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Smaller grey matter volumes in the anterior cingulate cortex and greater cerebellar volumes in patients with long-term remission of Cushing's disease: a case-control study.
- Source :
-
European journal of endocrinology [Eur J Endocrinol] 2013 Oct 21; Vol. 169 (6), pp. 811-9. Date of Electronic Publication: 2013 Oct 21 (Print Publication: 2013). - Publication Year :
- 2013
-
Abstract
- Objective: 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.<br />Design: A cross-sectional, case-control study.<br />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.<br />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.<br />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.
- Subjects :
- Adult
Anxiety etiology
Apathy
Case-Control Studies
Cognition Disorders pathology
Cross-Sectional Studies
Cushing Syndrome pathology
Cushing Syndrome psychology
Depression etiology
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Organ Size
Phobic Disorders etiology
Pituitary ACTH Hypersecretion blood
Pituitary ACTH Hypersecretion complications
Pituitary ACTH Hypersecretion therapy
Pituitary Hormones blood
Remission Induction
Severity of Illness Index
Surveys and Questionnaires
Time Factors
Cerebellum pathology
Cognition Disorders etiology
Gyrus Cinguli pathology
Hydrocortisone blood
Nerve Fibers, Unmyelinated pathology
Pituitary ACTH Hypersecretion pathology
Pituitary ACTH Hypersecretion psychology
Subjects
Details
- Language :
- English
- ISSN :
- 1479-683X
- Volume :
- 169
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- European journal of endocrinology
- Publication Type :
- Academic Journal
- Accession number :
- 24031092
- Full Text :
- https://doi.org/10.1530/EJE-13-0471