Pediatrics Department, Division of Pediatric Endocrinology, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Laboratory of Neurosciences, Universidade Federal de Minas Gerais, Department of Psychology, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Child Neuropsychol. 2021 Jul;27(5):587-600. doi: 10.1080/09297049.2021.1876010. Epub 2021 Feb 3.
Congenital hypothyroidism (CH) is an important cause of preventable intellectual disability. Implementation of CH neonatal screening programs leading to early treatment has improved cognitive outcome. However, more subtle cognitive impairments are still reported, and there is lack of clarity regarding factors that impact long-term cognitive outcome. Research to better understand these factors can lead to further improvements in the cognitive prognosis for these patients. The current study aimed to evaluate the cognitive performance of adolescents who were early-treated for primary permanent CH and possible associated variables. Neurocognitive evaluation was carried out in 66 adolescents, 11 to 16 years old: 34 with CH and 29 paired controls. Intellectual quotient (IQ), verbal fluency, processing speed, executive functions, and memory were investigated. CH patients and control subjects were comparable regarding sex, age, schooling, family's socioeconomic status and caregiver's educational level. Both groups presented not only similar IQ scores but also equivalent performances regarding Perceptual Reasoning, Working Memory and Processing Speed index scores. Patients presenting different CH etiologies (dysgenesis and dyshormonogenesis) showed similar cognitive performance. Socioeconomic aspects along with the initial levothyroxine dose were the main variables to positively influence the cognitive performance, the family's socioeconomic status having the strongest association with patients' cognitive skills.
先天性甲状腺功能减退症(CH)是可预防智力残疾的重要原因。实施新生儿 CH 筛查计划并进行早期治疗已改善认知结局。然而,仍有报道称存在更细微的认知障碍,并且对于影响长期认知结局的因素尚不清楚。研究这些因素可以进一步改善这些患者的认知预后。本研究旨在评估早期接受原发性永久性 CH 治疗的青少年的认知表现及其可能相关的变量。对 66 名 11 至 16 岁的青少年进行了神经认知评估:34 名 CH 患者和 29 名配对对照组。研究了智商(IQ)、语言流畅性、加工速度、执行功能和记忆。CH 患者和对照组在性别、年龄、受教育程度、家庭社会经济地位和照顾者教育水平方面相似。两组不仅在智商得分上相似,而且在知觉推理、工作记忆和加工速度指数得分上的表现也相当。具有不同 CH 病因(发育不良和激素生成障碍)的患者表现出相似的认知表现。社会经济方面以及初始左甲状腺素剂量是积极影响认知表现的主要变量,家庭的社会经济地位与患者的认知技能关联最强。