RESUMO
The acquisition of cognitive, sensory-motor and social emotional functions depend on a proper development of the Central Nervous System (CNS). This set of functions, known as intelligence, allows a better adaptation to the environment. In the last decades, an increase in the average of intelligence has been reported. However, such an increase cannot be observed in an equivalent way in economically and social underprivileged regions. Children from those regions are in great risk of being affected by mental retardation or impaired cognitive development. In later life they will, probably, be unable to transform and improve themselves and their communities, perpetuating the poverty of the region. Therefore, knowledge of factors involved in CNS development is a matter of health closely related to social improvement. Malnutrition throughout pregnancy and breastfeeding is clearly identifiable as a cause of damage in CNS development. Vitamin B1 (Thiamine) is a micronutrient important to the growth and maturity of the CNS. Thiamine shortcoming may affect 50% of pregnant women. Thiamine function in cerebral development is still not well known. There is a gap in the literature regarding systematical research about the blood thiamine concentration throughout the periods of gestation and breastfeeding. These studies are relevant in populations with a high level of nutritional vulnerability, because in a follow up offspring cognitive exam they could reveal if the maternal thiamine deficiency is related to child CNS impairment. This paper introduce the hypothesis that thiamine shortcoming during pregnancy and breastfeeding is directly related to cognitive impairment of child. Data about the neurophysiological role of thiamine, consequences of its shortcoming in experimental models, populations under the risk of thiamine shortcoming are presented. The hypothesis that maternal thiamine shortcoming causes damage related to child cognitive development needs to be considered. Thus, thiamine shortcoming during gestation and breastfeeding and its effects on children must be studied in many populations in order to know the magnitude of the problem and to indicate actions to overcome it.
Assuntos
Transtornos Cognitivos/etiologia , Pobreza , Efeitos Tardios da Exposição Pré-Natal/fisiopatologia , Deficiência de Tiamina/complicações , Sistema Nervoso Central/metabolismo , Feminino , Humanos , Gravidez , Tiamina/metabolismoRESUMO
Persistent developmental stuttering (PDS) is a common disorder of speech with no identifiable cause. Psychiatric disorders appear to be related and influence clinical manifestation of PDS. In this case report, we present the clinical evolution of 1 PDS patient submitted to pharmacological treatment with fluoxetine and speech therapy intervention. At the end of 12 weeks of treatment, she evolved from 28 at Beck Depression Inventory; 32 in the Hamilton Scale for Anxiety; 43 and 47, respectively, in the anxiety and avoidance components of the Liebowitz Social Anxiety Scale; and severe speech impairment according Iowa Scale, to 12 at Beck Depression Inventory; 8 at Hamilton Scale for Anxiety; 25 and 21 at Liebowitz Social Anxiety Scale anxiety and avoidance components, respectively; and moderate speech impairment. Diagnosing and treating psychiatric symptoms in addition to speech therapy appears to be the best therapeutic approach.