Cognitive profiles of patients with early detected and treated congenital hypothyroidism

Abstract

Introduction.Children with congenital hypothyroidism (CH) detected by newborn screening and adequately treated may have mild cognitive deficits. Objectives. To assess the intelligence quotient of children with CH and identify the presence of specific cognitive deficits. Population and methods. A group of 60 children with CH detected by newborn screening, who were aged 9-10 years old and received adequate treatment since their first month of life was selected and compared to a control group of 60 children without CH in the same age range. Inclusion criteria: children without concurrent diseases, who were attending school in a single shift, and whose parents had at least completed secondary education. The following tests were administered during individual interviews: the Wechsler Intelligence Scale for Children (third edition), the Rey complex figure test, the Woodcock-Muñoz revised test, the Conners Continuous Performance Test II, the Illinois Test of Psycholinguistic Abilities, the verbal fluency test, the Knox Cube Test, the Trail Making Test, the faces test, and the 5 digit test. The statistical analysis was done using Student's t tests (for independent samples) with Bonferroni's correction (p < 0.002). Results. Even within the normal average range, significant differences were observed between both groups in terms of total intelligence quotient and performance intelligence quotient (small and moderate effect sizes, respectively). In terms of performance, children with hypothyroidism had a significantly poorer performance in processing speed, reaction times, attention, cognitive flexibility, visuoconstruction, and long-term memory. No significant differences were found between both groups in the verbal area. Conclusions. Children with congenital hypothyroidism and without mental disability had mild cognitive deficits, which should be taken into account for a comprehensive patient care.

Two siblings with congenital central hypothyroidism caused by a novel mutation in the <i>IGSF1</i> gene

“…As IGSF1 is expressed in the brain ( 12 , 13 ), the neurological deficits may be due to a direct effect of IGSF1 deficiency. Attention and cognitive deficits have been observed in patients with CH due to low prenatal thyroid hormone levels and/or suboptimal replacement doses of levothyroxine ( 14 , 15 ). Indeed, treatment using levothyroxine in patient 2 was delayed until he was 3 yr of age.…”

Neonatal thyrotropin levels and auditory neural maturation in full-term newborns

“…The aim is to minimize the false positive rate while maintaining a low percentage of false negatives since the recall from newborn screening test determines the need for clinical reevaluation and follow-up, and is a source of stress for parents [ 23 ]. The cut-off TSH value also needs to be continually reviewed, as recent data in the literature show that even children diagnosed early with CH, who started treatment at the recommended time, experienced changes in neurocognitive development during the clinical follow-up [ 24 , 25 ], suggesting that these changes were established earlier in life.…”

Neuropsychological Alterations in Patients with Congenital Hypothyroidism Treated with Levothyroxine: Linked Factors and Thyroid Hormone Hyposensitivity

“…Some reports describe an improvement in IQ at 6 years of age, although a regular score is not fully reached [ 56 ]. Other authors point out that even when the IQ scores of children with CH-Tx are within normal limits, they have lower IQ values than healthy controls at ages 5 [ 42 ], 9 [ 58 ], and 11 to 15 [ 17 , 30 , 57 , 59 , 60 , 61 ]. Bongers-Schokking et al also reported CH-Tx patients with suboptimal treatment and with abnormalities in visuomotor and verbal scores, but normal IQ scores [ 29 ].…”