Effects of Treatment with Oxandrolone for 4 Years on the Frequency of Severe Arithmetic Learning Disability in Girls with Turner Syndrome

Ross, Judith L.; Mazzocco, Michele M.M.; Kushner, Harvey; Kowal, Karen; Cutler, Gordon B.; Roeltgen, David

doi:10.1016/j.jpeds.2009.05.031

« Previous Next »The Journal of Pediatrics
Volume 155, Issue 5 , Pages 714-720, November 2009

Effects of Treatment with Oxandrolone for 4 Years on the Frequency of Severe Arithmetic Learning Disability in Girls with Turner Syndrome

Judith L. Ross, MD
- Thomas Jefferson University, Philadelphia, PA
- Department of Pediatrics and the duPont Hospital for Children, Wilmington, DE
- Reprint requests: Dr Judith L. Ross, Thomas Jefferson University, Department of Pediatrics, Suite 726, 1025 Walnut Street, Philadelphia, PA 19107.
Michele M.M. Mazzocco, PhD
- Kennedy Krieger Institute, Johns Hopkins University, Baltimore, MD
Harvey Kushner, PhD
- Biomedical Computer Research Institute, Philadelphia, PA
Karen Kowal, PA
- Thomas Jefferson University, Philadelphia, PA
Gordon B. Cutler Jr., MD
- Developmental Endocrinology Branch, NICHD, NIH, Bethesda, MD
David Roeltgen, MD
- Department of Neurology and Center for Aphasia Research and Rehabilitation, Georgetown University, Washington, DC

Received 13 November 2008; received in revised form 14 April 2009; accepted 21 May 2009. published online 30 July 2009.

Objectives

To study androgen treatment effects on arithmetic performance in girls with Turner syndrome.

Study design

Forty-four girls, ages 10 to 14 years at baseline, completed 4 years of treatment with oxandrolone (Ox) or placebo (Pl). All received growth hormone and estrogen replacement therapy. We assessed the number of girls with severe learning disability (LD, standard score ≤5^th percentile) on measures of academic arithmetic and reading achievement (WRAT-3, arithmetic and reading), given yearly, and the WIAT numerical operations (NOS) and reading subtests, given at year 4.

Results

On the WRAT-3 arithmetic, the frequency of severe arithmetic LD was similar in the Ox and Pl groups at baseline and at years 1 and 2. At years 3 and 4, fewer girls in the Ox than Pl group had a severe arithmetic LD (year 4: 0/22 vs 5/21, P = .02). On the WIAT NOS (year 4), fewer girls in the Ox than Pl groups had a severe arithmetic LD (3/21 vs 8/20, P = .09). WIAT NOS error analysis suggested that the improved performance in the Ox group was associated with better performance on multiplication and division (P < .01). The frequency of severe LD for the WRAT-3 reading was similar for the Ox and Pl groups (all years) and for the WIAT reading subtest (year 4).

Conclusions

Androgen treatment for 4 years in girls with Turner syndrome resulted in a small decrease in frequency of severe arithmetic LD, with no effect on reading LD.

LD, Learning disability, MRS, Mathematics reasoning, NOS, Numerical operations, Ox, Oxandrolone, Pl, Placebo, TS, Turner syndrome, VIQ/PIQ, Verbal IQ/performance IQ, WIAT, Wechsler Individual Achievement Test, WISC, Wechsler Intelligence Scale for Children, WRAT, Wide Range Achievement Test