Sallie Baxendale, Professeur de neuropsychologie clinique
Member, Université College London
ABSTRACT
Concerns have been raised regarding the neuropsychological impact of medications that interrupt puberty, given the magnitude and complexity of changes that occur in brain function and structure during this sensitive window of neurodevelopment. This review examines the literature on the impact of pubertal suppression on cognitive and behavioural function in animals and humans. In mammals the effects are complex and often sex specific. There is no evidence that cognitive effects are fully reversible following discontinuation of treatment. No human studies have systematically explored the impact of these treatments on neuropsychological function with an adequate baseline and follow up. However there is some evidence of a detrimental impact of pubertal suppression on IQ, concordant with findings in the wider literature on gonadotropin-hormone-releasing-hormone expression in relevant brain structures. Critical questions remain unanswered regarding the nature, extent and permanence of any arrested development of cognitive function that may be associated with pharmacological blocking of puberty in humans. The impact of puberal suppression on measures of neuropsychological functions should be an urgent priority for future research. Neuropsychologists should be an integral member of the multidisciplinary team caring for people treated with puberty blockers to monitor the impact of these treatments.
Keywords:Â puberty, cognition, neurodevelopment; memory; intelligence; gonadotropin-hormone-releasing-hormone (GnRH); review