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A Battery of Motor Tests in a Neonatal Mouse Model of Cerebral Palsy
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A pilot study proposing an algorithm for pubertal induction in cerebral palsy.

Anne Trinh1,2, Angelina Lim3,2, Phillip Wong4,2

  • 1Monash Health, Clayton, VIC, Australia.

Journal of Pediatric Endocrinology & Metabolism : JPEM
|February 19, 2024
PubMed
Summary
This summary is machine-generated.

This study found that sex hormone supplementation is beneficial and well-tolerated for treating delayed puberty in individuals with cerebral palsy (CP). Early consideration for hormone therapy is recommended for severe pubertal delay or arrest.

Keywords:
cerebraldisabilityhormoneshypogonadismpuberty

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Area of Science:

  • Pediatric Endocrinology
  • Neurology
  • Reproductive Medicine

Background:

  • Delayed puberty is a concern in children with cerebral palsy (CP).
  • Current diagnostic and treatment protocols for pubertal delay in CP require further investigation.
  • Sex hormone supplementation is a potential intervention for pubertal delay.

Purpose of the Study:

  • To investigate the prevalence and characteristics of delayed puberty in individuals with cerebral palsy (CP).
  • To evaluate the acceptability and efficacy of a novel algorithm for puberty induction in CP.
  • To assess the impact of puberty induction on bone health, adverse effects, mobility, and quality of life.

Main Methods:

  • A two-phase cohort study involving children and adolescents with CP and delayed puberty.
  • Phase 1: Retrospective review of clinical records and interviews regarding sex-steroid treatment experiences.
  • Phase 2: Prospective trial of a puberty induction algorithm using transdermal testosterone (males) or estrogen (females), with two-year follow-up.

Main Results:

  • Sex-steroid treatment was well-tolerated in 11 out of 20 participants in Phase 1.
  • In Phase 2, 7 out of 10 participants reached Tanner stage 3 by nine months using the proposed algorithm.
  • Mean change in height-adjusted bone mineral density (BMAD) Z-scores was +0.27% (SD 0.002) in participants scanned by dual-energy X-ray absorptiometry (DXA).

Conclusions:

  • Delayed puberty in CP may be diagnosed late, highlighting the need for timely screening.
  • The proposed puberty induction algorithm was acceptable and showed beneficial effects.
  • Sex hormone supplementation should be considered for all patients with severe pubertal delay or arrest in CP due to its benefits and tolerability.