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Richard H Tuligenga INSERM U1018, Université Paris Sud, Centre for Research in Epidemiology and Population Health, Hôpital Paul Brousse, Bât 15/16, 16 Avenue Paul Vaillant Couturier, 94807 Paris, Villejuif Cedex, France
INSERM U1018, Université Paris Sud, Centre for Research in Epidemiology and Population Health, Hôpital Paul Brousse, Bât 15/16, 16 Avenue Paul Vaillant Couturier, 94807 Paris, Villejuif Cedex, France

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intensive glycaemic control does not reduce the risk of CVD in older patients with long-standing type 2 diabetes (13, 25, 26) . As type 2 diabetes affects cognitive function, intensive diabetes control may prevent the onset of microvascular disease in the

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Lukas Engler Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munchen, Germany

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Christian Adolf Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munchen, Germany

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Daniel A Heinrich Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munchen, Germany

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Anna-Katharine Brem Max-Planck-Institute of Psychiatry, Munich, Germany
Division of Interventional Cognitive Neurology, Department of Neurology, Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA

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Anna Riester Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munchen, Germany

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Anna Franke Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munchen, Germany

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Felix Beuschlein Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munchen, Germany

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Martin Reincke Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munchen, Germany

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Axel Steiger Max-Planck-Institute of Psychiatry, Munich, Germany

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Heike Künzel Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munchen, Germany

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, 4 ); however, the underlying pathophysiology is not fully clarified. Animal data emphasize the importance of a balanced MR/glucocorticoid receptor (GR) system for cognitive functions ( 5 ) and support the role of MR in memory functions. Furthermore

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Vanderlan O Batista Division of Psychiatry, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil

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Michael Kellner Department of Psychiatry and Psychotherapy, University Hospital Hamburg-Eppendorf, Hamburg, Germany and Technical University of Munich, Munich, Germany

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Roberto Salvatori Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

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Walter Lisboa Department of Psychology, Federal University of Sergipe, São Cristovão, Sergipe, Brazil

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André Faro Postgraduate Program in Psychology, Federal University of Sergipe, São Cristovão, Sergipe, Brazil

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Lucas B Santos Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil

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Enaldo V Melo Statistics division, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil

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Alécia A Oliveira-Santos Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil

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Carla R P Oliveira Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil

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Viviane C Campos Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil

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Cynthia S Barros-Oliveira Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil

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Elenilde G Santos Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil

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Nathalie O Santana Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil

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Keila R Villar-Gouy Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil

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Ângela C Leal Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil

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Rivia S Amorim Division of Geriatrics, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil

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Davi A Oliveira Simões Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil

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Manuel H Aguiar-Oliveira Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil

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Introduction Growth hormone (GH) has been reported to have a role in improving cognitive function, both by inducing cognitive behaviors related to learning and memory and by affecting excitatory circuits involved in synaptic plasticity ( 1

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Sheila Leone Department of Pharmacy, G. d’Annunzio University, Chieti, Italy

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Lucia Recinella Department of Pharmacy, G. d’Annunzio University, Chieti, Italy

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Annalisa Chiavaroli Department of Pharmacy, G. d’Annunzio University, Chieti, Italy

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Claudio Ferrante Department of Pharmacy, G. d’Annunzio University, Chieti, Italy

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Giustino Orlando Department of Pharmacy, G. d’Annunzio University, Chieti, Italy

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Michele Vacca Department of Pharmacy, G. d’Annunzio University, Chieti, Italy

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Roberto Salvatori Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

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Luigi Brunetti Department of Pharmacy, G. d’Annunzio University, Chieti, Italy

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lack the decline in cognitive ability in the Morris water maze test that is observed in WT mice ( 9 , 10 ). GHRHKO mice represent an animal model of isolated GH deficiency with otherwise normal pituitary function ( 11 ). We have recently demonstrated

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Orwa Dandash Department of Psychiatry, University of Melbourne, Austin Health, Heidelberg, Victoria, Australia

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James Allebone Department of Psychiatry, University of Melbourne, Austin Health, Heidelberg, Victoria, Australia

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Adam Mirabelli Department of Psychiatry, University of Melbourne, Austin Health, Heidelberg, Victoria, Australia

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Nicholas Russell Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia

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Mathis Grossmann Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia

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Andrea Gogos Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia
Department of Florey Institute, University of Melbourne, Parkville, Victoria, Australia

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Richard A Kanaan Department of Psychiatry, University of Melbourne, Austin Health, Heidelberg, Victoria, Australia

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. Testosterone, and its derivatives, dihydrotestosterone (DHT) and estradiol (E2), have diverse functions in mammalian physiology ( 2 ). Androgen receptors and estradiol receptors are distributed in cortical and subcortical brain regions responsible for cognitive

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Yen Kheng Tan Duke-NUS Medical School, SingHealth, Singapore, Singapore

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Yu Heng Kwan Department of Internal Medicine, Singapore General Hospital, Singapore, Singapore

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David Choon Liang Teo Department of Psychological Medicine, Changi General Hospital, Singapore, Singapore

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Marieke Velema Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands

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Jaap Deinum Division of Vascular Medicine, Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands

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Pei Ting Tan Department of Clinical Trials Research Unit, Changi General Hospital, Singapore, Singapore

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Meifen Zhang Department of Endocrinology, Changi General Hospital, Singapore, Singapore

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Joan Joo Ching Khoo Department of Endocrinology, Changi General Hospital, Singapore, Singapore

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Wann Jia Loh Department of Endocrinology, Changi General Hospital, Singapore, Singapore

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Linsey Gani Department of Endocrinology, Changi General Hospital, Singapore, Singapore

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Thomas F J King Department of Endocrinology, Changi General Hospital, Singapore, Singapore

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Eberta Jun Hui Tan Department of Endocrinology, Changi General Hospital, Singapore, Singapore

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Shui Boon Soh Department of Endocrinology, Changi General Hospital, Singapore, Singapore

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Vanessa Shu Chuan Au Department of Endocrinology, Changi General Hospital, Singapore, Singapore

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Tunn Lin Tay Department of Endocrinology, Changi General Hospital, Singapore, Singapore

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Lily Mae Quevedo Dacay Department of Endocrinology, Changi General Hospital, Singapore, Singapore

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Keng Sin Ng Department of Diagnostic Radiology, Changi General Hospital, Singapore, Singapore

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Kang Min Wong Department of Diagnostic Radiology, Changi General Hospital, Singapore, Singapore

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Andrew Siang Yih Wong Department of Surgery, Changi General Hospital, Singapore, Singapore

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Foo Cheong Ng Department of Urology, Changi General Hospital, Singapore, Singapore

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Tar Choon Aw Department of Laboratory Medicine, Changi General Hospital, Singapore, Singapore

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Yvonne Hui Bin Chan Duke-NUS Medical School, SingHealth, Singapore, Singapore

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Khim Leng Tong Department of Cardiology, Changi General Hospital, Singapore, Singapore

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Sheldon Shao Guang Lee Department of Cardiology, Changi General Hospital, Singapore, Singapore

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Siang Chew Chai Department of Cardiology, Changi General Hospital, Singapore, Singapore

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Troy Hai Kiat Puar Department of Endocrinology, Changi General Hospital, Singapore, Singapore

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developed to assess general HRQoL ( 8 ). PROMs cover multiple domains of health that are influenced by patient’s subjective experiences, perceptions, and beliefs ( 9 ). These include pain, physical functioning, mobility, mood and other important areas of

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Yi Wang Y Wang, Department of Endocrinology, Genetics and Metabolism , Beijing Children's Hospital Capital Medical University, Beijing, China

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Yingying Xu Y Xu, Department of Pediatrics, Sun Yat-Sen University, Guangzhou, China

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Rongrong Xie R Xie, Department of Endocrinology, Children’s Hospital of Soochow University, Suzhou, China

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Bing Yan Cao B Cao, Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital Capital Medical University, Beijing, China

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Yuan Ding Y Ding, Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital Capital Medical University, Beijing, China

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Jiayun Guo J Guo, Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital Capital Medical University, Beijing, China

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Xiaoqiao Li X Li, Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital Capital Medical University, Beijing, China

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Xiaolin Ni X Ni, Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital Capital Medical University, Beijing, China

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Zheng Yuan Z Yuan, Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital Capital Medical University, Beijing, China

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Linqi Chen L Chen, Department of Endocrinology, Children’s Hospital of Soochow University, Suzhou, China

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Liyang Liang L Liang, Department of Pediatrics, Sun Yat-Sen University, Guangzhou, China

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Chunxiu Gong C Gong, Department of Endocrinology, Genetics and Metabolism, Capital Medical University, Beijing, 100054, China

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Objective: Rapid-onset obesity with hypoventilation, hypothalamic dysfunction, and autonomic dysregulation (ROHHAD) is rare, and manifestations of autonomic dysregulation are diverse and may be overlooked. We aimed to evaluate the incidence of these manifestations.

Methods: Patients with ROHHAD syndrome reported before and after 2019 were divided into Groups 1 and 2. Patients who were diagnosed at three regional hospitals in China were included in Group 3. We collected the age of each specific term of the ROHHAD (neurogenic tumor, NET) acronym and the detailed manifestations of each term, and compared them among the three groups.

Results: A total of 16 patients were diagnosed within the 2-year period. Two had neurogenic tumors and cognitive and behavioral abnormalities before developing rapid obesity. At least 93.8% of the patients had ≥ 4 symptoms of autonomic dysregulation. When comparing autonomic dysregulation among Groups 1–3, the rates of cardiovascular manifestations were NA vs. 12.8% vs. 81.2%; gastrointestinal disturbances were 11.4% vs. 8.5% vs. 62.5%; strabismus was 25.7% vs. 12.8% vs. 62.5%; sleep disturbance was NA vs. 6.4% vs. 50.0%; and abnormal pain threshold was NA vs. 10.6% vs. 25.0% (all p<0.05). The rates of cognitive and behavioral abnormalities were NA vs 29.8% and 87.5% (p<0.01).

Conclusions: Rapid-onset obesity is not always the first sign of ROHHAD syndrome. Higher rates of autonomic dysregulation and cognitive and behavioral abnormalities with multiple manifestations of autonomic dysregulation coexisted in our cohort, indicating that evaluations of autonomic function and the limbic system should be strengthened when assessing this condition.

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G Giuffrida Endocrine Unit of University Hospital ‘AOU Policlinico G. Martino’, Messina, Italy
PhD School of Clinical and Experimental Biomedical Sciences, University of Messina, Messina, Sicily, Italy

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F Ferraù Endocrine Unit of University Hospital ‘AOU Policlinico G. Martino’, Messina, Italy
Department of Human Pathology ‘G. Barresi’, University of Messina, Messina, Sicily, Italy

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R Laudicella Nuclear Medicine Unit of University Hospital ‘AOU Policlinico G. Martino’, Messina, Italy
Department of Biomorphology, University of Messina, Messina, Sicily, Italy

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O R Cotta Department of Human Pathology ‘G. Barresi’, University of Messina, Messina, Sicily, Italy

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E Messina Endocrine Unit of University Hospital ‘AOU Policlinico G. Martino’, Messina, Italy

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F Granata Department of Biomorphology, University of Messina, Messina, Sicily, Italy
Neuroradiology Unit of University Hospital ‘AOU Policlinico G. Martino’, Messina, Italy

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F F Angileri Department of Biomorphology, University of Messina, Messina, Sicily, Italy
Neurosurgery Unit of University Hospital ‘AOU Policlinico G. Martino’, Messina, Italy

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A Vento Nuclear Medicine Unit of University Hospital ‘AOU Policlinico G. Martino’, Messina, Italy
Department of Biomorphology, University of Messina, Messina, Sicily, Italy

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A Alibrandi Department of Economics, University of Messina, Messina, Sicily, Italy

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S Baldari Nuclear Medicine Unit of University Hospital ‘AOU Policlinico G. Martino’, Messina, Italy
Department of Biomorphology, University of Messina, Messina, Sicily, Italy

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S Cannavò Endocrine Unit of University Hospital ‘AOU Policlinico G. Martino’, Messina, Italy
PhD School of Clinical and Experimental Biomedical Sciences, University of Messina, Messina, Sicily, Italy
Department of Human Pathology ‘G. Barresi’, University of Messina, Messina, Sicily, Italy

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prolactinoma too, underwent two cycles of PRRT with 177 Lu-DOTATOC (total activity 12.6 GBq) in 2015. In the same year, a third case (woman, 53 years old) with a giant non-functioning PT (NFPT) was treated with 177 Lu-DOTATOC (five cycles, total activity 29

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Sophie van Rijn Clinical Neurodevelopmental Sciences, Leiden University, Wassenaarseweg, Leiden, The Netherlands
TRIXY Center of Expertise, Leiden University Treatment and Expertise Centre (LUBEC), Sandifortdreef, Leiden, The Netherlands
Leiden Institute for Brain and Cognition, Leiden University, Wassenaarseweg, Leiden, The Netherlands

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Kimberly Kuiper Clinical Neurodevelopmental Sciences, Leiden University, Wassenaarseweg, Leiden, The Netherlands
TRIXY Center of Expertise, Leiden University Treatment and Expertise Centre (LUBEC), Sandifortdreef, Leiden, The Netherlands
Leiden Institute for Brain and Cognition, Leiden University, Wassenaarseweg, Leiden, The Netherlands

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Nienke Bouw Clinical Neurodevelopmental Sciences, Leiden University, Wassenaarseweg, Leiden, The Netherlands
TRIXY Center of Expertise, Leiden University Treatment and Expertise Centre (LUBEC), Sandifortdreef, Leiden, The Netherlands
Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, Sophia Children’s Hospital, Dr. Molewaterplein, Rotterdam, The Netherlands

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Evelien Urbanus Clinical Neurodevelopmental Sciences, Leiden University, Wassenaarseweg, Leiden, The Netherlands
TRIXY Center of Expertise, Leiden University Treatment and Expertise Centre (LUBEC), Sandifortdreef, Leiden, The Netherlands
Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat, Amsterdam, The Netherlands

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Hanna Swaab Clinical Neurodevelopmental Sciences, Leiden University, Wassenaarseweg, Leiden, The Netherlands
TRIXY Center of Expertise, Leiden University Treatment and Expertise Centre (LUBEC), Sandifortdreef, Leiden, The Netherlands
Leiden Institute for Brain and Cognition, Leiden University, Wassenaarseweg, Leiden, The Netherlands

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. Neurocognitive impairments may serve as sensitive early predictors of behavioral problems in later life, may function as markers for children with an ‘at-risk’ development (e.g. identify those that do not meet age-specific norms for language, cognitive, and motor

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Caroline Culen University Clinic of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria

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Diana-Alexandra Ertl University Clinic of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria

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Katharina Schubert University Clinic of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria

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Lisa Bartha-Doering University Clinic of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria

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Gabriele Haeusler University Clinic of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria

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executive functioning, self-regulation, working memory, planning skills and abstract reasoning might emerge – Organize psychological testing and support (complex cognitive processes), if necessary Vocational planning should start – Support emancipating from

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