Neurocognitive Profiles of Children with Permanent vs. Transient Congenital Hypothyroidism: A Comparative Study Using the CANTab Assessment

Abstract

Background: Congenital hypothyroidism (CH) is one of the most common and preventable causes of intellectual disability. Early diagnosis and treatment can prevent severe developmental delays, but subtle cognitive impairments may persist into childhood. Differences in neurocognitive outcomes between permanent and transient congenital hypothyroidism have not been well characterized. Objective: This study aimed to compare cognitive function in children with permanent versus transient congenital hypothyroidism using the Cambridge Neuropsychological Test Automated Battery (CANTab), a validated and language-independent cognitive assessment tool. Methods: A total of 60 children aged 7 to 10 years (30 with permanent and 30 with transient congenital hypothyroidism) were recruited from the Isfahan Endocrine and Metabolism Research Center. Three cognitive domains were assessed using the CANTab battery: memory, executive function, and attention & psychomotor speed. Data were analyzed using multivariate analysis of covariance (MANCOVA), adjusting for age, followed by univariate ANOVAs. Effect sizes were reported using partial eta squared (η²), and statistical power was calculated. Results: MANCOVA revealed a significant overall difference in cognitive function between groups (Wilks’ Lambda = 0.156, F (5,54) = 148.95, p < 0.0001, η² = 0.844). Children with permanent hypothyroidism demonstrated significantly lower performance across all domains, with the most pronounced impairments in memory and executive function. Moderate deficits were observed in attention. Conclusion: Children with permanent congenital hypothyroidism exhibit widespread cognitive impairments compared to those with transient hypothyroidism. These findings underscore the need for ongoing neurocognitive monitoring and early supportive interventions in this high-risk population. © 2025, Mashhad University of Medical Sciences. All rights reserved.