Early growth hormone therapy may aid cognition in kids with PWS

Starting growth hormone therapy as early as possible may help children with Prader-Willi syndrome (PWS) develop stronger thinking and language skills, according to a study from Taiwan.

“In addition to improved motor development, on the basis of previous studies, our study demonstrated that [growth hormone therapy] initiation at 3 years of age or earlier may benefit patients with PWS through improved cognitive function,” the researchers wrote.

The study, “Cognitive development in children with Prader–Willi syndrome receiving early growth hormone therapy,” was published in Pediatrics & Neonatology.

PWS causes problems with growth and development, with patients often having short stature and learning difficulties. Growth hormone therapy is commonly used to increase height and help the body build muscle while reducing fat.

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Assessing cognition

The researchers set out to determine whether starting growth hormone therapy at a younger age was linked to better cognitive development. They reviewed the medical records of 47 patients, 29 of whom started growth hormone therapy before age 3. The mean age at the start of growth hormone therapy was significantly different between those who started treatment before age 3 and those who started later (1.1 vs. 7.7).

To assess a child’s overall development relative to expected age milestones, the researchers used the developmental quotient (DQ); to evaluate their cognitive skills, they used the full-scale intelligence quotient (FSIQ). Children who started growth hormone therapy before age 3 had higher DQ/FSIQ scores than those who started it later (65.2 vs. 50.4 points), reflecting better cognitive development.

The researchers used the verbal intelligence quotient/verbal comprehension index (VIQ/VCI) to assess a child’s ability to understand language, process verbal information, and use words to communicate. Again, children who started growth hormone therapy before age 3 had higher average VIQ/VCI scores (75.7 vs. 54.1 points), indicating better language skills.

Further analyses showed that starting growth hormone therapy before age 3 was associated with an estimated 13-point higher DQ/FSIQ score and an estimated 21-point higher VIQ/VCI score. Additionally, analyses showed that every one-year delay in starting growth hormone therapy was associated with an average decrease of about 1.3 points in DQ/FSIQ and about two points in VIQ/VCI.

Growth hormone therapy “should be initiated as early as possible after the diagnosis is made,” the researchers wrote. “According to our study, the timing of [growth hormone therapy] was associated with better DQ/FSIQ scores before 3 years of age and as early as possible for better DQ/FSIQ scores and VIQ/VCI scores.”