Cognitive functioning in idiopathic hypogonadotropic hypogonadism

Abstract

This study investigated the cognitive function of untreated, androgen and gonadotropin deficient, delayed puberty males before and after hormone replacement treatment. Ten untreated idiopathic hypogonadotropic hypogonadal (IHH) male subjects (mean age = 22.9 years, education = 12.9 years) were compared with 9 male and 10 female controls of similar age and education on a neuropsychological battery. The battery included tests associated with cognitive sex differences (verbal and spatial abilities, field independence and laterality), as well as IQ, memory, speed and attention (Wechsler IQ and Memory Scale, Reaction Time, Rey Auditory Verbal Learning, Verbal Fluency, Mental Rotations, Sticks, Manikin, Streetmap, Embedded Figures, Rod and Frame and verbal Dichotic Listening).;IHH subjects performed significantly more poorly than controls in attention, speed and verbal learning. Additionally, IHH subjects failed to demonstrate a clear spatial deficit, contrary to findings of most previous IHH studies (Hier & Crowley, 1982; Buchsbaum & Henkin, 1980; Bobrow, Money, & Lewis, 1971). Their cognitive performance could not be characterized as clearly male or female in overall pattern. Furthermore, there were no significant changes after hormone treatment when subjects were retested months later.;IHH subjects did, however, demonstrate cross-modality attentional anomalies indicative of higher order cortical deficits. These anomalies may arise from developmental abnormalities of attentional or other regions (e.g., corpus callosum, pulvinar or left parietal cortex), particularly those associated with midline structures. Cognitive impairment in IHH subjects may, therefore, be associated with--rather than directly result from--androgen or gonadotropin deficiency, per se. Alternatively, it may arise from an interaction between structural abnormalities and hormonal deficits.