In:
European Journal of Endocrinology, Oxford University Press (OUP), Vol. 169, No. 6 ( 2013-12), p. 811-819
Abstract:
Patients with long-term remission of Cushing's disease (CD) have persistent psychological and cognitive impairments. It is unknown whether, and to what extent, these impairments are accompanied by structural abnormalities in the brain. We aim to investigate structural changes in the brain in patients with predominantly long-term remission of CD and to examine whether these changes are associated with psychological and cognitive dysfunction and clinical severity. Design A cross-sectional, case–control study. Methods In 25 patients with predominantly long-term remission of CD and 25 matched healthy controls, grey matter volumes in the regions of interest (hippocampus, amygdala, and anterior cingulate cortex (ACC)) and in the whole brain were examined, using 3T magnetic resonance imaging and a voxel-based morphometry approach. Psychological and cognitive functioning were assessed using validated questionnaires and clinical severity was assessed using the Cushing's syndrome severity index. Results Compared with controls, patients had smaller grey matter volumes of areas in the ACC (on average 14%, P 〈 0.05) and greater volume of the left posterior lobe of the cerebellum (on average 34%, P 〈 0.05). As expected, patients with remitted CD reported more depressive symptoms ( P =0.005), more anxiety ( P =0.003), more social phobia ( P =0.034), more apathy ( P =0.002), and more cognitive failure ( P =0.023) compared with controls, but the differences in grey matter volumes were not associated with psychological or cognitive measures, nor with clinical severity. Conclusion Patients with predominantly long-term remission of CD showed specific structural brain abnormalities, in the presence of psychological dysfunction. Our data form a basis for future work aimed at elucidating the relation of the structural brain abnormalities and the sustained psychological deficits after long-term exposure to high cortisol levels.
Type of Medium:
Online Resource
ISSN:
0804-4643
,
1479-683X
Language:
Unknown
Publisher:
Oxford University Press (OUP)
Publication Date:
2013
detail.hit.zdb_id:
1485160-X
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