TY - JOUR
T1 - 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
AU - Andela, Cornelie D.
AU - van der Werff, Steven J. A.
AU - Pannekoek, J. Nienke
AU - van den Berg, Susan M.
AU - Meijer, Onno C.
AU - van Buchem, Mark A.
AU - Rombouts, Serge A. R. B.
AU - van der Mast, Roos C.
AU - Romijn, Johannes A.
AU - Tiemensma, Jitske
AU - Biermasz, Nienke R.
AU - van der Wee, Nic J. A.
AU - Pereira, Alberto M.
PY - 2013
Y1 - 2013
N2 - 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. A cross-sectional, case-control study. 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. 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. 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
AB - 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. A cross-sectional, case-control study. 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. 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. 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
U2 - https://doi.org/10.1530/EJE-13-0471
DO - https://doi.org/10.1530/EJE-13-0471
M3 - Article
C2 - 24031092
SN - 0804-4643
VL - 169
SP - 811
EP - 819
JO - European journal of endocrinology / European Federation of Endocrine Societies
JF - European journal of endocrinology / European Federation of Endocrine Societies
IS - 6
ER -