Executive functions and associated brain volumetry in children with persistent stunting and catch-up growth

Abstract Early childhood stunting can result in sub-optimal executive functions (EF), affecting academic achievements and economic potential in later life. This study hypothesized that children always stunted (AS) at ages 2, 5 and 9 years had lower EF than those who were never stunted (NS). A birth-...

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Main Authors: Beena Koshy, Vedha Viyas Thilagarajan, Roshan S. Livingstone, Manikandan Srinivasan, Venkata Raghava Mohan, Rachel Beulah, Anitha Jasper, Sushil John, Gagandeep Kang
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Language:English
Published: Nature Portfolio 2025-04-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-98238-y
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author Beena Koshy
Vedha Viyas Thilagarajan
Roshan S. Livingstone
Manikandan Srinivasan
Venkata Raghava Mohan
Rachel Beulah
Anitha Jasper
Sushil John
Gagandeep Kang
author_facet Beena Koshy
Vedha Viyas Thilagarajan
Roshan S. Livingstone
Manikandan Srinivasan
Venkata Raghava Mohan
Rachel Beulah
Anitha Jasper
Sushil John
Gagandeep Kang
author_sort Beena Koshy
collection DOAJ
description Abstract Early childhood stunting can result in sub-optimal executive functions (EF), affecting academic achievements and economic potential in later life. This study hypothesized that children always stunted (AS) at ages 2, 5 and 9 years had lower EF than those who were never stunted (NS). A birth-cohort in Vellore, India was followed up with periodic anthropometric and development/cognitive measures over 2, 5 and 9 years of age. Based on stunting status at these time points, children were classified as NS, stunted at 2 years and caught up by 5 years (S2N5), stunted at 2 and 5 years but caught up later (S5N9), and AS. At 9th year, children underwent neuroimaging using 3T MRI scanner and EF assessment using FAS phonemic fluency test, colour cancellation test and colour trials tests (CTT). From the original birth-cohort of 251, 205 children were reviewed at 9 years. FAS phonemic fluency test showed NS group had significantly higher test scores compared to AS (11.52 vs. 7.4, p = 0.02). In CTT, a significant difference in near misses score was observed between NS and AS groups (0.12 vs. 0.38, p = 0.03). Upon evaluating unimodal brain association areas, volumes of right occipital fusiform gyrus (9991 mm3 vs. 9313 mm3; p = 0.04; η2 = 0.11), and left lateral occipital cortex (13458 mm3 vs. 12559 mm3; p = 0.03; η2 = 0.07) were significantly higher among NS compared to AS group. Considering higher order association areas, only left pars triangularis was found to be significantly reduced among AS children compared to NS group (4284 mm3 vs. 3291 mm3; p = 0.01; η2 = 0.07). Similarly, there were also significance visible in the basal ganglia regions and the cerebellum. Current study demonstrated EF dysfunction in verbal fluency and inhibitory control in a dose response fashion in groups AS-to-NS with corresponding EF-related brain volumetric changes, highlighting the need for focused nutritional and nurturing approaches in early childhood for gain in human capital.
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spelling doaj-art-85d19d7dddbf485f93f91b93fb8e802e2025-08-20T03:14:09ZengNature PortfolioScientific Reports2045-23222025-04-011511910.1038/s41598-025-98238-yExecutive functions and associated brain volumetry in children with persistent stunting and catch-up growthBeena Koshy0Vedha Viyas Thilagarajan1Roshan S. Livingstone2Manikandan Srinivasan3Venkata Raghava Mohan4Rachel Beulah5Anitha Jasper6Sushil John7Gagandeep Kang8Developmental Paediatrics, Christian Medical CollegeDevelopmental Paediatrics, Christian Medical CollegeLow Cost Effective Care Unit, Christian Medical CollegeWellcome Trust Research Laboratory, Christian Medical CollegeDepartment of Community Health, Christian Medical CollegeDevelopmental Paediatrics, Christian Medical CollegeDepartment of Radiodiagnosis, Christian Medical CollegeLow Cost Effective Care Unit, Christian Medical CollegeDepartment of Community Health, Christian Medical CollegeAbstract Early childhood stunting can result in sub-optimal executive functions (EF), affecting academic achievements and economic potential in later life. This study hypothesized that children always stunted (AS) at ages 2, 5 and 9 years had lower EF than those who were never stunted (NS). A birth-cohort in Vellore, India was followed up with periodic anthropometric and development/cognitive measures over 2, 5 and 9 years of age. Based on stunting status at these time points, children were classified as NS, stunted at 2 years and caught up by 5 years (S2N5), stunted at 2 and 5 years but caught up later (S5N9), and AS. At 9th year, children underwent neuroimaging using 3T MRI scanner and EF assessment using FAS phonemic fluency test, colour cancellation test and colour trials tests (CTT). From the original birth-cohort of 251, 205 children were reviewed at 9 years. FAS phonemic fluency test showed NS group had significantly higher test scores compared to AS (11.52 vs. 7.4, p = 0.02). In CTT, a significant difference in near misses score was observed between NS and AS groups (0.12 vs. 0.38, p = 0.03). Upon evaluating unimodal brain association areas, volumes of right occipital fusiform gyrus (9991 mm3 vs. 9313 mm3; p = 0.04; η2 = 0.11), and left lateral occipital cortex (13458 mm3 vs. 12559 mm3; p = 0.03; η2 = 0.07) were significantly higher among NS compared to AS group. Considering higher order association areas, only left pars triangularis was found to be significantly reduced among AS children compared to NS group (4284 mm3 vs. 3291 mm3; p = 0.01; η2 = 0.07). Similarly, there were also significance visible in the basal ganglia regions and the cerebellum. Current study demonstrated EF dysfunction in verbal fluency and inhibitory control in a dose response fashion in groups AS-to-NS with corresponding EF-related brain volumetric changes, highlighting the need for focused nutritional and nurturing approaches in early childhood for gain in human capital.https://doi.org/10.1038/s41598-025-98238-yChildhood stuntingCatch-up growthExecutive functionsBrain volumetryMagnetic resonance imaging
spellingShingle Beena Koshy
Vedha Viyas Thilagarajan
Roshan S. Livingstone
Manikandan Srinivasan
Venkata Raghava Mohan
Rachel Beulah
Anitha Jasper
Sushil John
Gagandeep Kang
Executive functions and associated brain volumetry in children with persistent stunting and catch-up growth
Scientific Reports
Childhood stunting
Catch-up growth
Executive functions
Brain volumetry
Magnetic resonance imaging
title Executive functions and associated brain volumetry in children with persistent stunting and catch-up growth
title_full Executive functions and associated brain volumetry in children with persistent stunting and catch-up growth
title_fullStr Executive functions and associated brain volumetry in children with persistent stunting and catch-up growth
title_full_unstemmed Executive functions and associated brain volumetry in children with persistent stunting and catch-up growth
title_short Executive functions and associated brain volumetry in children with persistent stunting and catch-up growth
title_sort executive functions and associated brain volumetry in children with persistent stunting and catch up growth
topic Childhood stunting
Catch-up growth
Executive functions
Brain volumetry
Magnetic resonance imaging
url https://doi.org/10.1038/s41598-025-98238-y
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