrum disorder (ASD) and other neurological conditions.

Vitamins and Minerals for Energy, Fatigue and Cognition: A Narrative Review of the Biochemical and Clinical Evidence

“…TPP is involved in dehydrogenase reactions, which result in the decarboxylation of pyruvate and of branched-chain amino acids to form acetyl-CoA (Figure 1, part A). Within the citric acid cycle, TPP supports the decarboxylation of alpha-ketoglutarate into succinyl-CoA [45,46] (Figure 1, part B).…”

Bariatric Surgery in Obesity: Effects on Gut Microbiota and Micronutrient Status

“…Thiamine-dependent enzymes are involved in energy metabolism, biosynthesis of nucleic acids, or antioxidant defense mechanisms. The brain depends upon mitochondrial ATP production and therefore is highly sensitive to thiamine shortages [131]. Low levels of intracellular thiamine are associated with energy failure and increased production of oxygen reactive species.…”

A novel PET tracer 18F-deoxy-thiamine: synthesis, metabolic kinetics, and evaluation on cerebral thiamine metabolism status

“…Thiamine de ciency (TD) is associated with some neuropsychological diseases, such as Wernicke-Korsakoff syndrome, Alzheimer's disease (AD), beriberi, Leigh syndrome, and so forth, and results in lactic acidosis, mitochondrial dysfunction, and energy de cits in brain, muscle, and heart, causing a broad range of clinical manifestations, such as anorexia, agitation, diminished tendon re exes, ataxia, disturbance of consciousness, muscle pain, and heart failure, etc. [2][3][4] Glucose is the predominant substrate of brain energy metabolism and plays a pivotal role in maintaining cerebral function [5], which makes the brain vulnerable to glucose dysmetabolism. TDP is the common coenzyme of the three key enzymes in glucose catabolism: pyruvate dehydrogenase and α-ketoglutarate dehydrogenase in the Krebs cycle that is responsible for producing ATP in mitochondria, and transketolase in pentose phosphate pathway that generates antioxidants and the substrates of biosynthesizing DNA, RNA, and fatty acid in cytosol [6].…”

“…TDP is the common coenzyme of the three key enzymes in glucose catabolism: pyruvate dehydrogenase and α-ketoglutarate dehydrogenase in the Krebs cycle that is responsible for producing ATP in mitochondria, and transketolase in pentose phosphate pathway that generates antioxidants and the substrates of biosynthesizing DNA, RNA, and fatty acid in cytosol [6]. Therefore, the brain also is susceptible to TD by disturbing glucose metabolism [2,[7][8][9][10][11][12] However, in vivo detection of cerebral thiamine metabolism status is still unavailable. In this study, a novel radiotracer of positron emission topography (PET)- 18 F-deoxy-thiamine was designed and synthesized ( Figure 1) and its metabolic kinetics was studied.…”