Prospective study of hippocampal volume and function in human subjects treated with corticosteroids.

Purpose: Decreased hippocampal volume reported in neuropsychiatric and endocrine disorders is considered a result of putative neuronal damage mediated by corticosteroids. This is the first prospective study of hippocampal volume and function in patients treated with corticosteroids.
Methods: 14 subjects treated systemically with prednisone or betamethasone for dermatological or rheumatic disorders underwent prospective neurocognitive testing (Auditory Verbal Learning Test-AVLT, Trail Making Test-TMT, Digit Span-DS) and nine of them also repeated magnetic resonance volumetry.
Results: The mean duration of treatment between the first and the second assessment was 73+/- 38 days with mean daily dose of 37+/- 17 mg prednisone and 193+/- 29 days, with mean daily dose of 24+/- 15 mg prednisone between the first and the third assessment. There was a trend towards decreases in total AVLT scores and an improvement in the TMT and DS, but no significant changes in the volumes of the right or the left hippocampi between the assessments. Prednisone dose did not correlate with the hippocampal volume change.
Conclusion: We observed a trend for decline in verbal memory despite improvement in psychomotor speed, attention/working memory and no macroscopic hippocampal volume changes during 36-238 days of treatment with therapeutic doses of corticosteroids.