title: Effect of cessation of GH treatment on cognition during transition phase in Prader-Willi syndrome: results of a 2-year crossover GH trial.
abstract: Patients with Prader-Willi syndrome (PWS) have a cognitive impairment. Growth hormone (GH) treatment during childhood improves cognitive functioning, while cognition deteriorates in GH-untreated children with PWS. Cessation of GH treatment at attainment of adult height (AH) might deteriorate their GH-induced improved cognition, while continuation might benefit them. We, therefore, investigated the effects of placebo versus GH administration on cognition in young adults with PWS who were GH-treated for many years during childhood and had attained AH.
  
  
  
  Two-year, randomized, double-blind, placebo-controlled cross-over study in 25 young adults with PWS. Cross-over intervention with placebo and GH (0.67 mg/m2/day), both during 1 year.
  
  
  
  Total (TIQ), verbal (VIQ) and performance IQ (PIQ) did not deteriorate during 1 year of placebo, compared to GH treatment (p > 0.322). Young adults with a lower TIQ had significantly more loss of TIQ points during placebo versus GH, in particular VIQ decreased more in those with a lower VIQ. The effect of placebo versus GH on TIQ, VIQ and PIQ was not different for gender or genotype.
  
  
  
  Compared to GH treatment, 1 year of placebo did not deteriorate cognitive functioning of GH-treated young adults with PWS who have attained AH. However, patients with a lower cognitive functioning had more loss in IQ points during placebo versus GH treatment. The reassuring finding that 1 year of placebo does not deteriorate cognitive functioning does, however, not exclude a gradual deterioration of cognitive functioning on the long term.
  
  
  
  ISRCTN24648386 , NTR1038 , Dutch Trial Register, www.trialregister.nl . Registered 16 August 2007.
authors.affiliation: Dutch Growth Research Foundation, Rotterdam, The Netherlands. R.Kuppens@kindengroei.nl.|Department of Pediatrics, Erasmus University Medical Center-Sophia Children's Hospital, Subdivision of Endocrinology, Westzeedijk 106, 3016 AH, Rotterdam, The Netherlands. R.Kuppens@kindengroei.nl.
authors.forename: R J
authors.initials: RJ
authors.lastname: Kuppens
authors.affiliation: Dutch Growth Research Foundation, Rotterdam, The Netherlands.
authors.forename: E F
authors.initials: EF
authors.lastname: Mahabier
authors.affiliation: Dutch Growth Research Foundation, Rotterdam, The Netherlands.
authors.forename: N E
authors.initials: NE
authors.lastname: Bakker
authors.affiliation: Dutch Growth Research Foundation, Rotterdam, The Netherlands.
authors.forename: E P C
authors.initials: EP
authors.lastname: Siemensma
authors.affiliation: Dutch Growth Research Foundation, Rotterdam, The Netherlands.|Department of Pediatrics, Erasmus University Medical Center-Sophia Children's Hospital, Subdivision of Endocrinology, Westzeedijk 106, 3016 AH, Rotterdam, The Netherlands.
authors.forename: S H
authors.initials: SH
authors.lastname: Donze
authors.affiliation: Dutch Growth Research Foundation, Rotterdam, The Netherlands.|Department of Pediatrics, Erasmus University Medical Center-Sophia Children's Hospital, Subdivision of Endocrinology, Westzeedijk 106, 3016 AH, Rotterdam, The Netherlands.
authors.forename: A C S
authors.initials: AC
authors.lastname: Hokken-Koelega
mesh_terms: D000293:Adolescent; D001827:Body Height; D003071:Cognition / Q000187:drug effects*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D013006:Growth Hormone / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011218:Prader-Willi Syndrome / Q000188:drug therapy*
chemical_list: D013006:Growth Hormone
keywords: Cognition; Growth hormone treatment; Prader-Willi syndrome; Young adults