Working memory performance is reduced in children with congenital adrenal hyperplasia |
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| Institution: | 1. Department of Psychology, University of Cambridge, Free School Lane, Cambridge CB2 3RQ, United Kingdom;2. Department of Paediatric Endocrinology, University College London, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, United Kingdom;3. Department of Paediatrics, University of Cambridge, Level 8/Box 116, Cambridge Biomedical Campus, Cambridge CB2 0QQ, United Kingdom;1. Department of Reproductive Medicine and Gynaecology, University Medical Center Utrecht, PB 85500, 3508 GA Utrecht, The Netherlands;2. Department of Obstetrics and Gynaecology, University Medical Center Groningen, PB 30001 9700RB Groningen, The Netherlands;3. Department of Epidemiology, University Medical Center Groningen, PB 30001, 9700RB Groningen, The Netherlands;4. Julius Center for Health Sciences and Primary Care, PB 85500, 3508 GA Utrecht, The Netherlands;1. Division of Rheumatology, Children''s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA;2. Division of Biomedical and Health Informatics, Children''s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA;3. Division of Nephrology, Children''s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA;4. Division of Gastroenterology, Children''s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA;5. Division of General Pediatrics, Children''s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA;1. Institute of Biochemistry, Graz University of Technology, NaWi Graz, Austria;2. Institute of Molecular Biosciences, University of Graz, NaWi Graz, Austria;1. Department of Medicine, Division of Cardiology, College of Physicians and Surgeons of Columbia University, 622 W 168th Street, New York, NY 10032, United States;2. Department of Pathology and Feinberg Cardiovascular Research Institute, Northwestern University, Feinberg School of Medicine, 300 E. Superior Street, Chicago, IL 60611, United States |
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| Abstract: | Individuals with classic congenital adrenal hyperplasia (CAH) experience impaired glucocorticoid production and are treated postnatally with glucocorticoids. Prior research with animals and other human populations indicates that glucocorticoids can influence memory, particularly working memory. We tested the hypothesis that children with CAH would show reduced working memory. Children in the United Kingdom, aged 7–11 years, with classical CAH (31 girls, 26 boys) were compared to their unaffected relatives (30 girls, 20 boys) on a test of working memory, the Digit Span test. Vocabulary was also assessed to measure verbal intelligence for control purposes. Children with CAH showed reduced working memory performance compared to controls, on both components of the Digit Span test: p = .008 for Digit Span Forward, and p = .027 for Digit Span Backward, and on a composite score, p = .004. These differences were of moderate size (d = .53 to .70). Similar differences were also seen in a subset of 23 matched pairs of children with CAH and their relatives (d = .78 to .92). There were no group differences on Vocabulary. Glucocorticoid abnormality, including treatment effects, could be responsible for the reduced Digit Span performance in children with CAH. Other factors related to CAH, such as salt-wasting crises, could also be involved. Additional research is needed to identify the cause of the memory reduction, which will help to determine if more rapid diagnosis or more precise glucocorticoid treatment would help prevent memory reduction. Educational interventions might also be considered for children with CAH. |
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