Neurodevelopmental Outcomes in Congenital Hypothyroidism: Comparison of Initial T4 Dose and Time to Reach Target T4 and TSH

Selva, Karin A.; Harper, Alfred E.; Downs, A.; Blasco, Peter A.; LaFranchi, Stephen

doi:10.1016/j.jpeds.2005.07.024

Cited by 174 publications

(125 citation statements)

References 13 publications

Supporting

Mentioning

110

Contrasting

Unclassified

Order By: Relevance

“…Some examples include attention deficits, 2,3,[5][6][7][8][9][10][11] memory deficits, 3,5-7,9-13 cognitive flexibility and working memory deficits, 6,14,15 problems with visuospatial skills, 3,[5][6][7]9,12,13,[15][16][17] and difficulties with processing speed and reaction times. 5,6,11 However, no studies have been conducted in our population to analyze mild cognitive deficits that may be potentially present in CH.…”

Section: Introductionmentioning

confidence: 99%

Cognitive profiles of patients with early detected and treated congenital hypothyroidism

et al. 2017

View full text Add to dashboard Cite

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.

show abstract

Section: Introductionmentioning

confidence: 99%

Cognitive profiles of patients with early detected and treated congenital hypothyroidism

et al. 2017

View full text Add to dashboard Cite

show abstract

“…A child with a confirmed diagnosis of CH needs prompt treatment with L-thyroxine and the etiological research may be delayed until 3 years of age, considering that the first concern is to preserve the child's developing central nervous system, growth and cognitive capacity (12)(13)(14)(15)(16).…”

Section: Discussionmentioning

confidence: 99%

Timing of thyroid ultrasonography in the etiological investigation of congenital hypothyroidism

Borges

Sedassari

et al. 2017

Arch. Endocrinol. Metab.

View full text Add to dashboard Cite

Objectives: To describe the findings of thyroid ultrasonography (T-US), its contribution to diagnose congenital hypothyroidism (CH) and the best time to perform it. Subjects and methods: Forty-four patients with CH were invited to undergo T-US and 41 accepted. Age ranged from 2 months to 45 years; 23 patients were females. All were treated with L-thyroxine; 16 had previously undergone scintigraphy and 30 had previous T-US, which were compared to current ones. Results: At the current T-US, the thyroid gland was not visualized in its normal topography in 10 patients (24.5%); 31 T-US showed topic thyroid, 17 with normal or increased volume due to probable dyshormonogenesis, 13 cases of hypoplasia and one case of left-lobe hemiagenesis. One patient had decreased volume due to central hypothyroidism. Scintigraphy scans performed 3-4 years earlier showed 100% agreement with current results. Comparisons with previous T-US showed concordant results regarding thyroid location, but a decrease in current volume was observed in eight due to the use of L-thyroxine, calling the diagnosis of hypoplasia into question. Conclusions: The role of T-US goes beyond complementing scintigraphy results. It allows inferring the etiology of CH, but it must be performed in the first months of life. An accurate diagnosis of CH will be attained with molecular study and the T-US can guide this early assessment, without therapy withdrawal. Arch Endocrinol Metab. 2017;61(5):432-7

show abstract

“…Even mild to moderately low levels of T 4 during the first trimester are associated with cognitive deficits in the children (Haddow, 2005;Haddow et al, 1999;Pop et al, 1999Pop et al, , 2003. Also, small deficits in circulating levels of TH are associated with decreased cognitive performance at various times during development and adulthood (Glinoer and Rovet, 2009;Heyerdahl and Oerbeck, 2003;LaFranchi and Austin, 2007;Selva et al, 2005;Simic et al, 2009).…”

Section: Th Function and Role In Developmentmentioning

confidence: 99%

“…Thyroid hormones, including, thyroxine (T 4 ) and triiodothyronine (T 3 ), are essential for normal brain development, particularly prenatally (Morreale de Escobar, 2001;Zoeller and Rovet, 2004). TH perturbations in pregnant mothers are associated with neurological deficits in their children, including IQ decrements (Haddow et al, 1999;Oerbeck et al, 2003;Selva et al, 2005). Moreover, numerous environmental chemicals can modulate TH levels (Crofton, 2008;Miller et al, 2009).…”

mentioning

confidence: 99%

Upstream adverse effects in risk assessment: A model of polychlorinated biphenyls, thyroid hormone disruption and neurological outcomes in humans

Wise

Parham

Axelrad

et al. 2012

Environmental Research

View full text Add to dashboard Cite

a b s t r a c tBackground: Increasing data on early biological changes from chemical exposures requires new interpretation tools to support decision-making. Objectives: To test the possibility of applying a quantitative approach using human data linking chemical exposures and upstream biological perturbations to overt downstream outcomes. Methods: Using polychlorinated biphenyl (PCB) exposures and maternal thyroid hormone (TH) perturbations as a case study, we model three relationships: (1) prenatal PCB exposures and TH changes, using free T 4 (FT 4 ); (2) prenatal TH and childhood neurodevelopmental outcomes; and (3) prenatal PCB exposures and childhood neurodevelopmental outcomes (IQ). We surveyed the epidemiological literature; extracted relevant quantitative data; and developed models for each relationship, applying meta-analysis where appropriate. Results: For relationship 1, a meta-analysis of 3 studies gives a coefficient of À 0.27 pg/mL FT 4 per ln(sum of PCBs) (95% confidence interval [CI] À 0.82 to 0.27). For relationship 2, regression coefficients from three studies of maternal FT 4 levels and cognitive scores ranged between 0.99 IQ points/(pg/mL FT 4 ) (95% CI À 0.31 to 2.2) and 7.6 points/(pg/mL FT 4 ) (95% CI 1.2 to 16.3). For relationship 3, a metaanalysis of five studies produces a coefficient of À 1.98 IQ points (95% CI À 4.46 to 0.50) per unit increase in ln(sum of PCBs). Combining relationships 1 and 2 yields an estimate of À 2.0 to À 0.27 points of IQ per unit increase in ln(sum of PCBs). Conclusions: Combining analysis of chemical exposures and early biological perturbations (PCBs and FT 4 ) with analysis of early biological perturbations and downstream overt effects (FT 4 and IQ) yields estimates within the range of studies of exposures and overt effects (PCBs and IQ). This is an example approach using upstream biological perturbations for effect prediction.

show abstract

Neurodevelopmental Outcomes in Congenital Hypothyroidism: Comparison of Initial T4 Dose and Time to Reach Target T4 and TSH

Cited by 174 publications

References 13 publications

Cognitive profiles of patients with early detected and treated congenital hypothyroidism

Cognitive profiles of patients with early detected and treated congenital hypothyroidism

Timing of thyroid ultrasonography in the etiological investigation of congenital hypothyroidism

Upstream adverse effects in risk assessment: A model of polychlorinated biphenyls, thyroid hormone disruption and neurological outcomes in humans

Contact Info

Product

Resources

About