Association between fat-soluble nutrient status and auditory and visual related potentials in newly diagnosed non-screened infants with cystic fibrosis: A case-control study

Abstract Background : Nutritional deficiencies often precede the diagnosis of cystic fibrosis (CF) in infants, and occur at a stage where the rapidly developing brain is more vulnerable to insult. While deficits in behavioral, cognitive development and social functioning have been reported in older CF children, their origins remain poorly understood. We seek to compare fat-soluble nutrient status of newly diagnosed non-screened infants with CF to that of healthy infants, and explore the association with neurodevelopment evaluated by electroencephalography(EEG). Methods : Serum vitamin A, E, D and K, red blood cell fatty acid levels, resting-state EEG, and event-related potentials (auditory and visual) were measured in CF infants (n = 5) with pancreatic insufficiency (PI) prior to the initiation of any treatment. Healthy age-matched infants (n = 30-31) served as controls. Results : CF infants had lower levels of all fat-soluble vitamins and docosahexaenoic acid(DHA) compared to controls. Auditory evoked potentialresponses (P2 and N2 amplitudes) were higher in CF compared to controls whereas the visual components did not differ between groups. DHA levels were correlated with auditory P2 amplitude (r = -0.730; p Conclusions : Newly diagnosed non-screened CF infants with PI showed alterations in sensory responses mimicking an immature auditory processing. The role of lower DHA status as a potential contributing factor warrants further investigation. As CF neonatal screeningbecomes widespread, this study emphasizes the importance of early nutritional intervention and neurodevelopmental follow-up in CF newborns to protect brain development. Summary Nutritional deficiencies often precede the diagnosis of cystic fibrosis (CF) in infants, and occur at a stage where the rapidly developing brain is more vulnerable to insult. We aim to compare fat-soluble nutrient status of newly diagnosed non-screened infants with CF to that of healthy infants, and explore the association with neurodevelopment evaluated by electroencephalography(EEG). Our results show that CF infants had lower levels of all fat-soluble vitamins and docosahexaenoic acid(DHA) compared to controls. The auditory evoked potentialresponses were higher in CF compared to controls whereas the visual components did not differ between groups. DHA levels were correlated with auditory evoked potentialresponses. Although resting state frequency power was similar between groups, we observed a negative correlation between DHA levels and low frequencies. This study emphasizes the need for long-term neurodevelopmental follow-up of CF infants and pursuing intervention strategies in the future.