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Ricciardi G, Cammisa L, Bove R, Picchiotti G, Spaziani M, Isidori AM, Aceti F, Giacchetti N, Romani M, Sogos C. Clinical, Cognitive and Neurodevelopmental Profile in Tetrasomies and Pentasomies: A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1719. [PMID: 36360447 PMCID: PMC9688827 DOI: 10.3390/children9111719] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/28/2022] [Accepted: 11/05/2022] [Indexed: 10/23/2023]
Abstract
Background: Sex chromosome aneuploidies (SCAs) are a group of disorders characterised by an abnormal number of sex chromosomes. Collective prevalence rate of SCAs is estimated to be around 1 in 400-500 live births; sex chromosome trisomies (e.g., XXX, XXY, XYY) are most frequent, while tetra- and pentasomies (e.g., XXXX, XXXXX, XXXY, XXXXY) are rarer, and the most common is 48, XXYY syndrome. The presence of additional X and/or Y chromosomes is believed to cause neurodevelopmental differences, with increased risk for developmental delays, language-based learning disabilities, cognitive impairments, executive dysfunction, and behavioural and psychological disorders. Aim of the Study: Our review has the purpose of analysing the neurocognitive, linguistical and behavioural profile of patients affected by sex chromosomes supernumerary aneuploidies (tetrasomy and pentasomy) to better understand the specific areas of weakness, in order to provide specific rehabilitation therapy. Methods: The literature search was performed by two authors independently. We used MEDLINE, PubMed, and PsycINFO search engines to identify sources of interest, without year or language restrictions. At the end of an accurate selection, 16 articles fulfilled the inclusion and exclusion criteria. Results and Conclusions: International literature has described single aspects of the neuropsychological profile of 48, XXYY and 49, XXXXY patients. In 48, XXYY patients, various degrees of psychosocial/executive functioning issues have been reported and there is an increased frequency of behavioural problems in childhood. Developmental delay and behavioural problems are the most common presenting problems, even if anxiety, depression and oppositional defiant disorder are also reported. They also show generalized difficulties with socialization and communication. Cognitive abilities are lower in measures of verbal IQ than in measures of performance IQ. Visuospatial skills are a relative strength compared to verbal skills. In patients with 49, XXXXY, both intellectual and adaptive functioning skills fall into the disability range, with better non-verbal cognitive performance. Speech and language testing reveals more deficits in expressive language than receptive language and comprehension. Anxiety, thought problems, internalizing and externalizing problems, and deficits in social cognition and communication are reported. Behavioural symptoms lessen from school age to adolescence, with the exception of thought problems and anxiety. Individuals affected by sex chromosome aneuploidies show testosterone deficiency, microorchidism, lack of pubertal progression and infertility. Hormone replacement therapy (HRT) is usually recommended for these patients: different studies have found that testosterone-based HRT benefit a wide range of areas initiated in these disorders, affecting not only neuromotor, cognitive and behavioural profile but also structural anomalies of the brain (i.e., increase of volume of grey temporal lobe matter). In conclusion, further studies are needed to better understand the neuropsychological profile with a complete evaluation, including neurocognitive and psychosocial aspects and to establish the real impact of HRT on improving the cognitive and behavioural profile of these patients.
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Affiliation(s)
- Giacomina Ricciardi
- Section of Child and Adolescents Neuropsychiatry, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
| | - Luca Cammisa
- Section of Child and Adolescents Neuropsychiatry, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
| | - Rossella Bove
- Section of Child and Adolescents Neuropsychiatry, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
| | - Giorgia Picchiotti
- Section of Child and Adolescents Neuropsychiatry, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
| | - Matteo Spaziani
- Advanced Endocrine Diagnostics Unit, Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy
| | - Andrea M. Isidori
- Advanced Endocrine Diagnostics Unit, Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy
| | - Franca Aceti
- Post-Partum Disorders Unit, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
| | - Nicoletta Giacchetti
- Post-Partum Disorders Unit, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
| | - Maria Romani
- Section of Child and Adolescents Neuropsychiatry, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
| | - Carla Sogos
- Section of Child and Adolescents Neuropsychiatry, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
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Gropman AL, Porter GF, Lasutschinkow PC, Sadeghin T, Tipton ES, Powell S, Samango-Sprouse CA. Neurocognitive development and capabilities in boys with 49,XXXXY syndrome. Am J Med Genet A 2020; 185:3541-3546. [PMID: 32662248 DOI: 10.1002/ajmg.a.61736] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 06/05/2020] [Indexed: 01/25/2023]
Abstract
49,XXXXY was previously associated with profound to severe intellectual deficits. However, prior research papers on the cognitive profiles of this population were confounded by small samples sizes, wide age spreads, and incomplete histories of testosterone replacement therapy. This study is the first comprehensive, international investigation of the neurocognitive aspects of 49,XXXXY, and the potential effects of biological treatment on this profile. Sixty-seven boys from infancy to 11 years of age were enrolled in this longitudinal study, with the majority of boys postnatally diagnosed though chromosomal analysis. These boys received a comprehensive neurocognitive evaluation tailored to specific language-based deficits and cognitive challenges. Results revealed higher neurocognitive capacities, both verbally and nonverbally, than previously reported in this disorder. Infant boys with 49,XXXXY who received early hormonal therapy (EHT) had significantly higher scores on the cognitive domain of the Bayley Scales of Infant Development than untreated infants (p = .013). In addition, treated school-aged participants had significantly better scaled scores than untreated boys in form completion (p = .042), a task that requires deductive reasoning, on nonverbal testing on the Leiter International Performance Scales. This study indicates greater cognitive capacities with a wide range of abilities in the child with 49,XXXXY, thus warranting further investigation to identify and understand the critical influences on the etiology and the variability of those capacities.
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Affiliation(s)
- Andrea L Gropman
- Division of Neurogenetics and Developments Pediatrics, Children's National Health System, Washington, District of Columbia, USA.,Department of Neurology, George Washington University, Washington, District of Columbia, USA
| | - Grace F Porter
- Research Department, The Focus Foundation, Davidsonville, Maryland, USA
| | | | - Teresa Sadeghin
- Research Department, The Focus Foundation, Davidsonville, Maryland, USA
| | | | - Sherida Powell
- Department of Economics, George Washington University, Washington, District of Columbia, USA
| | - Carole A Samango-Sprouse
- Research Department, The Focus Foundation, Davidsonville, Maryland, USA.,Department of Pediatrics, George Washington University, Washington, District of Columbia, USA.,Department of Human and Molecular Genetics, Florida International University, Miami, Florida, USA
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Samango-Sprouse CA, Gropman AL. Introduction: Comprehensive investigation into an international cohort of boys with 49,XXXXY. Am J Med Genet A 2020; 185:3554-3556. [PMID: 32656873 DOI: 10.1002/ajmg.a.61739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 06/06/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Carole A Samango-Sprouse
- Research Department, The Focus Foundation, Davidsonville, Maryland, USA.,Department of Pediatrics, George Washington University, Washington, District of Columbia, USA.,Department of Human and Molecular Genetics, Florida International University, Miami, Florida, USA
| | - Andrea L Gropman
- Division of Neurogenetics and Developments Pediatrics, Children's National Health System, Washington, District of Columbia, USA.,Department of Neurology, George Washington University, Washington, District of Columbia, USA
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