Evaluation of cognitive function and behavioural performances in girls with non-classical congenital adrenal hyperplasia

Background: Impaired cognitive function and bebavionral disorders have been reported in girls with classical congenita! hyperplasia (CAH), possibly due to prenatal androgen exposnre. Objective and hypotheses: Aim ofthis study was to investigate whether the same disorders may be observed even in girls with non-classica1 (NC) CAH, where thc role of prenatal hyperandrogenism could be cxcluded. Padents and design: We administered the following neuropsychological tests to 9 girls with NC CAH (median age 12.9 years, IQR 11.2-15.5) and to their age-matehed healthy sisters (lO girls, median age 14.5 years, IQR 13.016.3): Leiter-R, 16 Persollality Factor lnventory (16PF), Multidimellsional Self Concept Scale (MSCS), Chi Id Behaviour Check lisI (CBCL). Dose of glucocorticoid treatment, 17-0HP and Androstenedione levels dunng the lasl year were chosen as indicalors ofpostnatal androgen excess. Results: Both full-scale IQ (p< 0.05) and reasoning subtest (p< 0.01) were significantly lower in the patient group, when compared to conlrol gl'Oup [89.7 (75-103.5) vs 103.2 (91-115) and 86 (67-99) vs 100 (97-118), respectively]. No other sigrùficant differences were found. In NC-CAH group, no correlations between IQ Icvels and androgen levels were found. Conduslons: a) even in the NC CAH girls is present an impaired cognitive function, probably related to a postnatal androgen excess; b) tbe behavioural changes, secn in girls with classical CAH and related to prenatal androgen excess, does not seem to be present in NC-CAH patients; c) studles on larger NC-CAH populations should be performed for confinning our preliminary findings.