Developmental language impairment in 59 children, aged 5-7 years, exposed to a thiamine deficiency in defective milk formula fed during the first year of life is studied by researchers at Tel Aviv University and Sourasky Medical Centre, Israel. Various tests of phrase and sentence comprehension, word retrieval and conceptual abilities were compared in thiamine deficient and normally fed controls. Almost all (57) of the 59 thiamine-deficient children examined had language impairment, compared with 3 of the 35 controls (9%), whereas conceptual and cognitive abilities were spared (only 6 (10%) were conceptually impaired). 
COMMENT. In 2003, 20 infants were hospitalized in Israel with severe neurological symptoms, including ophthalmoplegia, vomiting, nystagmus, seizures and coma. Brain MRI showed hyperintense signal in the basal ganglia, mamillary bodies and periaqueductal grey matter. Two died of cardiomyopathy and 10 had residual cardiac and brain damage. Wernicke's encephalopathy was suspected, and examination of the infant formula found an absence of vitamin Bl. Treatment with supplementary thiamine resulted in improvements in affected infants. The above study was conducted on patients fed the same thiamine-deficient formula but showing no neurological deficits. The research demonstrates the influence of diet deficiencies, specifically thiamine, on the developing brain of infants and the effect on language performance in later childhood.