Neuropsychological effects of konzo: A neuromotor disease associated with poorly processed cassava

Michael J. Boivin, Daniel Okitundu, Guy Makila Mabe Bumoko, Marie Therese Sombo, Dieudonne Mumba, Thorkild Tylleskar, Connie F. Page, Jean Jacques Tamfum Muyembe, Desire Tshala-Katumbay

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

BACKGROUND: Konzo is an irreversible upper-motor neuron disorder affecting children dependent on bitter cassava for food. Although the neuroepidemiology of konzo is well characterized, we report the first neuropsychological findings. METHOD: Children with konzo in the Democratic Republic of Congo (mean age 8.7 years) were compared with children without konzo (mean age 9.1 years) on the Kaufman Assessment Battery for Children, second edition (KABC-II), and the Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2). Both groups were also compared with normative KABC measures from earlier studies in a nearby nonkonzo region. RESULTS: Using a Kruskal-Wallis test, children with konzo did worse on the KABC-II simultaneous processing (visual-spatial analysis) (K [1] = 8.78, P = .003) and mental processing index (MPI) (K [1] = 4.56, P = .03) than children without konzo. Both konzo and nonkonzo groups had poorer KABC sequential processing (memory) and MPI relative to the normative group from a nonkonzo region (K [2] = 75.55, P < .001). Children with konzo were lower on BOT-2 total (K [1] = 83.26, P < .001). KABC-II MPI and BOT-2 total were predictive of konzo status in a binary logistic regression model: odds ratio = 1.41, P < .013; 95% confidence interval 1.13-1.69. CONCLUSIONS: Motor proficiency is dramatically affected, and both children with and without konzo have impaired neurocognition compared with control children from a nonoutbreak area. This may evidence a subclinical neurocognitive form of the disease, extending the human burden of konzo with dramatic public health implications.

Original languageEnglish (US)
Pages (from-to)e1231-e1239
JournalPediatrics
Volume131
Issue number4
DOIs
StatePublished - Apr 2013

Keywords

  • Africa
  • Cassava
  • Children
  • Cognitive ability
  • Konzo
  • Memory
  • Motor function
  • Motor neuron disease
  • Neuropsychology

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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    Boivin, M. J., Okitundu, D., Bumoko, G. M. M., Sombo, M. T., Mumba, D., Tylleskar, T., Page, C. F., Muyembe, J. J. T., & Tshala-Katumbay, D. (2013). Neuropsychological effects of konzo: A neuromotor disease associated with poorly processed cassava. Pediatrics, 131(4), e1231-e1239. https://doi.org/10.1542/peds.2012-3011