Ontiveros-Mendoza Esperanza, González-Medrano Juan Antonio, Rivera-González Rolando, Sánchez-Huerta Karla, Sánchez Carmen, Barragán-Mejía Gerardo
Centro de Investigación en Neurodesarrollo. Instituto Nacional de Pediatría, Mexico City, México.
Universidad Autónoma Metropolitana-Unidad Xochimilco, Mexico City, México.
Pediatr Res. 2025 Jan 22. doi: 10.1038/s41390-025-03850-3.
Congenital hypothyroidism's sequelae include visuomotor and intellectual developmental deficits. Visual-motor perception is a cognitive function related to academic performance. Intellect is the ability to learn and use acquired knowledge to solve and achieve goals. Our objective was to evaluate visual-motor and intellectual development in children with late initiation of treatment for congenital hypothyroidism enrolled in a developmental follow-up and intervention program.
We evaluated the visual-motor and intellectual development of 75 infants with congenital hypothyroidism, 34 with athyrosis, and 41 with ectopia using the Bender Visual-Motor Development Test and the Weschler Intelligence Scale at eight and nine years of age.
Children with ectopia had a visual-motor delay of -2 years and an Intelligence Quotient (IQ) greater than 98 points. Children with athyrosis had a visual-motor delay equivalent to -3.2 years and an IQ below 90 points. Better performance on Bender's test was positively correlated with IQ. Attending more than 80% of Developmental Intervention Program appointments had a positive impact on intellectual development.
Timely diagnosis and early treatment with the appropriate dose of levothyroxine are determining factors; however, attendance to a development follow-up and intervention program could further support the cognitive development of children with congenital hypothyroidism.
Visuomotor development influences cognitive functions related to school performance. Deficits in the ability to learn and use acquired knowledge to solve problems and achieve goals are characteristic of children with congenital hypothyroidism. Delayed treatment is associated with more severe sequelae in both visual-motor and intellectual development. Here, we show that treatment with adequate doses of levothyroxine and inclusion in a follow-up and developmental program are highly recommended for patients with delayed treatment. A better understanding of these factors will allow clinicians to target therapeutic interventions.
先天性甲状腺功能减退症的后遗症包括视觉运动和智力发育缺陷。视觉运动感知是一种与学业成绩相关的认知功能。智力是学习和运用所学知识解决问题并实现目标的能力。我们的目的是评估参加发育随访和干预项目的先天性甲状腺功能减退症治疗起步较晚的儿童的视觉运动和智力发育情况。
我们使用本德尔视觉运动发育测试和韦氏智力量表，在8岁和9岁时评估了75例先天性甲状腺功能减退症婴儿、34例甲状腺缺如婴儿和41例异位甲状腺婴儿的视觉运动和智力发育情况。
异位甲状腺患儿的视觉运动延迟达2年，智商高于98分。甲状腺缺如患儿的视觉运动延迟相当于3.2年，智商低于90分。本德尔测试表现较好与智商呈正相关。参加超过80%的发育干预项目预约对智力发育有积极影响。
及时诊断并使用适当剂量的左甲状腺素进行早期治疗是决定性因素；然而，参加发育随访和干预项目可以进一步支持先天性甲状腺功能减退症患儿的认知发育。
视觉运动发育影响与学业成绩相关的认知功能。学习和运用所学知识解决问题并实现目标的能力缺陷是先天性甲状腺功能减退症患儿的特征。治疗延迟与视觉运动和智力发育方面更严重的后遗症相关。在此，我们表明，对于治疗延迟的患者，强烈建议使用适当剂量的左甲状腺素进行治疗并纳入随访和发育项目。更好地理解这些因素将使临床医生能够针对性地进行治疗干预。
