title: Working memory performance is reduced in children with congenital adrenal hyperplasia.
abstract: Individuals with classic congenital adrenal hyperplasia (CAH) experience impaired glucocorticoid production and are treated postnatally with glucocorticoids. Prior research with animals and other human populations indicates that glucocorticoids can influence memory, particularly working memory. We tested the hypothesis that children with CAH would show reduced working memory. Children in the United Kingdom, aged 7-11years, with classical CAH (31 girls, 26 boys) were compared to their unaffected relatives (30 girls, 20 boys) on a test of working memory, the Digit Span test. Vocabulary was also assessed to measure verbal intelligence for control purposes. Children with CAH showed reduced working memory performance compared to controls, on both components of the Digit Span test: p=.008 for Digit Span Forward, and p=.027 for Digit Span Backward, and on a composite score, p=.004. These differences were of moderate size (d=.53 to .70). Similar differences were also seen in a subset of 23 matched pairs of children with CAH and their relatives (d=.78 to .92). There were no group differences on Vocabulary. Glucocorticoid abnormality, including treatment effects, could be responsible for the reduced Digit Span performance in children with CAH. Other factors related to CAH, such as salt-wasting crises, could also be involved. Additional research is needed to identify the cause of the memory reduction, which will help to determine if more rapid diagnosis or more precise glucocorticoid treatment would help prevent memory reduction. Educational interventions might also be considered for children with CAH.
authors.affiliation: Department of Psychology, University of Cambridge, Free School Lane, Cambridge CB2 3RQ, United Kingdom.
authors.forename: Wendy V
authors.initials: WV
authors.lastname: Browne
authors.affiliation: Department of Paediatric Endocrinology, University College London, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, United Kingdom.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Hindmarsh
authors.affiliation: Department of Psychology, University of Cambridge, Free School Lane, Cambridge CB2 3RQ, United Kingdom; Department of Paediatrics, University of Cambridge, Level 8/Box 116, Cambridge Biomedical Campus, Cambridge CB2 0QQ, United Kingdom.
authors.forename: Vickie
authors.initials: V
authors.lastname: Pasterski
authors.affiliation: Department of Paediatrics, University of Cambridge, Level 8/Box 116, Cambridge Biomedical Campus, Cambridge CB2 0QQ, United Kingdom.
authors.forename: Ieuan A
authors.initials: IA
authors.lastname: Hughes
authors.affiliation: Department of Paediatrics, University of Cambridge, Level 8/Box 116, Cambridge Biomedical Campus, Cambridge CB2 0QQ, United Kingdom.
authors.forename: Carlo L
authors.initials: CL
authors.lastname: Acerini
authors.affiliation: Department of Psychology, University of Cambridge, Free School Lane, Cambridge CB2 3RQ, United Kingdom.
authors.forename: Debra
authors.initials: D
authors.lastname: Spencer
authors.affiliation: Department of Psychology, University of Cambridge, Free School Lane, Cambridge CB2 3RQ, United Kingdom.
authors.forename: Sharon
authors.initials: S
authors.lastname: Neufeld
authors.affiliation: Department of Psychology, University of Cambridge, Free School Lane, Cambridge CB2 3RQ, United Kingdom. Electronic address: mh504@cam.ac.uk.
authors.forename: Melissa
authors.initials: M
authors.lastname: Hines
mesh_terms: D000312:Adrenal Hyperplasia, Congenital / Q000503:physiopathology*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology*
keywords: Androgen; Congenital adrenal hyperplasia; Glucocorticoid; Working memory