ArticleBMC medical imaging2026
Structural MRI assessment of hypothalamic alterations and cognitive implications in adolescents with rapid pubertal progression.
Article in BMC medical imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRapid pubertal progression involves hormonal and hypothalamic adaptations, yet its neurocognitive implications remain unclear. Insulin-like growth factor 1 (IGF-1), a key mediator of growth and neurodevelopment, is closely linked to pubertal processes. This study aims to investigate IGF-1-associated hypothalamic structural changes and their cognitive consequences in adolescents with rapid pubertal progression (Tanner stage advancement ≥ 1 within 3–6 months).
methodsIn this retrospective, cross-sectional cohort, 124 adolescents (8 to 13 years old) underwent a single session of structural MRI, cognitive assessments (The Wechsler Intelligence Scale for Children, Fourth Edition-Chinese Version), and gonadotropin-releasing hormone (GnRH) stimulation tests at baseline. The GnRH stimulation test was performed to assess hypothalamic-pituitary-gonadal (HPG) axis (HPG) axis activation, which was used to classify participants as HPG axis-activated (HPG+, n = 73) or non-activated (HPG−, n = 51) based on peak luteinizing hormone responses. Hypothalamic subunit volumes were quantified via high-resolution T1-weighted imaging. Stepwise forward regression identified structural predictors of HPG activation; mediation models tested IGF-1’s role in linking hypothalamic morphology to cognition. Covariates included sex, age, body mass index, and total intracranial volume.
resultsHPG+ adolescents exhibited elevated IGF-1 (p < 0.05), poorer cognitive performance (p < 0.05), and volumetric alterations in inferior tuberal and posterior hypothalamic subunits (p < 0.01). A model integrating right and total inferior tuberal volumes predicted HPG+ status with 83.9% accuracy. Mediation analysis demonstrated that total inferior tuberal enlargement fully mediated the inverse relationship between IGF-1 elevation and poorer cognitive performances.
conclusionsIGF-1-driven remodeling of the inferior tuberal hypothalamus contributes to cognitive deficits during rapid pubertal progression, revealing a neuroendocrine pathway linking hormonal activation, structural plasticity, and neurodevelopment. These findings position the hypothalamus as a biomarker candidate for early intervention in adolescents with atypical pubertal trajectories.
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