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Cognitive, Emotional, and Psychosocial Functioning of Girls Treated with Pharmacological Puberty Blockage for Idiopathic Central Precocious Puberty.

Wojniusz S, Callens N, Sütterlin S, Andersson S, De Schepper J, Gies I, Vanbesien J, De Waele K, Van Aken S, Craen M, Vögele C, Cools M, Haraldsen IR - Front Psychol (2016)

Bottom Line: CPP is associated with lower adult height and increased risk for development of psychological problems.Unexpectedly, the CPP group showed significantly lower resting heart rates than the controls (p = 0.004; Cohen's d = 1.03); lower heart rate was associated with longer treatment duration (r = -0.582, p = 0.037).The results suggest that GnRHa treated CPP girls do not differ in their cognitive or psychosocial functioning from age matched controls.

View Article: PubMed Central - PubMed

Affiliation: Division of Surgery and Clinical Neuroscience, Department of Medical Neurobiology, Oslo University HospitalOslo, Norway; Department of Physiotherapy, Oslo and Akershus University College of Applied SciencesOslo, Norway.

ABSTRACT
Central precocious puberty (CPP) develops due to premature activation of the hypothalamic-pituitary-gonadal (HPG) axis, resulting in early pubertal changes and rapid bone maturation. CPP is associated with lower adult height and increased risk for development of psychological problems. Standard treatment of CPP is based on postponement of pubertal development by blockade of the HPG axis with gonadotropin releasing hormone analogs (GnRHa) leading to abolition of gonadal sex hormones synthesis. Whereas the hormonal and auxological effects of GnRHa are well-researched, there is a lack of knowledge whether GnRHa treatment influences psychological functioning of treated children, despite the fact that prevention of psychological problems is used as one of the main reasons for treatment initiation. In the present study we seek to address this issue by exploring differences in cognitive function, behavior, emotional reactivity, and psychosocial problems between GnRHa treated CPP girls and age-matched controls. Fifteen girls with idiopathic CPP; median age 10.4 years, treated with slow-release GnRHa (triptorelin acetate-Decapeptyl SR® 11.25) and 15 age-matched controls, were assessed with a comprehensive test battery consisting of paper and pencil tests, computerized tasks, behavioral paradigms, heart rate variability, and questionnaires filled in by the children's parents. Both groups showed very similar scores with regard to cognitive performance, behavioral and psychosocial problems. Compared to controls, treated girls displayed significantly higher emotional reactivity (p = 0.016; Cohen's d = 1.04) on one of the two emotional reactivity task conditions. Unexpectedly, the CPP group showed significantly lower resting heart rates than the controls (p = 0.004; Cohen's d = 1.03); lower heart rate was associated with longer treatment duration (r = -0.582, p = 0.037). The results suggest that GnRHa treated CPP girls do not differ in their cognitive or psychosocial functioning from age matched controls. However, they might process emotional stimuli differently. The unexpected finding of lower heart rate that was associated with longer duration of the treatment should be further explored by methods appropriate for assessment of cardiac health.

No MeSH data available.


Related in: MedlinePlus

Emotional flanker task. In 207 trials, children were requested to decide as fast as possible whether two houses were identical or not. The faces were irrelevant for task solution and did not need to be attended to. The difference between reaction times in the presence of anxious and neutral faces (flanker valence effect) was used as a measure of emotional reactivity. Pictures of facial expressions were obtained from the Karolinska Directed Emotional Faces database (Lundqvist et al., 1998).
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Figure 1: Emotional flanker task. In 207 trials, children were requested to decide as fast as possible whether two houses were identical or not. The faces were irrelevant for task solution and did not need to be attended to. The difference between reaction times in the presence of anxious and neutral faces (flanker valence effect) was used as a measure of emotional reactivity. Pictures of facial expressions were obtained from the Karolinska Directed Emotional Faces database (Lundqvist et al., 1998).

Mentions: EFT was used to assess emotional reactivity. The task is an adapted version based on previous studies (Bishop et al., 2004). With an inter-trial interval of 1000 ms, on each trial, two faces and two houses were presented in horizontal and vertical pairs, respectively (Figure 1). Participants were instructed to decide as fast as possible whether the presented buildings were identical or not, and to respond by pressing a corresponding response button. They were informed that the faces presented in the periphery were irrelevant and didn't need to be attended to. If a participant did not make a choice within the first 4 s, the next trial was automatically presented. After five practice trials, participants were exposed to 207 trials, starting with three consecutive trials with neutral flankers to increase the effects of emotional flankers (Bishop et al., 2004). Out of the remaining 204 trials, target stimuli (houses) were identical in 50% of the trials; in 35% of all presentation trials flanker stimuli consisted of anxious faces, and in 65% of trials of faces with neutral expressions. The lower proportion of emotional flankers was chosen to increase the stimulus valence and resulting reactivity to these trials (Bishop et al., 2004).


Cognitive, Emotional, and Psychosocial Functioning of Girls Treated with Pharmacological Puberty Blockage for Idiopathic Central Precocious Puberty.

Wojniusz S, Callens N, Sütterlin S, Andersson S, De Schepper J, Gies I, Vanbesien J, De Waele K, Van Aken S, Craen M, Vögele C, Cools M, Haraldsen IR - Front Psychol (2016)

Emotional flanker task. In 207 trials, children were requested to decide as fast as possible whether two houses were identical or not. The faces were irrelevant for task solution and did not need to be attended to. The difference between reaction times in the presence of anxious and neutral faces (flanker valence effect) was used as a measure of emotional reactivity. Pictures of facial expressions were obtained from the Karolinska Directed Emotional Faces database (Lundqvist et al., 1998).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4940404&req=5

Figure 1: Emotional flanker task. In 207 trials, children were requested to decide as fast as possible whether two houses were identical or not. The faces were irrelevant for task solution and did not need to be attended to. The difference between reaction times in the presence of anxious and neutral faces (flanker valence effect) was used as a measure of emotional reactivity. Pictures of facial expressions were obtained from the Karolinska Directed Emotional Faces database (Lundqvist et al., 1998).
Mentions: EFT was used to assess emotional reactivity. The task is an adapted version based on previous studies (Bishop et al., 2004). With an inter-trial interval of 1000 ms, on each trial, two faces and two houses were presented in horizontal and vertical pairs, respectively (Figure 1). Participants were instructed to decide as fast as possible whether the presented buildings were identical or not, and to respond by pressing a corresponding response button. They were informed that the faces presented in the periphery were irrelevant and didn't need to be attended to. If a participant did not make a choice within the first 4 s, the next trial was automatically presented. After five practice trials, participants were exposed to 207 trials, starting with three consecutive trials with neutral flankers to increase the effects of emotional flankers (Bishop et al., 2004). Out of the remaining 204 trials, target stimuli (houses) were identical in 50% of the trials; in 35% of all presentation trials flanker stimuli consisted of anxious faces, and in 65% of trials of faces with neutral expressions. The lower proportion of emotional flankers was chosen to increase the stimulus valence and resulting reactivity to these trials (Bishop et al., 2004).

Bottom Line: CPP is associated with lower adult height and increased risk for development of psychological problems.Unexpectedly, the CPP group showed significantly lower resting heart rates than the controls (p = 0.004; Cohen's d = 1.03); lower heart rate was associated with longer treatment duration (r = -0.582, p = 0.037).The results suggest that GnRHa treated CPP girls do not differ in their cognitive or psychosocial functioning from age matched controls.

View Article: PubMed Central - PubMed

Affiliation: Division of Surgery and Clinical Neuroscience, Department of Medical Neurobiology, Oslo University HospitalOslo, Norway; Department of Physiotherapy, Oslo and Akershus University College of Applied SciencesOslo, Norway.

ABSTRACT
Central precocious puberty (CPP) develops due to premature activation of the hypothalamic-pituitary-gonadal (HPG) axis, resulting in early pubertal changes and rapid bone maturation. CPP is associated with lower adult height and increased risk for development of psychological problems. Standard treatment of CPP is based on postponement of pubertal development by blockade of the HPG axis with gonadotropin releasing hormone analogs (GnRHa) leading to abolition of gonadal sex hormones synthesis. Whereas the hormonal and auxological effects of GnRHa are well-researched, there is a lack of knowledge whether GnRHa treatment influences psychological functioning of treated children, despite the fact that prevention of psychological problems is used as one of the main reasons for treatment initiation. In the present study we seek to address this issue by exploring differences in cognitive function, behavior, emotional reactivity, and psychosocial problems between GnRHa treated CPP girls and age-matched controls. Fifteen girls with idiopathic CPP; median age 10.4 years, treated with slow-release GnRHa (triptorelin acetate-Decapeptyl SR® 11.25) and 15 age-matched controls, were assessed with a comprehensive test battery consisting of paper and pencil tests, computerized tasks, behavioral paradigms, heart rate variability, and questionnaires filled in by the children's parents. Both groups showed very similar scores with regard to cognitive performance, behavioral and psychosocial problems. Compared to controls, treated girls displayed significantly higher emotional reactivity (p = 0.016; Cohen's d = 1.04) on one of the two emotional reactivity task conditions. Unexpectedly, the CPP group showed significantly lower resting heart rates than the controls (p = 0.004; Cohen's d = 1.03); lower heart rate was associated with longer treatment duration (r = -0.582, p = 0.037). The results suggest that GnRHa treated CPP girls do not differ in their cognitive or psychosocial functioning from age matched controls. However, they might process emotional stimuli differently. The unexpected finding of lower heart rate that was associated with longer duration of the treatment should be further explored by methods appropriate for assessment of cardiac health.

No MeSH data available.


Related in: MedlinePlus