Neuropsychological Effects of Konzo: A Neuromotor Disease Associated With Poorly Processed Cassava

Boivin, Michael J.; Okitundu, Daniel; Bumoko, Guy Makila Mabe; Sombo, Marie Thérèse; Mumba, Dieudonné; Tylleskär, Thorkild; Page, Connie; Muyembe, Jean Jacques; Tshala-Katumbay, Desiré

doi:10.1542/peds.2012-3011

Cited by 62 publications

(100 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a recent epidemiological survey in the Democratic Republic of Congo (DRC), we confirmed that outbreaks of konzo were associated with poor socioeconomic status, malnourishment, and reliance on insufficiently processed cyanogenic cassava as main source of food (Bonmarin et al, 2002, Boivin et al, 2013). For the first time, we showed that children with konzo had poor cognition relative to those without konzo and recruited from the same study population.…”

Section: Introductionsupporting

confidence: 55%

Determinants of cognitive performance in children relying on cyanogenic cassava as staple food

et al. 2014

View full text Add to dashboard Cite

Background While risk factors for konzo are known, determinants of cognitive impairment in konzo-affected children remain unknown. Method We anchored cognitive performance (KABC-II scores) to serum levels of free-thyroxine (free-T4), thyroid-stimulating hormone (TSH), albumin, and motor proficiency (BOT-2 scores) in 40 children including 21 with konzo (median age: 9 years) and 19 without konzo (median age: 8 years). A multiple regression model was used to determine variables associated with changes in KABC-II scores. Results Age (β: − 0.818, 95%CI: − 1.48, − 0.152) (p=0.018), gender (β: − 5.72; 95% CI: − 9.87, −1.57 for females) (p=0.009), BOT-2 score (β: 0.390; 95% CI: 0.113, 0.667) (p=0.008), and free-T4 (β: 1.88; 95% CI: 0.009, 3.74) (p=0.049) explained 61.1% of variation in KABC-II scores. Subclinical hypothyroidism was not associated with poor cognition. A crude association was found between serum albumin and KABC-II scores (β: 1.26; 95% CI: 0.136, 2.39) (p=0.029). On spot urinary thiocyanate reached 688 μmol/l in children without konzo and 1032 μmol/L in those with konzo. Conclusion Female gender and low serum albumin are risk factors common to cognitive and proportionally associated motor deficits in children exposed to cassava cyanogens. The two types of deficits may share common mechanisms.

show abstract

Section: Introductionsupporting

confidence: 55%

Determinants of cognitive performance in children relying on cyanogenic cassava as staple food

et al. 2014

View full text Add to dashboard Cite

show abstract

“…A detailed description of the study population including children with konzo (N = 123) or without the disease (N = 87; gender and tentatively age-matched to those with konzo) has been provided in a previous publication by our study group (7). Children with the diagnosis of konzo had to fulfil the WHO criteria for the disease i.e.…”

Section: Methodsmentioning

confidence: 99%

“…All study participants were subjected to neuropsychological testing using the Kaufman Assessment Battery for Children, 2 nd edition (KABC-II) for cognition and the Bruininks/Oseretsky Test, 2 nd Edition (BOT-2) measure for motor proficiency as previously described (7). Both the KABC-II and BOT-2 composite scores are used as outcomes measures in the present study, along with the disease status and severity according the WHO criteria for the definition of konzo (11).…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Lower serum levels of selenium, copper, and zinc are related to neuromotor impairments in children with konzo

Bumoko

Sadiki

Rwatambuga

et al. 2015

Journal of the Neurological Sciences

View full text Add to dashboard Cite

We assessed the relationship between key trace elements and neurocognitive and motor impairments observed in konzo, a motor neuron disease associated with cassava cyanogenic exposure in nutritionally challenged African children. Serum concentrations of iron, copper, zinc, selenium, and neurotoxic lead, mercury, manganese, cadmium, and cobalt were measured in 123 konzo children (mean age 8.53 years) and 87 non-konzo children (mean age 9.07 years) using inductively coupled plasma mass spectrometry (ICPMS). Concentrations of trace elements were compared and related to performance scores on the Kaufman Assessment Battery for Children, 2nd edition (KABC-II) for cognition and Bruininks-Oseretsky Test, 2nd edition (BOT-2) for motor proficiency. Children with konzo had low levels of selenium, copper, and zinc relative to controls. Selenium concentration significantly correlated with serum 8,12-iso-iPF2α-VI isoprostane (spearman r = 0.75, p < 0.01) and BOT-2 scores (r = 0.31, p = 0.00) in children with konzo. Elemental deficiency was not associated with poor cognition. Mean (SD) urinary levels of thiocyanate were 388.03 (221.75) μmol/l in non-konzo compared to 518.59 (354.19) μmol/l in konzo children (p < 0.01). Motor deficits associated with konzo may possibly be driven by the combined effects of cyanide toxicity and Se deficiency on prooxidant mechanisms. Strategies to prevent konzo may include dietary supplementation with trace elements, preferentially, those with antioxidant and cyanide-scavenging properties.

show abstract

“…Studies have recently documented neurocognitive impairments in children with konzo. Furthermore, even children who do not show signs of konzo, but who live in konzo-affected households may have neurocognitive impairment of working memory and learning ability 55 . Konzo offers an important opportunity for integrative neurodevelopmental science.…”

Section: Food-borne Neurotoxins and Nutritional Malabsorptionmentioning

confidence: 99%

Reducing neurodevelopmental disorders and disability through research and interventions

Boivin

Kakooza

Warf

et al. 2015

Nature

Self Cite

126

View full text Add to dashboard Cite

Neuropsychological Effects of Konzo: A Neuromotor Disease Associated With Poorly Processed Cassava

Cited by 62 publications

References 27 publications

Determinants of cognitive performance in children relying on cyanogenic cassava as staple food

Determinants of cognitive performance in children relying on cyanogenic cassava as staple food

Lower serum levels of selenium, copper, and zinc are related to neuromotor impairments in children with konzo

Reducing neurodevelopmental disorders and disability through research and interventions

Contact Info

Product

Resources

About