title: Neuropsychological assessment in prepubertal patients with congenital adrenal hyperplasia: preliminary study.
abstract: OBJECTIVE
  Individuals with congenital adrenal hyperplasia (CAH) provide a test population for the theory that elevated testosterone levels alter pre-/perinatal brain development.
  
  
  METHODS
  Seven prepuberal girls with CAH and seven matched controls has been submitted to a neuropsychological evaluation. We measured abilities where gender differences repeatedly has been observed or that had earlier shown differences between CAH subjects and controls. The following cognitive functions were tested: general intelligence, attention, verbal and non-verbal abilities, cerebral dominance for verbal and non-verbal material, frontal functions, peripheral dominance and motor fluency. Since several animal studies shown hippocampal morphological changes induced by prolonged hydrocortisone exposure, we also investigated memory functions.
  
  
  RESULTS
  No differences were recorded between two groups on those abilities that are not sexually dimorphic. The mean general intelligence level of the patients was significantly lower than the controls', in agreement with previous studies. The verbal and non-verbal tasks revealed an age-related male-like pattern (i.e., verbal disadvantage) and an inversion of the hemispheric dominances. The latter observation was supported by a right-to-left shift of the peripheral dominances. The patients memory performances were all inferior to the controls'. The results are discussed in the light of possible hormonal influences.
  
  
  CONCLUSIONS
  Our main findings support the hypothesis that elevated pre-/perinatal androgen exposure can influence some cognitive pattern of specific sexual dimorphic abilities in prepubertal subjects.
authors.affiliation: Institute of Neurological and Psychiatric Sciences of Childhood and Adolescence, University of Milan, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Somajni
authors.forename: V
authors.initials: V
authors.lastname: Sovera
authors.forename: A
authors.initials: A
authors.lastname: Albizzati
authors.forename: G
authors.initials: G
authors.lastname: Russo
authors.forename: P
authors.initials: P
authors.lastname: Peroni
authors.forename: G
authors.initials: G
authors.lastname: Seragni
authors.forename: C
authors.initials: C
authors.lastname: Lenti
mesh_terms: D000312:Adrenal Hyperplasia, Congenital / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism / Q000523:psychology*; D015992:Body Mass Index; D001921:Brain / Q000378:metabolism; D016022:Case-Control Studies; D002648:Child; D003071:Cognition; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007361:Intelligence Tests; D007806:Language Disorders / Q000523:psychology; D007859:Learning Disabilities / Q000523:psychology; D008403:Mass Screening / Q000379:methods; D009483:Neuropsychological Tests; D009765:Obesity / Q000523:psychology; D011627:Puberty / Q000523:psychology; D015203:Reproducibility of Results; D012307:Risk Factors; D012720:Severity of Illness Index; D013739:Testosterone / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D013739:Testosterone