Children with classic congenital adrenal hyperplasia have decreased amygdala volume: potential prenatal and postnatal hormonal effects.

摘要: Children with classic congenital adrenal hyperplasia (CAH) have multiple endocrine imbalances, including prenatal glucocorticoid and adrenomedullary deficiency androgen excess, possible postnatal iatrogenic hyperandrogenism, hypofunction. Prenatal masculinization of the brain has been suggested in girls CAH. Hormones hypothalamic-pituitary-adrenal axis sex hormones interact extrahypothalamic regulatory centers brain, amygdala hippocampus. The is important processing emotion generation fear, whereas hippocampus plays an role memory. Chronic hypercortisolemia shown to be associated hippocampal damage, while glucocorticoids corticotropin-releasing factor play a major regulation function. We performed magnetic resonance imaging on 27 children CAH 47 sex- age-matched controls. Volumes cerebrum, ventricles, temporal lobe, amygdala, were quantified. Females did not brains male-specific characteristics. In contrast, significant decrease volume was observed both males females (males, P = 0.01; females, 0.002). Iatrogenic effects due therapy These results suggest that resulting alterations regulation, steroid or some combination these preferentially affect growth development structure functional implications warrant further exploration.