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Szakács H, Mutlu MC, Balestrieri G, Gombos F, Braun J, Kringelbach ML, Deco G, Kovács I. Navigating Pubertal Goldilocks: The Optimal Pace for Hierarchical Brain Organization. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2308364. [PMID: 38489748 DOI: 10.1002/advs.202308364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/22/2024] [Indexed: 03/17/2024]
Abstract
Adolescence is a timed process with an onset, tempo, and duration. Nevertheless, the temporal dimension, especially the pace of maturation, remains an insufficiently studied aspect of developmental progression. The primary objective is to estimate the precise influence of pubertal maturational tempo on the configuration of associative brain regions. To this end, the connection between maturational stages and the level of hierarchical organization of large-scale brain networks in 12-13-year-old females is analyzed. Skeletal maturity is used as a proxy for pubertal progress. The degree of maturity is defined by the difference between bone age and chronological age. To assess the level of hierarchical organization in the brain, the temporal dynamic of closed eye resting state high-density electroencephalography (EEG) in the alpha frequency range is analyzed. Different levels of hierarchical order are captured by the measured asymmetry in the directionality of information flow between different regions. The calculated EEG-based entropy production of participant groups is then compared with accelerated, average, and decelerated maturity. Results indicate that an average maturational trajectory optimally aligns with cerebral hierarchical order, and both accelerated and decelerated timelines result in diminished cortical organization. This suggests that a "Goldilocks rule" of brain development is favoring a particular maturational tempo.
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Affiliation(s)
- Hanna Szakács
- Laboratory for Psychological Research, Pázmány Péter Catholic University, 1 Mikszáth Square, Budapest, 1088, Hungary
- Semmelweis University Doctoral School, Division of Mental Health Sciences, 26 Üllői road, Budapest, 1085, Hungary
| | - Murat Can Mutlu
- Institute of Biology, Otto-von-Guericke University, 44 Leipziger Straße, 39120, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Otto-von-Guericke University, 44 Leipziger Straße, 39120, Magdeburg, Germany
| | - Giulio Balestrieri
- Center for Brain and Cognition, Universitat Pompeu Fabra, 25-27 Ramon Trias Fargas, Barcelona, 08005, Spain
| | - Ferenc Gombos
- Laboratory for Psychological Research, Pázmány Péter Catholic University, 1 Mikszáth Square, Budapest, 1088, Hungary
- HUN-REN-ELTE-PPKE Adolescent Development Research Group, 1 Mikszáth Kálmán Square, Budapest, 1088, Hungary
| | - Jochen Braun
- Institute of Biology, Otto-von-Guericke University, 44 Leipziger Straße, 39120, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Otto-von-Guericke University, 44 Leipziger Straße, 39120, Magdeburg, Germany
| | - Morten L Kringelbach
- Centre for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, Wellington Square, Oxford, OX3 9BX, UK
- Department of Psychiatry, University of Oxford, Wellington Square, Oxford, OX3 7JX, UK
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University, Nordre Ringgade 1, Aarhus, 8000, Denmark
| | - Gustavo Deco
- Center for Brain and Cognition, Universitat Pompeu Fabra, 25-27 Ramon Trias Fargas, Barcelona, 08005, Spain
- Department of Information and Communication Technologies, Universitat Pompeu Fabra, 122-140 Carrer de Tànger, Barcelona, 08018, Spain
- Institució Catalana de la Recerca i Estudis Avançats (ICREA), 23 Passeig de Lluís Companys, Barcelona, 08010, Spain
| | - Ilona Kovács
- HUN-REN-ELTE-PPKE Adolescent Development Research Group, 1 Mikszáth Kálmán Square, Budapest, 1088, Hungary
- Institute of Psychology, Faculty of Education and Psychology, Eötvös Loránd University, 25-27 Kazinczy Street, Budapest, 1075, Hungary
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Kovács I, Kovács K, Gerván P, Utczás K, Oláh G, Tróznai Z, Berencsi A, Szakács H, Gombos F. Ultrasonic bone age fractionates cognitive abilities in adolescence. Sci Rep 2022; 12:5311. [PMID: 35351941 PMCID: PMC8964807 DOI: 10.1038/s41598-022-09329-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 03/22/2022] [Indexed: 12/12/2022] Open
Abstract
Adolescent development is not only shaped by the mere passing of time and accumulating experience, but it also depends on pubertal timing and the cascade of maturational processes orchestrated by gonadal hormones. Although individual variability in puberty onset confounds adolescent studies, it has not been efficiently controlled for. Here we introduce ultrasonic bone age assessment to estimate biological maturity and disentangle the independent effects of chronological and biological age on adolescent cognitive abilities. Comparing cognitive performance of female participants with different skeletal maturity we uncover the impact of biological age on both IQ and specific abilities. We find that biological age has a selective effect on abilities: more mature individuals within the same age group have higher working memory capacity and processing speed, while those with higher chronological age have better verbal abilities, independently of their maturity. Based on our findings, bone age is a promising biomarker of adolescent maturity.
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Affiliation(s)
- Ilona Kovács
- Laboratory for Psychological Research, Pázmány Péter Catholic University, 1 Mikszáth sq., 1088, Budapest, Hungary. .,Adolescent Development Research Group, Hungarian Academy of Sciences-Pázmány Péter Catholic University, 1088, Budapest, Hungary. .,Institute of Cognitive Neuroscience and Psychology, Res. Centre for Natural Sciences, 1117, Budapest, Hungary.
| | - Kristóf Kovács
- Institute of Psychology, ELTE Eötvös Loránd University, 1075, Budapest, Hungary
| | - Patrícia Gerván
- Laboratory for Psychological Research, Pázmány Péter Catholic University, 1 Mikszáth sq., 1088, Budapest, Hungary.,Adolescent Development Research Group, Hungarian Academy of Sciences-Pázmány Péter Catholic University, 1088, Budapest, Hungary
| | - Katinka Utczás
- Research Centre for Sport Physiology, University of Physical Education, 1123, Budapest, Hungary
| | - Gyöngyi Oláh
- Laboratory for Psychological Research, Pázmány Péter Catholic University, 1 Mikszáth sq., 1088, Budapest, Hungary.,Adolescent Development Research Group, Hungarian Academy of Sciences-Pázmány Péter Catholic University, 1088, Budapest, Hungary
| | - Zsófia Tróznai
- Research Centre for Sport Physiology, University of Physical Education, 1123, Budapest, Hungary
| | - Andrea Berencsi
- Institute for the Methodology of Special Needs Education and Rehabilitation, Bárczi Gusztáv Faculty of Special Needs Education, Eötvös Loránd University, 1097, Budapest, Hungary
| | - Hanna Szakács
- Laboratory for Psychological Research, Pázmány Péter Catholic University, 1 Mikszáth sq., 1088, Budapest, Hungary
| | - Ferenc Gombos
- Laboratory for Psychological Research, Pázmány Péter Catholic University, 1 Mikszáth sq., 1088, Budapest, Hungary.,Adolescent Development Research Group, Hungarian Academy of Sciences-Pázmány Péter Catholic University, 1088, Budapest, Hungary
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Song W, Zhao F, Liang S, Li G, Xue J. Is a Combination of a GnRH Agonist and Recombinant Growth Hormone an Effective Treatment to Increase the Final Adult Height of Girls with Precocious or Early Puberty? Int J Endocrinol 2018; 2018:1708650. [PMID: 30693027 PMCID: PMC6332953 DOI: 10.1155/2018/1708650] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 09/18/2018] [Accepted: 10/04/2018] [Indexed: 02/02/2023] Open
Abstract
The aim of treatment for idiopathic central precocious puberty (ICPP) is to increase final adult stature, for which gonadotropin-releasing hormone agonist (GnRHa) is the gold standard. Early puberty is frequently similar to ICPP, with pubertal onset only slightly advanced. Short stature may result from early pubertal onset. Some studies have suggested that recombinant human growth hormone (rhGH) should be combined with a GnRHa to improve adult height, while others have not. Here, the aim was to compare the efficacy of combined GnRHa and rhGH treatment with GnRHa or rhGH treatment alone, or no therapy, for the improvement of the final height of girls with ICPP or early puberty. Electronic databases of randomized and quasi-randomized controlled trials, in which the efficacy of GnRHa preparations was compared with that of rhGH for the treatment of children with precocious or early puberty, were searched and a meta-analysis conducted. Five studies of early puberty and four studies of ICPP were identified. There were no statistically significant differences between final adult height standard deviation score and initial height standard deviation score in the treatment of early puberty (GnRHa and rhGH versus rhGH alone or no treatment). The overall analysis of the data failed to indicate any benefit of combined therapy, while individual reports suggested that in specific instances combined therapy may be beneficial in preserving or reclaiming growth potential and improving adult height.
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Affiliation(s)
- Wei Song
- Department of Pediatrics, The Second Hospital of Shandong University, Jinan, Shandong Province, China
| | - Fei Zhao
- Department of Pediatrics, The Second Hospital of Shandong University, Jinan, Shandong Province, China
| | - Shuang Liang
- Department of Pediatrics, The Second Hospital of Shandong University, Jinan, Shandong Province, China
| | - Guimei Li
- Department of Pediatrics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Jiang Xue
- Department of Pediatrics, The Second Hospital of Shandong University, Jinan, Shandong Province, China
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Hsieh CW, Liu TC, Wang JK, Jong TL, Tiu CM. Simplified radius, ulna, and short bone-age assessment procedure using grouped-Tanner-Whitehouse method. Pediatr Int 2011; 53:567-75. [PMID: 21486377 DOI: 10.1111/j.1442-200x.2011.03378.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The Tanner-Whitehouse III (TW3) method is popular for assessing children's bone age, but it is time-consuming in clinical settings; to simplify this, a grouped-TW algorithm (GTA) was developed. METHODS A total of 534 left-hand roentgenograms of subjects aged 2-15 years, including 270 training and 264 testing datasets, were evaluated by a senior pediatrician. Next, GTA was used to choose the appropriate candidate of radius, ulna, and short bones and to classify the bones into three groups by data mining. Group 1 was composed of the maturity pattern of the radius and the middle phalange of the third and fifth digits and three weights were obtained by data mining, yielding a result similar to that of TW3. Subsequently, new bone-age assessment tables were constructed for boys and girls by linear regression and fuzzy logic. In addition, the Bland-Altman plot was utilized to compare accuracy between the GTA, the Greulich-Pyle (GP), and the TW3 method. RESULTS The relative accuracy between the GTA and the TW3 was 96.2% in boys and 95% in girls, with an error of 1 year, while that between the assessment results of the GP and TW3 was about 87%, with an error of 1 year. However, even if the three weights were not optimally processed, GTA yielded a marginal result with an accuracy of 78.2% in boys and 79.6% in girls. CONCLUSIONS GTA can efficiently simplify the complexity of the TW3 method, while maintaining almost the same accuracy. The relative accuracy between the assessment results of GTA and GP can also be marginal.
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Affiliation(s)
- Chi-Wen Hsieh
- Department of Electrical Engineering, National Chiayi University, Chiayi City, Taiwan.
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Hsieh CW, Jong TL, Tiu CM. Bone age estimation based on phalanx information with fuzzy constrain of carpals. Med Biol Eng Comput 2007; 45:283-95. [PMID: 17242901 DOI: 10.1007/s11517-006-0155-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2006] [Accepted: 12/14/2006] [Indexed: 11/29/2022]
Abstract
The proposed automatic bone age estimation system was based on the phalanx geometric characteristics and carpals fuzzy information. The system could do automatic calibration by analyzing the geometric properties of hand images. Physiological and morphological features are extracted from medius image in segmentation stage. Back-propagation, radial basis function, and support vector machine neural networks were applied to classify the phalanx bone age. In addition, the proposed fuzzy bone age (BA) assessment was based on normalized bone area ratio of carpals. The result reveals that the carpal features can effectively reduce classification errors when age is less than 9 years old. Meanwhile, carpal features will become less influential to assess BA when children grow up to 10 years old. On the other hand, phalanx features become the significant parameters to depict the bone maturity from 10 years old to adult stage. Owing to these properties, the proposed novel BA assessment system combined the phalanxes and carpals assessment. Furthermore, the system adopted not only neural network classifiers but fuzzy bone age confinement and got a result nearly to be practical clinically.
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Affiliation(s)
- Chi-Wen Hsieh
- Department of Electrical Engineering, National Tsing Hwa University, Hsinchu, Taiwan, ROC.
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Abstract
The problems of central precocious puberty (CPP) are serious enough to the patient to deserve treatment. There is a general consensus among paediatric endocrinologists that the treatment of true CPP (i.e., in children young enough to have a formal diagnosis) is indicated in many cases. In children with modestly early puberty who are not fulfilling the diagnostic criteria, this is not the case. The treatment of choice is a gonadotropin-releasing hormone (GnRH) analogue. Prolonged analogues are more effective than short-acting ones and, most importantly, independent of patient compliance. Data on agonists have accumulated over two decades and evidence of effects is rich in girls but sparse in boys. GnRH agonists are generally effective and safe drugs; the suppression of puberty is reversible and there is much information on GnRH agonists for the treatment of CPP showing very few adverse effects and the effects on final height are well documented in girls < 6 years of age. There is some (but not highly convincing) evidence for their effect on final height for those of 6 - 8 years of age and there is no evidence for an increase in final height after the age of 8 years in girls. If a decision to have treatment is taken, treatment should start immediately as a possible benefit is less probable if the start of treatment is delayed. When treatment should be stopped is a matter of controversy. Combination with growth hormone increases final height, but the clinical relevance can be discussed as well as the health economy aspects. The limits of indications are still to be defined.
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Affiliation(s)
- Torsten Tuvemo
- Uppsala University, Department of Women's and Children's Health, Uppsala University Children's Hospital, S-751 85 Uppsala, Sweden.
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