Vitamin b12 deficiency and impact on mri morphometrics: Association between cognitive impairment and neuroimaging findings

Abstract

Vitamin B12 deficiency has been associated with various neuropsychiatric symptoms, and it has also been reported to be a reversible cause of dementia. In addition to myelopathy and hematological changes, increasing evidence suggests an association between low vitamin B12 status and cognitive impairment. The negative impacts of low vitamin B12 status on cerebrum range from subclinical microstructural changes to an overt debilitating state associated with permanent cerebral volume reduction. Therefore, prompt diagnosis of cognitive syndromes related to vitamin B12 deficiency is of paramount clinical importance, since this can significantly alter the prognosis and treatment approach. In addition, the impact of low vitamin B12 status can vary in terms of clinical phenotype and disease severity, resulting in further challenges in clinical practice. This raises the urgent need for other objective tools with sufficient reliability and reproducibility in addition to the existing serology profile survey. By incorporating structuralized cognitive and magnetic resonance imaging evaluations, the cognitive profiles and neuronal substrates vulnerable to vitamin B12 deficiency in the context of neurobiochemistry basis can be further explored. This chapter will provide an overview of the current knowledge from studies aiming on cognitive and magnetic resonance imaging evaluations, and discuss supportive evidence in related fields.