{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T21:13:22Z","timestamp":1790630002142,"version":"4.1.0"},"reference-count":69,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,5,25]],"date-time":"2024-05-25T00:00:00Z","timestamp":1716595200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Reports"],"abstract":"<jats:p>Klinefelter syndrome (KS), also known as 47,XXY, is a genetic disorder characterized by the presence of an extra X chromosome. Despite the prevalence of verbal learning disabilities, memory impairments, and executive function deficits in individuals with KS, comprehensive research on the neuropsychological profiles of affected children and adolescents remains limited. Additionally, KS has been associated with comorbid conditions such as depression, anxiety, schizophrenia, attention-deficit hyperactivity disorder (ADHD), and autism spectrum disorders (ASDs). However, systematic investigations into the neuropsychological manifestations of KS in pediatric populations are scarce. Therefore, the primary objectives of this review are to provide an overview of key studies examining the neuropsychological profiles of children and adolescents with KS and to delineate the limitations and implications of existing research findings. By synthesizing available literature, this review aims to bridge the gap in understanding the cognitive and behavioral characteristics of children and adolescents with KS, shedding light on potential avenues for future research and clinical interventions. Ultimately, this review serves as a valuable resource for clinicians, researchers, policymakers, parents, and educators involved in the assessment and management of the neuropsychological aspects of Klinefelter syndrome in pediatric populations.<\/jats:p>","DOI":"10.3390\/pediatric16020036","type":"journal-article","created":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T10:27:59Z","timestamp":1716805679000},"page":"420-431","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Understanding the Neuropsychological Implications of Klinefelter Syndrome in Pediatric Populations: Current Perspectives"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9678-9928","authenticated-orcid":false,"given":"Panagiota","family":"Tragantzopoulou","sequence":"first","affiliation":[{"name":"School of Social Sciences, University of Westminster, London W1W 6UW, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaitsa","family":"Giannouli","sequence":"additional","affiliation":[{"name":"School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1136\/archdischild-2020-320831","article-title":"Klinefelter syndrome: Going beyond the diagnosis","volume":"108","author":"Butler","year":"2023","journal-title":"Arch. Dis. Child."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1210\/jcem-2-11-615","article-title":"Syndrome characterized by gynecomastia, aspermatogenesis without a-Leydigism and increased secretion of follicle-stimulating hormone","volume":"2","author":"Klinefelter","year":"1942","journal-title":"J. Clin. Endocrinol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1038\/163676a0","article-title":"A morphological distinction between neurons of the male and female, and the behavior of the nucleolar satellite during accelerated nucleoprotein synthesis","volume":"163","author":"Barr","year":"1949","journal-title":"Nature"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"488","DOI":"10.3181\/00379727-89-21854","article-title":"Oral smear as a method of chromosomal sex detection","volume":"89","author":"Marberger","year":"1955","journal-title":"Proc. Soc. Exp. Biol. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"235","DOI":"10.3109\/10520295709111629","article-title":"A universal stain for the sex chromatin body","volume":"32","author":"Klinger","year":"1957","journal-title":"Stain Technol."},{"key":"ref_6","first-page":"853","article-title":"Testicular dysgenesis affecting the seminiferous tubules principally, with chromatin-positive nuclei","volume":"271","author":"Barr","year":"1956","journal-title":"Lancet"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1210\/jcem-16-5-689","article-title":"Chromatin test in Klinefelter\u2019s syndrome","volume":"16","author":"Bradbury","year":"1956","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1038\/183302a0","article-title":"A case of human intersexuality having a possible XXY sex-determining mechanism","volume":"183","author":"Jacobs","year":"1959","journal-title":"Nature"},{"key":"ref_9","unstructured":"King, R.A., Potter, J., and Motulsky, A. (1992). The Genetic Basis of Common Disease, Oxford University Press. [1st ed.]."},{"key":"ref_10","first-page":"321","article-title":"Klinefelter\u2019s syndrome and its variants: A hormonal and chromosomal study","volume":"24","author":"Paulsen","year":"1968","journal-title":"Recent Prog. Horm. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1146\/annurev-psych-113011-143750","article-title":"Executive Functions","volume":"64","author":"Diamond","year":"2013","journal-title":"Annu. Rev. Psychol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1002\/ajmg.1320480312","article-title":"Neuropsychological impairment in 42 adolescents with sex chromosome abnormalities","volume":"48","author":"Bender","year":"1993","journal-title":"Am. J. Med. Genet. Part A"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1002\/ajmg.a.32232","article-title":"Cognitive and Motor Development During Childhood in Boys with Klinefelter Syndrome","volume":"146A","author":"Ross","year":"2008","journal-title":"Am. J. Med. Genet. Part A"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1002\/ddrr.85","article-title":"An extra X or Y chromosome: Contrasting the cognitive and motor phenotypes in childhood in boys with 47, XYY syndrome or 47, XXY Klinefelter syndrome","volume":"15","author":"Ross","year":"2009","journal-title":"Dev. Disabil. Res. Rev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1016\/S0028-3932(03)00061-7","article-title":"Executive skills in Klinefelter\u2019s syndrome","volume":"41","author":"Temple","year":"2003","journal-title":"Neuropsychologia"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1002\/ajmg.a.38621","article-title":"International investigation of neurocognitive and behavioral phenotype in 47,XXY (Klinefelter syndrome): Predicting individual differences","volume":"176","author":"Stapleton","year":"2018","journal-title":"Am. J. Med. Genet. Part A"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1017\/S1355617711000312","article-title":"Executive Function in Young Males with Klinefelter (XXY) Syndrome with and without Comorbid Attention-Deficit\/Hyperactivity Disorder","volume":"17","author":"Lee","year":"2011","journal-title":"J. Int. Neuropsychol. Soc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2374","DOI":"10.1002\/ajmg.a.61360","article-title":"Hormonal replacement therapy and its potential influence on working memory and competency\/adaptive functioning in 47,XXY (Klinefelter syndrome)","volume":"179","author":"Tran","year":"2019","journal-title":"Am. J. Med. Genet. Part A"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1002\/ajmg.c.31804","article-title":"Executive function in XXY: Comparison of performance-based measures and rating scales","volume":"184","author":"Janusz","year":"2020","journal-title":"Am. J. Med. Genet. Part C Semin. Med. Genet."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1080\/09297049.2017.1386781","article-title":"Assessment of executive function in ADHD adolescents: Contribution of performance tests and rating scales","volume":"24","author":"Krieger","year":"2018","journal-title":"Child Neuropsychol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1111\/dmcn.15020","article-title":"Effect of sex chromosome number variation on attention-deficit\/hyperactivity disorder symptoms, executive function, and processing speed","volume":"64","author":"Green","year":"2022","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1002\/ddrr.83","article-title":"The cognitive phenotype in Klinefelter syndrome: A review of the literature including genetic and hormonal factors","volume":"15","author":"Boada","year":"2009","journal-title":"Dev. Disabil. Res. Rev."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1353\/mpq.2008.0007","article-title":"Individual Differences in Preschoolers\u2019 Self-Regulation and Theory of Mind","volume":"54","author":"Jahromi","year":"2008","journal-title":"Merrill-Palmer Q."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e88","DOI":"10.1210\/clinem\/dgad487","article-title":"Executive Dysfunction in Klinefelter Syndrome: Associations with Brain Activation and Testicular Failure","volume":"109","author":"Ghasemi","year":"2023","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1055\/s-2001-15400","article-title":"The mental development in polysomy X Klinefelter syndrome (47,XXY; 48,XXXY): Effects of incomplete X-activation","volume":"19","year":"2001","journal-title":"Semin. Reprod. Med."},{"key":"ref_26","unstructured":"Samango-Sprouse, C., and Law, P. (2001, January 15\u201319). The neurocognitive profile of children with sex chromosome anomalies. Proceedings of the International Conference of Human Genetics, Vienna, Austria."},{"key":"ref_27","first-page":"115","article-title":"Chromosomal abnormalities in the New Haven newborn study: A prospective study of development of children with sex chromosome anomalies","volume":"15","author":"Leonard","year":"1979","journal-title":"Birth Defects Orig. Artic. Ser."},{"key":"ref_28","first-page":"261","article-title":"Early communicative skills of children with Klinefelter syndrome","volume":"15","author":"Robinson","year":"1979","journal-title":"Birth Defects Orig. Artic. Ser."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1080\/02699206.2017.1384853","article-title":"Vocal and gestural productions of 24-month-old children with sex chromosome trisomies","volume":"32","author":"Zampini","year":"2018","journal-title":"Clin. Linguist. Phon."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/0093-934X(82)90005-0","article-title":"Verbal deficits in children with 47, XXY and 47, XXX karyotypes: A descriptive and experimental study","volume":"17","author":"Netley","year":"1982","journal-title":"Brain Lang."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1542\/peds.81.6.795","article-title":"Oral and Written Language Abilities of XXY Boys: Implications for Anticipatory Guidance","volume":"81","author":"Graham","year":"1988","journal-title":"Pediatrics"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Melogno, S., Pinto, M.A., Orsolini, M., and Tarani, L. (2018). Beyond the Literal Meaning of Words in Children with Klinefelter Syndrome: Two Case Studies. Brain Sci., 8.","DOI":"10.3390\/brainsci8090171"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1111\/j.1651-2227.2011.02246.x","article-title":"Clinical and biological parameters in 166 boys, adolescents and adults with nonmosaic Klinefelter syndrome: A Copenhagen experience","volume":"100","author":"Almstrup","year":"2011","journal-title":"Acta Paediatr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1007\/BF01071315","article-title":"Dyslexia in 47, XXY boys identified at birth","volume":"16","author":"Bender","year":"1986","journal-title":"Behav. Genet."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.jcomdis.2019.02.003","article-title":"Speech and language in children with Klinefelter syndrome","volume":"78","author":"Ponchard","year":"2019","journal-title":"J. Commun. Disord."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1002\/1098-2779(2000)6:2<107::AID-MRDD4>3.0.CO;2-2","article-title":"Neurobehavioral phenotype of Klinefelter syndrome","volume":"6","author":"Geschwind","year":"2000","journal-title":"Ment. Retard. Dev. Disabil. Res. Rev."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1111\/j.1651-2227.2011.02150.x","article-title":"Klinefelter syndrome as a window on the aetiology of language and communication impairments in children: The neuroligin-neurexin hypothesis","volume":"100","author":"Bishop","year":"2011","journal-title":"Acta Paediatr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1590\/1982-021620182056818","article-title":"Klinefelter syndrome: A speech-language and neuropsychological assessment","volume":"20","author":"Lamonica","year":"2018","journal-title":"Rev. CEFAC"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Mazzocco, M.M.M., and Ross, J.L. (2007). Neurogenetic Developmental Disorders: Variation of Manifestation in Childhood, MIT Press. [1st ed.].","DOI":"10.7551\/mitpress\/4946.001.0001"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1542\/peds.96.2.302","article-title":"Psychosocial adaptation of 39 adolescents with sex chromosome abnormalities","volume":"96","author":"Bender","year":"1995","journal-title":"Pediatrics"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1093\/schbul\/20.3.495","article-title":"Schizophrenia and Sex Chromosome Anomalies","volume":"20","author":"DeLisi","year":"2004","journal-title":"Schizophr. Bull."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1210\/jc.2005-0697","article-title":"Morbidity in Klinefelter syndrome: A Danish Register Study based on hospital discharge diagnoses","volume":"91","author":"Bojesen","year":"2006","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1080\/13576500342000374","article-title":"Directional asymmetry is the key to the origin of modern Homo sapiens (the Broca-Annett axiom): A reply to Rogers\u2019 review of The Speciation of Modern Homo Sapiens","volume":"9","author":"Crow","year":"2004","journal-title":"Laterality"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1002\/ajmg.b.30163","article-title":"Klinefelter\u2019s syndrome (XXY) as a genetic model for psychotic disorders","volume":"135B","author":"DeLisi","year":"2005","journal-title":"Am. J. Med. Genet. Part B Neuropsychiatr. Genet."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.schres.2008.02.001","article-title":"Effects of an extra X chromosome on language lateralization: An fMRI study with Klinefelter men (47,XXY)","volume":"101","author":"Aleman","year":"2008","journal-title":"Schizophr. Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e865","DOI":"10.1542\/peds.2008-1954","article-title":"Psychiatric Characteristics in a Self-Selected Sample of Boys With Klinefelter Syndrome","volume":"123","author":"Bruining","year":"2009","journal-title":"Pediatrics"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1136\/adc.80.2.192","article-title":"Long term outcome in children of sex chromosome abnormalities","volume":"80","author":"Ratcliffe","year":"1999","journal-title":"Arch. Dis. Child."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1002\/(SICI)1096-8628(19990416)88:2<200::AID-AJMG18>3.0.CO;2-3","article-title":"Psychosocial competence of unselected young adults with sex chromosome abnormalities","volume":"88","author":"Bender","year":"1999","journal-title":"Am. J. Med. Genet."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.schres.2007.03.015","article-title":"Psychiatric morbidity and X-chromosomal origin in Klinefelter sample","volume":"93","author":"Boks","year":"2007","journal-title":"Schizophr. Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"966","DOI":"10.1097\/GIM.0b013e3182227576","article-title":"Prevalence and psychosocial correlates of depressive symptoms among adolescents and adults with Klinefelter syndrome","volume":"13","author":"Turriff","year":"2011","journal-title":"Genet. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e12465","DOI":"10.1111\/gbb.12465","article-title":"The nature of social cognitive deficits in children and adults with Klinefelter syndrome (47,XXY)","volume":"17","author":"Swaab","year":"2018","journal-title":"Genes Brain Behav."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1016\/j.ridd.2012.02.013","article-title":"Social deficits in male children and adolescents with sex chromosome aneuploidy: A comparison of XXY, XYY, and XXYY syndromes","volume":"33","author":"Cordeiro","year":"2012","journal-title":"Res. Dev. Disabil."},{"key":"ref_53","first-page":"151","article-title":"The spectrum of the behavioral phenotype in boys and adolescents 47,XXY (Klinefelter syndrome)","volume":"8","author":"Tartaglia","year":"2010","journal-title":"Pediatr. Endocrinol. Rev."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1111\/gbb.12134","article-title":"Social cognition and underlying cognitive mechanisms in children with an extra X chromosome: A comparison with autism spectrum disorder: Social cognition and an extra X chromosome","volume":"13","author":"Stockmann","year":"2014","journal-title":"Genes Brain Behav."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/j.schres.2006.02.020","article-title":"X Chromosomal effects on social cognitive processing and emotion regulation: A study with Klinefelter men (47,XXY)","volume":"84","author":"Swaab","year":"2006","journal-title":"Schizophr. Res."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1007\/s10633-013-9406-x","article-title":"Retinal dysfunction and high myopia in association with 48,XXYY syndrome","volume":"127","author":"Karampelas","year":"2013","journal-title":"Doc. Ophthalmol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"13130","DOI":"10.1038\/s41598-017-13528-4","article-title":"Aberrant ocular architecture and function in patients with Klinefelter syndrome","volume":"7","author":"Brand","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_58","first-page":"130","article-title":"Klinefelter\u2019s syndrome and taurodontism","volume":"91","author":"Giambersio","year":"2019","journal-title":"Arch. Ital. Di Urol. Androl."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1002\/ajmg.c.31784","article-title":"High prevalence of cardiometabolic risk features in adolescents with 47,XXY\/Klinefelter syndrome. American journal of medical genetics","volume":"184","author":"Davis","year":"2020","journal-title":"Part C Semin. Med. Genet."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"E518","DOI":"10.1210\/jc.2014-2780","article-title":"Gene expression patterns in relation to the clinical phenotype in Klinefelter syndrome","volume":"100","author":"Zitzmann","year":"2015","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_61","first-page":"472","article-title":"Short QTc interval in males with Klinefelter syndrome-influence of CAG repeat length, body composition, and testosterone replacement therapy","volume":"38","author":"Skakkebaek","year":"2014","journal-title":"Pacing Clin. Electrophysiol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1007\/s10897-016-0041-z","article-title":"The impact of living with Klinefelter syndrome: A qualitative exploration of adolescents and adults","volume":"26","author":"Turriff","year":"2017","journal-title":"J. Genet. Couns."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"van Rijn, S. (2018). Salivary testosterone in relation to social cognition and social anxiety in children and adolescents with 47,XXY (Klinefelter syndrome). PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0200882"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.jpeds.2017.02.036","article-title":"Androgen treatment effects on motor function, cognition, and behavior in boys with Klinefelter syndrome","volume":"185","author":"Ross","year":"2017","journal-title":"J. Pediatr."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1007\/s12687-022-00585-0","article-title":"Communicating the diagnosis of Klinefelter syndrome to children and adolescents: When, how, and who?","volume":"13","author":"Aliberti","year":"2022","journal-title":"J. Community Genet."},{"key":"ref_66","first-page":"1","article-title":"Teacher perspectives on information sharing and parent knowledge of special education","volume":"24","author":"Farley","year":"2022","journal-title":"J.-Risk"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1007\/s12325-016-0284-y","article-title":"The effectiveness of an educational brochure as a risk minimization activity to communicate important rare adverse events to health-care professionals","volume":"33","author":"Bester","year":"2016","journal-title":"Adv. Ther."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1352\/1944-7558-126.1.1","article-title":"Social management training in males with 47,XXY (Klinefelter syndrome): A pilot study of a neurocognitive-behavioral treatment targeting social, emotional, and behavioral problems","volume":"126","author":"Martin","year":"2021","journal-title":"Am. J. Intellect. Dev. Disabil."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/23279095.2023.2262659","article-title":"Effectiveness of social management training on executive functions in males with Klinefelter syndrome (47,XXY)","volume":"10","author":"Martin","year":"2023","journal-title":"Appl. Neuropsychol. 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