695 - Early Childhood Biomarkers of Behavioral Difficulties and the Associated Influence of Early Androgen Therapy in Males with 47,XXY, (Klinefelter syndrome)

Sunday, April 30, 2023

3:30 PM – 6:00 PM ET

Poster Number: 695
Publication Number: 695.308

Carole Samango-Sprouse, George Washington University, Crofton, MD, United States

Presenting Author(s)

CS

Carole Samango-Sprouse, Ed.D. (she/her/hers)

Associate Clinical Professor in the Department of Pediatrics
George Washington University
Crofton, Maryland, United States

Background: 47,XXY, is the most common X and Y variation (1:650) and is characterized by androgen deficiency and increased levels of anxiety, and attentional difficulties. Recent research demonstrates that early hormonal treatment (EHT) may mitigate symptoms of anxiety and behavioral problems among males with 47,XXY. This study identifies early biomarkers of behavioral dysfunction among untreated boys with 47,XXY and explores the benefits of EHT on the behavioral phenotype.

Objective: We hypothesize that EHT may improve behavioral functioning therefore strengthens the relationship between neurodevelopment and androgen dysfunction.

Design/Methods:

Parents of 223 boys with 47,XXY between 18 months and 6 years old (CA 37.7 months) completed the Child Behavior Checklist (CBCL) and the Behavior Rating Inventory of Executive Function years Preschool questionnaire (BRIEF-P). Subjects were segregated into two groups: 46 no-T and 177 EHT. Independent samples t-tests were utilized to assess group differences.

Results:

On the CBCL, boys who received EHT had significantly lower scores in emotional reactivity (P=0.001), withdrawn (P=0.016), sleep problems (P=0.009), attention problems (P=0.005), aggressive behavior (P< 0.05), internal problems (P=0.002), total problems (P=0.002), and anxiety (P=0.003).

On the BRIEF, boys with EHT had significantly lower scores in shift (P=0.02), emotional control (P=0.003), inhibitory self (P=0.02), and flexibility (P=0.004).

Conclusion(s):

This study indicates that EHT may have considerable positive impacts on behavior among boys with 47,XXY. Many problematic behaviors characteristic of boys with 47,XXY, were significantly improved in association with the administration of EHT. Identifying how the behavioral phenotype of 47,XXY evolves with age is critical to understanding the diagnosis and mitigating further behavioral problems that surface later in life.