Neurophysiological correlates of vitamin D, B12, and folate deficiency in children with primary nocturnal enuresis.

BACKGROUND

Primary nocturnal enuresis (PNE) is a prevalent pediatric disorder often associated with delayed cortical maturation and autonomic dysregulation. Growing evidence suggests that metabolic deficiencies, particularly in vitamin D, vitamin B12, and folate, may influence neuronal development and the neural circuits regulating micturition.

OBJECTIVE

To investigate the association between serum levels of vitamin D, vitamin B12, and folate and neurophysiological parameters in children with PNE.

METHODS

A cross-sectional study was conducted in 68 children aged 5-14 years with PNE and 20 age-matched healthy controls. All participants underwent clinical assessment, electroencephalography (EEG), magnetic resonance imaging (MRI), and computerized attention testing (TOVA). Serum concentrations of 25-hydroxyvitamin D, vitamin B12, folate, ferritin, and hemoglobin were measured using immunoassay methods.

RESULTS

Children with PNE demonstrated significantly lower serum levels of vitamin D (16.4 ± 2.8 ng/mL vs 26.7 ± 3.1 ng/mL; p < 0.01), vitamin B12 (198 ± 41 pg/mL vs 283 ± 33 pg/mL; p = 0.001), and folate (4.1 ± 0.8 ng/mL vs 13.6 ± 1.2 ng/mL; p = 0.001) compared with controls, whereas ferritin and hemoglobin showed no significant difference. EEG revealed delayed cortical maturation in 66 % of cases, and MRI demonstrated minor, non-specific structural variants in 34 % of children with PNE.

CONCLUSIONS

Lower serum levels of vitamin D, vitamin B12, and folate were associated with neurophysiological markers of delayed cortical maturation in children with PNE. Given the cross-sectional design, these findings should be interpreted as exploratory and hypothesis-generating. The observed associations warrant further longitudinal and interventional studies to determine whether micronutrient status is independently related to neurophysiological maturation or clinical outcomes in children with PNE.