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Neuropsychiatric Aspects in Men with Klinefelter Syndrome

[ Vol. 19 , Issue. 2 ]

Author(s):

Vito Angelo Giagulli*, Beatrice Campone, Marco Castellana, Ciro Salzano, Alessandra Daphne Fisher, Cristina de Angelis, Rosario Pivonello, Annamaria Colao, Daniela Pasquali, Mario Maggi, Vincenzo Triggiani and On behalf of the Klinefelter ItaliaN Group (KING)   Pages 109 - 115 ( 7 )

Abstract:


Background and objective: Klinefelter Syndrome (KS) is the most common sex chromosome aneuploidy (47, XXY) and cause of male hypergonadotropic hypogonadism. It is characterized by an extreme clinical heterogeneity in presentation, including infertility, hypogonadism, language delay, metabolic comorbidities, and neurocognitive and psychiatric disorders. Since testosterone is known to have organizational, neurotrophic and neuroprotective effects on brain, the condition of primary hypogonadism could play a role. Moreover, given that KS subjects have an additional X, genes on the extra-chromosome could also exert a significant impact. The aim of this narrative review is to analyze the available literature on the relationship between KS and neuropsychiatric disorders.

Methods: To extend to the best of published literature on the topic, appropriate keywords and MeSH terms were identified and searched in Pubmed. Finally, references of original articles and reviews were examined.

Results: Both morphological and functional studies focusing on the brain showed that there were important differences in brain structure of KS subjects. Different psychiatric disorders such as Schizophrenia, autism, attention deficit hyperactivity disorder, depression and anxiety were frequently reported in KS patients according to a broad spectrum of phenotypes. T supplementation (TRT) was not able to improve the psychotic disorders in KS men with or without overt hypogonadism.

Conclusion: Although the risk of psychosis, depression and autism is increased in subjects with KS, no definitive evidence has been found in studies aiming at identifying the relationship between aneuploidy, T deficit and the risk of psychiatric and cognitive disorders in subjects affected by KS.

Keywords:

Klinefelter Syndrome, Hypergonadotropic hypogonadism, testosterone, autism, schizophrenia, attention deficit, hyperactivity disorder, depression; anxiety.

Affiliation:

Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, Interdisciplinary Department of Medicine, University of Bari, School of Medicine, Policlinico, Bari, Psychiatric Unit Department of Health Science, University of Florence, via Turi 44 Rutigliano, Bari, Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università , Sexual Medicine and Andrology Unit, Department of Experimental Clinical and Biomedical Sciences , Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università , Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università , Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università , Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, University of Campania , Sexual Medicine and Andrology Unit, Department of Experimental Clinical and Biomedical Sciences , Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, Interdisciplinary Department of Medicine, University of Bari, School of Medicine, Policlinico, Bari

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