title: Childhood-onset growth hormone deficiency, cognitive function and brain N-acetylaspartate.
abstract: Cognitive deficits have been reported in adults with childhood-onset growth hormone (GH) deficiency. We evaluated cognitive deficits simultaneously with parameters for neuronal integrity using (1)H magnetic resonance spectroscopy (MRS) in a cross-sectional design. We studied 11 adults (mean age 24.5 years) with childhood-onset GH deficiency, which persisted after reaching final height. All subjects were evaluated after interruption of GH supplementation for at least 3 months. We performed neuropsychological assessment (NPA) using tests evaluating memory, mental processing speed, reading ability and executive functioning. MRS was used to assess brain N-acetylaspartate (NAA)/choline ratios. Data were compared with an age-, sex- and education-matched control group (n=9, mean age 27.3 years). NPA demonstrated attenuated performance of the patients in the delayed verbal memory recall score (P<0.05) and the trail making A test (P<0.05), a measure of planning of behavior, processing speed and attention. Other neuropsychological tests were not affected. NAA/choline ratios were significantly reduced (P<0.01) in GH deficient subjects. Specific cognitive defects indicating affected memory and attention were found in patients with childhood-onset GH deficiency. These defects occur simultaneously with reduced neuronal integrity.
authors.affiliation: Department of Clinical Endocrinology, University Medical Center, Utrecht, The Netherlands. p.s.vandam@olvg.nl
authors.forename: P Sytze
authors.initials: PS
authors.lastname: van Dam
authors.forename: Channa F
authors.initials: CF
authors.lastname: de Winter
authors.forename: Rehana
authors.initials: R
authors.lastname: de Vries
authors.forename: Jeroen
authors.initials: J
authors.lastname: van der Grond
authors.forename: Madeleine L
authors.initials: ML
authors.lastname: Drent
authors.forename: Marijn
authors.initials: M
authors.lastname: Lijffijt
authors.forename: J Leon
authors.initials: JL
authors.lastname: Kenemans
authors.forename: André
authors.initials: A
authors.lastname: Aleman
authors.forename: Edward H F
authors.initials: EH
authors.lastname: de Haan
authors.forename: Hans P F
authors.initials: HP
authors.lastname: Koppeschaar
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000375:Aging / Q000523:psychology; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000097:blood / Q000378:metabolism*; D001921:Brain / Q000473:pathology; D001923:Brain Chemistry / Q000502:physiology*; D002794:Choline / Q000378:metabolism; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000473:pathology; D005260:Female; D019382:Human Growth Hormone / Q000172:deficiency*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D009474:Neurons / Q000473:pathology; D009483:Neuropsychological Tests
chemical_list: D019382:Human Growth Hormone; D001224:Aspartic Acid; D007334:Insulin-Like Growth Factor I; C000179:N-acetylaspartate; D002794:Choline