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THE ELEMENTAL COMPOSITION OF THE HAIR OF CHILDREN DIAGNOSED WITH CEREBRAL PALSY
- Authors: Larionova T.K.1, Daukaev R.A.1, Shaikhlislamova E.R.1, Larionova A.N.2, Aukhadieva E.A.2, Allayarova G.R.2, Adieva G.F.2, Zelenkovskaya E.E.2
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Affiliations:
- Ufa Research Institute of Occupational Health and Human Ecology
- Scientific and Practical Center of Child Psychoneurology of the Department of Health of the City of Moscow, Moscow, Russia Federation
- Section: ORIGINAL STUDY ARTICLES
- Submitted: 17.12.2024
- Accepted: 21.04.2025
- Published: 27.04.2025
- URL: https://hum-ecol.ru/1728-0869/article/view/643109
- DOI: https://doi.org/10.17816/humeco643109
- ID: 643109
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Abstract
BACKGROUND: The risk of developing various pathologies in children, including diseases of the nervous system, is often associated with a violation of mineral metabolism in the body, as macro- and micro-elements play an important role in maintaining the activity of the central and autonomic nervous systems. An imbalance of elements in a child's body may be both a consequence of abnormal intrauterine development and due to external environmental factors.
AIM: To analyze and assess the elemental composition of hair in children with cerebral palsy.
MATERIAL AND METHOD: A selective cohort study of 93 children aged 3-6 years was conducted. All the examined were divided into two groups: the main group, which included children with an established diagnosis of cerebral palsy (spastic diplegia), and a control group. To assess elemental status by atomic absorption spectrometry, 14 chemical elements were identified in hair samples.
RESULTS: Elemental homeostasis in children diagnosed with cerebral palsy was impaired both in terms of essential and conditionally essential elements and toxic ones. In children of the main group's hair, levels of manganese, chromium, nickel, and lead were significantly increased relative to the upper limit of the reference range and indicators of the control group, while there was a significant decrease in selenium concentration relative to lower limits of norm and indicators for the control group (by 46 and 20 times) (p<0,05).
CONCLUSION: The study of the elemental composition of hair can be used as an additional test for diagnosing diseases of the nervous system in children and for prescribing additional medications to correct mineral metabolism.
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JUSTIFICATION
The study of the imbalance of macro- and microelements in various diseases, the development of rehabilitation systems by correcting elemental homeostasis is a very important task of preventive medicine. Numerous studies conducted in recent years by both Russian and foreign scientists have shown that the risk of developing various pathologies is often associated with a violation of mineral metabolism in the body. Macro- and microelements play an important role in ensuring the activity of the central and autonomic nervous system [1-5]. An elemental imbalance in the child's body can be both a consequence of abnormalities of intrauterine development, and associated with external environmental influences and irrational nutrition [6-10].
The formation of children's health disorders in the perinatal period is mainly associated with conditions that occur in the mother during pregnancy, and may be due to the influence of the maternal organism on the fetus and pollution of environmental objects [11, 12]. Some elements have the ability to penetrate the placental barrier. Placentas of women living in conditions of increased atmospheric pollution have signs of suppression of compensatory and adaptive mechanisms. In the research of A.A. Aghajanyan, A.V. Rocky (Agajanyan N.A., Skalny A.V.)[13] it was shown that by the concentration of many metals in the mother's hair, it is possible to reliably judge the elemental status of a newborn and the risk of developing microelementoses in him. As a result of our previous studies, the accumulation of lead, cadmium, chromium, nickel, zinc, copper, and iron in the hair of pregnant women was revealed, correlating with the level of metals in the hair of her newborn child (r=0.60-0.78). It was found that mothers with an imbalance of elemental homeostasis were more likely to have children with low indicators of physical development, with perinatal damage to the central nervous system. Direct correlations of average strength between elevated levels of zinc and iron in hair and a burdened obstetric and gynecological history (r = 0.51), cadmium - with weakness of labor activity (r = 0.59), manganese – with rapid childbirth (r = 0.66), lead – with pathological staining of amniotic fluid (r = 0.74) [14]. Therefore, the establishment of an imbalance of elements in the mother's body can serve as a prognosis (risk criterion) for the occurrence of disorders in the child's body.
In the structure of diseases that are the main causes of childhood disability, mental disorders and behavioral disorders occupy the first place – 29.8%, diseases of the nervous system – 17.6%, in the third place – congenital anomalies – 13.9% (according to the Ministry of Labor of the Russian Federation, 2021)[15]. In the class of diseases of the nervous system, the leading importance belongs to cerebral palsy (cerebral palsy), the most severe consequence of perinatal damage to the nervous system [16]. The violation of mineral metabolism in this pathology is probably congenital in nature and may be associated, among other things, with an imbalance of elements in the mother's body. Toxic elements, for example, lead and cadmium, are able to overcome the hematoplacental barrier, penetrate into the fetus, and due to antagonistic relationships, a deficiency of cobalt, selenium and zinc is formed as a result. A change in elemental homeostasis in the antenatal period causes delayed fetal development, impaired development of the nervous system and regulation of metabolic processes [17].
A number of essential micro- and macronutrients (Fe, Cu, Zn, Ca, Mg Se, etc.) play a significant physiological role for the development of the child's body. Heavy metals (lead, cadmium, mercury) and arsenic are neurotoxic poisons and have an adverse effect on the nervous system even at low concentrations. Some essential elements, such as manganese and copper, also become neurotoxic at high concentrations.
The above confirms the need for a detailed study of elemental homeostasis in children with diseases of the nervous system to increase the effectiveness of therapeutic and preventive measures.
The purpose of the study is to analyze and evaluate the elemental composition of hair in children diagnosed with cerebral palsy.
MATERIALS AND METHODS.
A selective cohort study of 93 children aged 3-6 years was conducted. All the examined patients were divided into two groups: the main group, which included children with an established diagnosis of cerebral palsy (spastic diplegia) (n=43, 17 boys and 26 girls), and the control group (n=50, 15 boys and 35 girls). To assess the elemental status of children, the hair was analyzed by atomic absorption spectrometry in accordance with current guidelines. For analysis, hair was cut from the occipital part of the head in an amount of 0.1 - 0.5 g, treated with acetone, then washed with deionized water. The hair was dried at room temperature for 15 minutes. Prior to the analysis, the hair samples were stored in paper bags in a dry place at room temperature. Sampling and storage of samples of biological material was carried out in accordance with current methodological recommendations. After microwave decomposition of hair samples in the Speedwave Xpert system (Berghof Products + Instruments GmbH), essential (Fe, Cu, Zn, Ca, Mg, Cr, Co, Se, Mn), conditionally essential (Ni, As) and toxic elements (Pb, Cd, Hg) were determined by atomic absorption spectrometry on AA devices of models 240FS and 240Z with flame and thermal atomization ("Varian").
The results of studies of the content of chemical elements in the hair of children with an established diagnosis of cerebral palsy were evaluated relative to the reference values [18]. Since different regions are characterized by a specific background level of metals in biological media [6, 9, 19], metal concentrations in children's hair were also compared with the level in the control group.
The study was carried out with the obligatory observance of ethical principles and ensuring the confidentiality of the information received, approved by the bioethical Commission of the Ufa Research Institute of Occupational Medicine and Human Ecology (extract from the minutes of the meeting of the Bioethical Commission dated 12/25/2019 No. 01-12). Informed consent to participate in the study was received from the children's legal representatives.
The statistical analysis was carried out using Microsoft Office Excel and Statistica 10 software (IBM, USA). The distribution was checked for normality using the Kolmogorov-Smirnov criterion. The significance of the differences between the groups was assessed using the Mann-Whitney test and the Student's t-test. The tables show the average values, the error of the average (M ±m), the median, the minimum and maximum levels of elements in the biological environment of the organism.
RESULTS
The analysis of the obtained results of the study of the hair of healthy children and those with cerebral palsy revealed a number of significant differences in the elemental composition. Concentrations of essential elements (copper, zinc, iron, cobalt, calcium and magnesium) in the hair of children diagnosed with cerebral palsy are within the reference range, significant differences with the control group have not been established (p>0.05). The average concentration of zinc in the hair of all examined children is close to the lower limit of the norm (Table 1).
Table 1: The level of essential elements in hair samples of examined children (mcg/g)
Cu | Zn | Fe | Mn | Co | Cr | Ca | Mg | Se |
Reference values | ||||||||
8-12 | 94-183 | 13-27 | 0,32-0,93 | 0,02-0,11 | 0,26-0,70 | 254-611 | 18-56 | 0,65-2,43 |
The content of chemical elements in hair (main group) | ||||||||
(М±m) | ||||||||
9,4 ±0,3 | 99,3 ±5,6 | 20,6±1,1 | 1,14* ±0,05 | 0,07 ±0,01 | 1,52* ±0,21 | 413 ±27 | 46,7 ±3,4 | 0,014* ±0,001 |
Median | ||||||||
9,5 | 102,2 | 15,0 | 1,04 | 0,07 | 1,00 | 380 | 42,2 | 0,014 |
min – max | ||||||||
4,5- 14,4 | 35,2-216,1 | 12,8-54,3 | 0,61-1,97 | 0,02-0,21 | 0,49-5,45 | 53- 973 | 15,2-98,7 | 0,006-0,025 |
The content of chemical elements in hair (control group) | ||||||||
(М±m) | ||||||||
9,9 ±0,5 | 86,0 ±5,9 | 17,0 ±1,3 | 0,40 ±0,03 | 0,07 ±0,01 | 0,67 ±0,04 | 388 ±34 | 41,4 ±3,2 | 0,277 ±0,017 |
Median | ||||||||
9,2 | 87,4 | 15,0 | 0,34 | 0,08 | 0,65 | 321 | 37,9 | 0,290 |
min – max | ||||||||
4,1-19,2 | 36,3-191,1 | 3,9-4 5,3 | 0,09-0,92 | 0,03-0,12 | 0,22-1,66 | 63- 973 | 12,1-99,4 | 0,120-0,390 |
Note: * - differences with the control group are significant (p<0,05).
The level of chromium in the hair of 82% of children in the main group is higher than the upper limit of the reference value (by an average value of 2.2 times) and the content in the control group (U = 0.0001, p<0.05). The manganese level in 81% of children of the main group is higher than the upper limit of the reference value (by an average value of 1.2 times) and 2.9 times higher than the content in the hair of children of the control group (p<0.001). The selenium content in the main group is 46 times, and in the control group is 2 times less than the lower limit of the norm, the differences between the groups are significant (p<0.001).
According to the estimates of foreign researchers, the "level of concern" for lead was determined at a concentration in children's hair of 3 micrograms/g or more [13]. As a result of the studies, the average lead level was increased by 1.4 times relative to the reference values and 5.4 times relative to the control group (p<0.001). In 65% of the surveyed children, the indicator value exceeds the upper limit of the norm and is above the "level of concern" (Table 2).
Table 2. The level of conditionally essential and toxic elements in the hair of the examined children, mcg/g
Pb | Cd | Ni | As | Hg |
Reference values [18] | ||||
0,76-2,73 | 0,03-0,18 | 0,15-0,55 | 0-0,69 | ПДУ 0,5 |
The content of chemical elements in hair (main group) | ||||
(М±m) | ||||
3,71* ± 0,31 | 0,06* ± 0,01 | 2,25* ± 0,24 | 0,011 ± 0,001 | 0,013* ± 0,001 |
Median | ||||
3,14 | 0,06 | 1,88 | 0,008 | 0,010 |
min – max | ||||
0,98-9,12 | 0,01-0,15 | 1,07-9,47 | 0,001-0,030 | 0,001-0,043 |
The content of chemical elements in hair (control group) | ||||
(М±m) | ||||
0,68 ± 0,75 | 0,10 ± 0,01 | 0,27 ± 0,07 | 0,013 ± 0,003 | 0,183 ± 0,011 |
Median | ||||
0,36 | 0,06 | 0,25 | 0,011 | 0,180 |
min – max | ||||
0,01-2,92 | 0,00-0,39 | 0,05-0,56 | 0,002-0,035 | 0,024-0,350 |
Note: * - differences with the control group are significant (p<0.05).
Despite the fact that mercury belongs to neurotoxic poisons, its content in the hair of children diagnosed with cerebral palsy is significantly lower (14 times) than in the comparison group (p<0.001). The average nickel concentration is 4.1 times higher than the upper limit of the reference level and 8.3 times higher than the values of the control group, and the excess was determined in 100% of hair samples (U = 0.0001, p<0.05).
The content of lead and chromium in boys' hair is significantly higher than that of girls, while the levels of cadmium, calcium and magnesium are reduced (p<0.05). There were no significant differences between the content of the other studied elements in the hair of children with cerebral palsy, depending on the sex of the child.
Figure 1 shows the results of studies of the elemental composition of children's hair relative to the upper limit of the range of reference concentrations.
DISCUSSION
The conducted studies have shown that the elemental homeostasis of children diagnosed with cerebral palsy is impaired both in relation to essential and conditionally essential elements (Mn, Cr, Se, Ni) and in relation to toxic (Pb). There was a statistically significant increase in the levels of manganese, chromium, nickel, lead and a significant deficiency of selenium.
Schematically, this can be represented as the ratio:
cerebral palsy = Mn, Cr, Ni, Pb / Se;
where there is an excess in the numerator and a lack of elements in the denominator.
According to Tinkov A.A. and co-authors (Tinkov A.A. et al.) (2020), children diagnosed with cerebral palsy have a pronounced manganese deficiency [19]. Our research has not confirmed this, the level of the element is higher than both the reference values and the indicators of the control group. Despite the fact that manganese is an essential trace element necessary, among other things, for the synthesis of neurotransmitters, its excess in the human body can manifest itself in neurotic syndromes.
Chromium, whose concentrations in the hair of children with cerebral palsy are significantly increased, which is consistent with the data [20], is able to penetrate the placental barrier and accumulate in fetal tissues, including in the brain, causing abnormalities in its development.
Nickel is a conditionally essential element, however, the high concentrations of the metal we have identified can negatively affect the state of the body as a whole.
Lead, whose levels also exceeded the values in the control group, refers to toxic elements that cause pathological changes in the nervous system, blood and blood vessels. It is believed that the toxic effect of lead is largely due to its antagonistic interaction with essential elements – Ca, Mg [13].
Thus, all the elements contained in increased amounts in the hair of children with cerebral palsy are associated with the activity of the nervous system.
The hair of children diagnosed with cerebral palsy has a reduced content of selenium, the most important biologically active trace element. Selenium deficiency negatively affects reproductive function, slows down the development of the placenta, and leads to diseases of the musculoskeletal system and skeletal muscles [20]. In mothers with selenium deficiency, newborns have reduced muscle mass and lag behind in development [13]. The role of selenium in the body is determined by its antioxidant effect, it is an antagonist of mercury, lead, cadmium, and arsenic. Research by Tinkov A.A. and co-authors (Tinkov A.A. et al.) (2019), who studied selenium metabolism in children with cerebral palsy, confirmed a reduced level of the element in the hair with its increased content in the blood. The authors of the work believe that for an informative assessment of the violation of selenium metabolism, it is necessary to determine several markers of the body's availability of this element [21].
CONCLUSION
The results of the assessment of elemental homeostasis in children diagnosed with cerebral palsy (spastic diplegia) revealed deviations relative to the physiological norm and indicators of the control group in 6 elements. Nickel, chromium, lead, and manganese predominate in the structure of excess states, and the deficiency state is characteristic of selenium.
The revealed elemental imbalance indicates a violation of adaptive mechanisms, since the exchange of trace elements is an important link in the pathogenesis of diseases of both the central nervous system and the human body as a whole.
The study of the elemental composition of hair can be used as one of the tests in the diagnosis of diseases of the nervous system in children. Early diagnosis of dyselementosis in children diagnosed with cerebral palsy can serve as one of the effective ways to maintain a child's health by conducting preventive health measures, increasing the effectiveness of therapeutic and preventive measures by including additional medications and organizing individual nutrition to correct mineral metabolism.
About the authors
Tatyana K. Larionova
Ufa Research Institute of Occupational Health and Human Ecology
Author for correspondence.
Email: larionovatk@yandex.ru
ORCID iD: 0000-0001-9754-4685
SPIN-code: 5305-0589
Кандидат биологических наук, доцент по специальности "Медицина труда", ведущий научный сотрудник химико-аналитического отдела
Russian Federation, Россия, 450106, Уфа, Степана Кувыкина, 94Rustem A. Daukaev
Email: ufa.lab@yandex.ru
ORCID iD: 0000-0002-0421-4802
SPIN-code: 4086-7132
Elmira R. Shaikhlislamova
Email: shajkh.ehmira@yadex.ru
ORCID iD: 0000-0002-6127-7703
SPIN-code: 1041-3862
Anna N. Larionova
Scientific and Practical Center of Child Psychoneurology of the Department of Health of the City of Moscow, Moscow, Russia Federation
Email: annalario21@yandex.ru
ORCID iD: 0000-0001-9652-4236
SPIN-code: 8038-6346
Заведующий отделением №2
Russian Federation, 74 Michurinsky Prospekt, Moscow, 119602, RussiaElvira A. Aukhadieva
Email: ufa.lab@yandex.ru
ORCID iD: 0000-0002-6793-6992
SPIN-code: 9475-1793
Guzel R. Allayarova
Email: ufa.lab@yandex.ru
ORCID iD: 0000-0003-0838-3598
SPIN-code: 3704-1010
Gyuzeliya F. Adieva
Email: ufa.lab@yandex.ru
ORCID iD: 0000-0003-2377-3471
SPIN-code: 3805-1755
Evgeniya E. Zelenkovskaya
Email: ufa.lab@yandex.ru
ORCID iD: 0000-0001-7682-2703
SPIN-code: 4662-3255
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