Published online August 1, 2007
PEDIATRICS Vol. 120 No. 2 August 2007, pp. e336-e345 (doi:10.1542/peds.2006-2525)
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ARTICLE

An Event-Related Potential Study of Attention and Recognition Memory in Infants With Iron-Deficiency Anemia

Matthew J. Burden, PhDa, Alissa J. Westerlund, BAb, Rinat Armony-Sivan, PhDc, Charles A. Nelson, PhDb, Sandra W. Jacobson, PhDa, Betsy Lozoff, MDd, Mary Lu Angelilli, MDe and Joseph L. Jacobson, PhDa,f

a Departments of Psychiatry and Behavioral Neurosciences
e Pediatrics
f Obstetrics/Gynecology, Wayne State University School of Medicine, Detroit, Michigan
b Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
c Department of Pediatrics, Shaare-Zedek Medical Center, Jerusalem, Israel
d Center for Human Growth and Development and Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan

OBJECTIVES. The purpose of this work was to determine whether iron-deficiency anemia in infancy represents a risk factor for deficits in attention and memory development using event-related potentials.

METHODS. Artifact-free event-related potential data were obtained at 9 and/or 12 months from 15 infants with iron-deficiency anemia and 19 who were iron sufficient during a test of the infant's ability to discriminate a highly familiar stimulus, the mother's face, from a stranger's face.

RESULTS. A midlatency negative component associated with attention and a late-occurring positive slow wave associated with memory updating were identified at both ages in the iron-deficiency anemia and iron-sufficient groups. Consistent with the age-appropriate pattern of development at 9 months, the iron-sufficient group showed a greater attentional response (negative component) to the mother and a greater updating of memory for the stranger (positive slow wave). This pattern of responses was not evident in the iron-deficiency anemia group until 12 months, suggesting a delay in cognitive development.

CONCLUSIONS. These data suggest that iron-deficiency anemia adversely affects the allocation of neurophysiologic resources to attention and recognition memory during the processing of information about familiar and unfamiliar stimuli. This delay in cognitive development may reflect alterations in efficiency of central nervous system functions that seem related to early iron deficiency.

Key Words: infant • iron-deficiency anemia • event-related potentials • attention • memory

Abbreviations: IDA—iron-deficiency anemia • ID—iron deficiency • IS—iron sufficiency • Hb—hemoglobin • ERP—event-related potential • NC—negative component • PSW—positive slow wave • EOG—electrooculogram

Accepted Jan 29, 2007.