Positive effects of early androgen therapy on the behavioral phenotype of boys with 47,XXY

Am J Med Genet C Semin Med Genet. 2015 Jun;169(2):150-7. doi: 10.1002/ajmg.c.31437. Epub 2015 May 1.

Abstract

47, XXY occurs in up to 1 in 650 male births and is associated with androgen deficiency, neurodevelopmental delays, and atypical social-behaviors. Previously, we showed that young boys with 47, XXY who received early hormonal therapy (EHT) had significantly improved neurodevelopment. The objective of this follow-up study was to examine the effects of EHT on social behavior in boys with 47, XXY. The study consisted of boys prenatally diagnosed with 47, XXY who were referred for evaluations. Twenty-nine boys received three injections of 25 mg testosterone enanthate and 57 controls did not receive EHT. Behavioral functioning was assessed using the Behavior Rating Inventory of Executive Function, Social Responsiveness Scale, 2nd Ed., and the Child Behavior Checklist for Ages 6-18. The hypothesis that EHT may affect behavior was formulated prior to data collection. Questionnaire data was prospectively obtained and analyzed to test for significance between two groups. Significant differences were identified between group's scores over time in Social Communication (P=0.007), Social Cognition (P=0.006), and Total T-score (P=0.001) on the SRS-2; Initiation (P=0.05) on the BRIEF; and Externalizing Problems (P=0.024), Affective Problems (P=0.05), and Aggressive Behaviors (P=0.031) on the CBCL. This is the third study revealing positive effects of EHT on boys with XXY. There was a significant improvements associated with the 47, XXY genotype in boys who received EHT. Research is underway on the neurobiological mechanisms, and later developmental effects of EHT.

Keywords: Klinefelter syndrome; XXY; androgens; chromosomal disorders.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Androgens / therapeutic use*
  • Behavior Rating Scale
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Communication
  • Developmental Disabilities / diagnosis
  • Developmental Disabilities / drug therapy*
  • Developmental Disabilities / physiopathology
  • Developmental Disabilities / psychology
  • Follow-Up Studies
  • Hormone Replacement Therapy / methods*
  • Humans
  • Karyotyping
  • Male
  • Phenotype
  • Prenatal Diagnosis
  • Sex Chromosome Disorders / diagnosis
  • Sex Chromosome Disorders / drug therapy*
  • Sex Chromosome Disorders / physiopathology
  • Sex Chromosome Disorders / psychology
  • Social Behavior*
  • Testosterone / analogs & derivatives*
  • Testosterone / therapeutic use
  • Treatment Outcome
  • XYY Karyotype / diagnosis
  • XYY Karyotype / drug therapy*
  • XYY Karyotype / physiopathology
  • XYY Karyotype / psychology

Substances

  • Androgens
  • Testosterone
  • testosterone enanthate

Supplementary concepts

  • 47, XYY syndrome