Physical, neuromotor and intellectual impairment in non-cretinous schoolchildren with iodine deficiency.

Thyroid status and neurologic, psychometric and auditory functions were evaluated in presumably normal schoolchildren aged 6 to 16 years from three areas of iodine deficiency in Iran. The subjects from each area were identified as members of groups A, B or C. In group A there were retarded growth, high prevalence of visible goiter (93%), low T4 (39%) and high TSH (70%). In group B 66% had a visible goiter and 7% had high serum TSH. In group C visible goiter was present in 22% of the subjects but they had normal thyroid function. Urinary iodine excretion was low in all three groups. Head circumference was less in groups A and B, as compared to C. Pyramidal signs occurred in over half of the subjects in Group A (hyperreflexia in 39% and crossed adductor reflex in 29%). The glabellar sign was present in 50% of group A and 20% of group B. Forty-four percent of the subjects in group A and 17% in group B had hearing deficits as shown by audiometry. Psychomotor examination was performed using the Bender Gestalt test. A higher number of errors was evident in groups A and B their psychomotor age was below their chronological age. The results of the Raven test showed mild impairment of IQ in group A, with 55% having an IQ below 91 and 15% less than 70. The subjects in group B had lower IQ than group C, but higher than group A. There was a negative correlation between serum TSH and free thyroid indices and a positive correlation between TSH and the number of pyramidal signs. This study demonstrates that mild to moderate growth retardation and neurological, auditory and psychomotor impairments occur in apparently normal subjects residing in areas of iodine deficiency.