P300, a tool for cognitive assessment in women with iron deficiency anemia: A systematic review

Iron-deficiency anemia (IDA) is a common nutritional disorder and an important risk factor for the development of mild cognitive impairment that may progress to dementia, if untreated. The anemic status due to iron deficiency (ID) alters the electrogenesis in the central nervous system. P300 is a cognitive evoked potential (CEP) used as an objective tool to assess cognitive function. Mild cognitive impairment is indicated by prolonged P300 wave latency and reduced amplitude. IDA is highly prevalent among women particularly in the reproductive phase and data on cognitive assessment using P300 in them are sparse. This review aims to analyze the evidence from recent literature regarding the effect of IDA on evoked potentials like P300 in women. A systematic literature review was conducted and databases, like PubMed, Medline, Scopus, and Google Scholar, were searched for studies from the last 20 years. We selected research papers that compared P300 between anemic women and controls of the same age, and evaluated the effects of iron supplementation on P300 in anemic women. Based on the inclusion criteria, three studies were found. The studies demonstrated impaired P300 potentials in anemic women that improved following iron supplementation. Promoting screening of anemic women with P300 aids in the early detection of subclinical cognitive decline. Ensuring adequate iron treatment can prevent mild cognitive impairment from progressing to severe forms like dementia and other neuropsychological disorders. Further studies utilizing P300 as a cognitive tool need to be encouraged to establish definite conclusions regarding its efficacy in detecting cognitive dysfunctions in anemia

Cognitive Evoked Potentials in Anaemic Women: A Cross-sectional Study

Introduction: Iron Deficiency Anaemia (IDA) is a globally prevalent nutritional disorder and an important risk factor for the development of Mild Cognitive Impairment (MCI). A manifestation of IDA is altered electrogenesis in the central nervous system. As women of reproductive age are more susceptible to this form of anaemia, it is important to assess their cognitive function. Auditory cognitive evoked potentials/ P300 are sensitive in detecting MCI which is indicated by prolonged latency and reduced amplitude. Aim: To investigate the effect of IDA on cognitive function using cognitive evoked potentials/P300 in neurologically intact women. Materials and Methods: A cross-sectional study was conducted at the Central Neurophysiology Laboratory, Acharya Vinobha Bhave Rural hospital (AVBRH) attached to Jawaharlal Nehru Medical College (JNMC), Wardha, Maharashtra, India, from January 2018 to February 2022. A total of 260 women were recruited for the study. Based on their blood haemoglobin and serum ferritin levels, 130 women were grouped as anaemic and 130 as non anaemic. The P300 was used as an objective tool to assess cognitive function. Haematological parameters like blood haemoglobin and serum ferritin levels were compared (‘t’- test) and correlated (Spearman’s correlation) with the latency and amplitude of the P300 wave in the two groups. Results: The mean age (years) and Body Mass Index (BMI) (kg/m2) of anaemic women were 23.88±3.67 and 20.98±1.45, respectively; and that of non anaemic women were 24.09±3.41, and 21.25±1.27 (p>0.05) respectively. The blood haemoglobin (mg/dL) and serum ferritin (ng/mL) were significantly (p<0.001) lower in anaemic group (10.37±0.95, 8.55±3.78) compared to non anaemic group (13.02±0.70, 27.61±10.52). The latency of P300 wave (ms) was significantly prolonged (p<0.001) in anaemic women (317.75±7.34) in comparison to non anaemic women (311.71±9.02), while the P300 amplitude did not differ between the two groups (p>0.05). A highly significant low negative correlation of P300 latency with haemoglobin (r=-0.48, p<0.001) and highly significant moderate negative correlation with serum ferritin (r=-0.55, p<0.001) was observed. And a negligible positive correlation of P300 amplitude with haemoglobin (r=0.26, p<0.05) and serum ferritin (r=0.24, p<0.05) was observed. Conclusion: Cognitive evoked potential is an objective method that aids in the early detection of cognitive impairment. Evaluating the cognitive function in anaemic women and ensuring adequate iron treatment can prevent MCI from progressing to severe forms like dementia and other neuropsychological disorders