General intelligence and cognitive profile in women with congenital adrenal hyperplasia (CAH)

Spatial Ability and Prenatal Androgens: Meta-Analyses of Congenital Adrenal Hyperplasia and Digit Ratio (2D:4D) Studies

“…Females-Effect sizes for differences in spatial ability between CAH females and controls were obtained for nine samples from eight studies, involving a total of 128 CAH females and 108 controls (Baker & Ehrhardt, 1974;Hampson et al, 1998;Helleday et al, 1994;Hines et al, 2003;Malouf et al, 2006 [two samples];McGuire et al, 1975;Perlman, 1973;Resnick et al, 1986, Table 1). CAH Females outperformed controls on spatial tasks.…”

“…Although the hormonal abnormalities of CAH are treated shortly after birth, girls with CAH show signs of elevated prenatal androgen exposure (for example, virilized genitalia) and tend to be masculinized along several behavioral dimensions (Berenbaum, 1999). Some studies have found CAH females to exhibit masculinized spatial abilities (Hampson, Rovet, & Altmann, 1998;Hines et al, 2003;Perlman, 1973;Resnick, Berenbaum, Gottesman, & Bouchard, 1986), although others have not (Baker & Ehrhardt, 1974;Helleday, Bartfai, Ritzen, & Forsman, 1994;Malouf, Migeon, Carson, Petrucci, & Wisniewski, 2006;McGuire, Ryan, & Omenn, 1975;Ripa, Johannsen, Mortensen, & Muller, 2003). Studies of spatial ability in CAH males have obtained equally inconsistent results, with some finding worse spatial ability in CAH males relative to controls (Hampson et al, 1998;Hines et al, 2003) and others finding no significant difference (Baker & Ehrhardt, 1974;McGuire et al, 1975;Resnick et al, 1986).…”

Spatial function in adolescents and young adults with congenital adrenal hyperplasia: Clinical phenotype and implications for the androgen hypothesis

“…Although not well-documented, diminished cognitive function is observed in a subset of children who experienced early salt-wasting crises (Johannsen et al, 2006). Reports of lower mean IQs in salt-wasting than simple-virilizing groups due to a few very low-scoring individuals (Nass and Baker, 1991a,b;Helleday et al, 1994) suggest the phenomenon may be more prevalent than often recognized. If present, impaired IQ associated with neurological complications could mask any improvement in spatial ability attributable to androgens because performance on many spatial tasks is influenced by general intelligence not just spatial ability.…”

“…The capacity of androgens to modify spatially relevant regions of the CNS in laboratory animals (Isgor and Sengelaub, 2003) supports the possibility that spatial function in humans too is organized by androgens. A few studies have reported superior performance by females with CAH relative to controls on mental rotation tasks, figural disembedding, or learning the layout of a virtual environment (Resnick et al, 1986;Hampson et al, 1998;Mueller et al, 2008;Berenbaum et al, 2012), but these data are controversial because other studies have failed to find an effect on spatial abilities (Baker and Ehrhardt, 1974;McGuire et al, 1975;Helleday et al, 1994) or have even found lower scores in CAH samples (Perlman, 1973). Hines et al (2003) reported that females with CAH outperformed unaffected female relatives on throwing projectiles at targets, but showed no difference on tests of mental rotation.…”

Cognitive Outcome in Adult Women Affected by Congenital Adrenal Hyperplasia due to 21-Hydroxylase Deficiency

“…However, a previous study on a similar sample, which found no differences on spatial or verbal abilities [7], as well as several recent studies have led us to question the original observations. One such study found mixed results [8], demonstrating the predicted male-typical cognitive pattern of lower verbal ability but no differences on any of the visuospatial tasks and poorer performance on a measure of spatial perception which typically favors males [1, 9]. More recently, two studies, both of which included a wide age range (adolescent to 40s) have found no differences between women with CAH and women without CAH on performance of tasks measuring mental rotation abilities [10, 11].…”