Children and adolescents previously treated with glucocorticoids display lower verbal intellectual abilities

Holm, Sven; Vestergaard, Martin; Madsen, Kathrine Skak; Baaré, William F.C.; Hammer, Trine Bjørg; Born, Alfred Peter; Siebner, Hartwig R.; Paulson, Olaf B.; Uldall, Peter

doi:10.1111/apa.13010

Cited by 9 publications

(16 citation statements)

References 28 publications

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“…Patients and controls did not significantly differ in pubertal development, physical activity, or stressful life events in the preceding year. In accordance with our previous Articles | Holm et al findings in a larger cohort (21), the amount of stressful life events during the child's entire lifetime was higher in patients compared with that in controls; however, after exclusion of disease-related questions, this difference was no longer present.…”

Section: Background Variables Cognitive and Behavioral Measuressupporting

confidence: 92%

“…The controls were between 7.0 and 15.6 years of age and consisted of 11 boys and 19 girls. The subjects were part of a larger cohort, which has been described in detail elsewhere (21). Of the initial thirty-eight included patients (21), seven did not complete MRI scanning and one was excluded because of poor image quality due to motion artifacts.…”

Section: Participants and Clinical Characteristicsmentioning

confidence: 99%

“…The assessment of background and cognitive variables are described in detail elsewhere (21). Height, weight, head circumference, and pubertal development (Tanner staging) were measured.…”

Section: Background Variablesmentioning

confidence: 99%

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Total brain, cortical, and white matter volumes in children previously treated with glucocorticoids

et al. 2018

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BackgroundPerinatal exposure to glucocorticoids and elevated endogenous glucocorticoid levels during childhood can have detrimental effects on the developing brain. Here, we examined the impact of glucocorticoid treatment during childhood on brain volumes.MethodsA total of 30 children and adolescents with rheumatic or nephrotic disease previously treated with glucocorticoids and 30 controls matched on age, sex, and parent education underwent magnetic resonance imaging (MRI) of the brain. Total cortical gray and white matter, brain, intracranial volume, and total cortical thickness and surface area were derived from MRI scans.ResultsPatients had significantly smaller gray and white matter and total brain volumes relative to healthy controls. Brain volume differences disappeared when accounting for intracranial volume, as patients had relatively smaller intracranial volumes. Group differences were mainly driven by the children with rheumatic disease. Total cortical thickness and cortical surface area did not significantly differ between groups. We found no significant associations between glucocorticoid-treatment variables and volumetric measures.ConclusionObserved smaller total brain, cortical gray, and white matter volumes in children and adolescents previously treated with glucocorticoids compared with that in healthy controls may reflect both developmental and degenerative processes. Prospective longitudinal studies are warranted to clarify whether findings are related to treatment or disease.

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Section: Background Variables Cognitive and Behavioral Measuressupporting

confidence: 92%

Section: Participants and Clinical Characteristicsmentioning

confidence: 99%

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Total brain, cortical, and white matter volumes in children previously treated with glucocorticoids

et al. 2018

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“…A cross‐sectional study by a Danish group investigated the intellectual abilities of 38 children aged 7‐16 who had been treated with steroids for rheumatic diseases or NS. They were matched for age, gender and parental education with 42 healthy controls . The study was carried out an average of 3.5 years after the patients had received a median cumulative dose of 158 mg/kg of steroids.…”

Section: Socio‐cognitive Function Quality Of Life and Cosmetic Factorsmentioning

confidence: 99%

“…They were matched for age, gender and parental education with 42 healthy controls 55. The study was carried out an average of 3.5 years after the patients had received a median cumulative dose of 158 mg/kg of steroids.…”

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Review on long‐term non‐renal complications of childhood nephrotic syndrome

et al. 2019

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Background Nephrotic syndrome (NS) is the most common glomerular childhood disease. A body of literature has described the long‐term renal prognosis of childhood‐onset idiopathic NS. However, the nonrenal outcomes have not been studied as much. Aim We aimed to discuss the long‐term non‐renal outcomes of childhood NS, highlighting studies with a follow‐up period of more than 10 years. Results We reviewed the literature and found that a number of immunosuppressive agents have stopped inflammation, stabilised the podocyte cytoskeleton and reduce proteinuria. However, prolonged treatment has frequently been associated with a high risk of renal and non‐renal complications in patients with a complicated disease course, defined as frequent relapses or steroid dependency. Non‐renal complications may include impaired longitudinal growth and pubertal development, undesirable fertility outcomes, ocular complications, bone mineral diseases and potential malignancies. Conclusion This review discusses and summarises the non‐renal outcomes of idiopathic childhood NS.

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Comparison of two corticosteroid regimens on brain volumetrics in patients with Duchenne muscular dystrophy

Geuens,

Van Dessel,

Govaarts

et al. 2023

Ann Clin Transl Neurol

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ObjectiveDuchenne muscular dystrophy (DMD) is a neuromuscular disorder in which many patients also have neurobehavioral problems. Corticosteroids, the primary pharmacological treatment for DMD, have been shown to affect brain morphology in other conditions, but data in DMD are lacking. This study aimed to investigate the impact of two corticosteroid regimens on brain volumetrics in DMD using magnetic resonance imaging (MRI).MethodsIn a cross‐sectional, two‐center study, T1‐weighted MRI scans were obtained from three age‐matched groups (9–18 years): DMD patients treated daily with deflazacort (DMDd, n = 20, scan site: Leuven), DMD patients treated intermittently with prednisone (DMDi, n = 20, scan site: Leiden), and healthy controls (n = 40, both scan sites). FSL was used to perform voxel‐based morphometry analyses and to calculate intracranial, total brain, gray matter, white matter, and cerebrospinal fluid volumes. A MANCOVA was employed to compare global volumetrics between groups, with site as covariate.ResultsBoth patient groups displayed regional differences in gray matter volumes compared to the control group. The DMDd group showed a wider extent of brain regions affected and a greater difference overall. This was substantiated by the global volume quantification: the DMDd group, but not the DMDi group, showed significant differences in gray matter, white matter, and cerebrospinal fluid volumes compared to the control group, after correction for intracranial volume.InterpretationVolumetric differences in the brain are considered part of the DMD phenotype. This study suggests an additional impact of corticosteroid treatment showing a contrast between pronounced alterations seen in patients receiving daily corticosteroid treatment and more subtle differences in those treated intermittently.

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Children and adolescents previously treated with glucocorticoids display lower verbal intellectual abilities

Abstract: Children and adolescents previously treated with glucocorticoids seemed to have lower intellectual verbal abilities than healthy controls.

Cited by 9 publications

References 28 publications

Total brain, cortical, and white matter volumes in children previously treated with glucocorticoids

Total brain, cortical, and white matter volumes in children previously treated with glucocorticoids

Review on long‐term non‐renal complications of childhood nephrotic syndrome

Comparison of two corticosteroid regimens on brain volumetrics in patients with Duchenne muscular dystrophy

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