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Decreased prefrontal functional brain response during memory testing in women with Cushing's syndrome in remission

Artikel i vetenskaplig tidskrift
Författare Oskar Ragnarsson
A. Stomby
P. Dahlqvist
J. A. Evang
M. Ryberg
T. Olsson
J. Bollerslev
L. Nyberg
Gudmundur Johannsson
Publicerad i Psychoneuroendocrinology
Volym 82
Sidor 117-125
ISSN 0306-4530
Publiceringsår 2017
Publicerad vid Institutionen för medicin
Sidor 117-125
Språk en
Länkar doi.org/10.1016/j.psyneuen.2017.05....
Ämnesord Cushing's syndrome, Cognitive function, Hippocampus, Prefrontal cortex, Functional magnetic resonance imaging, surface-based analysis, long-term remission, mineralocorticoid receptor, cognitive impairments, repeated stress, disease, cortex, system, scale, hypercortisolemia, Endocrinology & Metabolism, Neurosciences & Neurology, Psychiatry
Ämneskategorier Klinisk medicin

Sammanfattning

Neurocognitive dysfunction is an important feature of Cushing's syndrome (CS). Our hypothesis was that patients with CS in remission have decreased functional brain responses in the prefrontal cortex and hippocampus during memory testing. In this cross-sectional study we included 19 women previously treated for CS and 19 commis matched for age, gender, and education. The median remission time was 7 (IQR 6-10) years. Brain activity was studied with functional magnetic resonance imaging during episodic- and working memory tasks. The primary regions of interest were the prefrontal cortex and the hippocampus. A voxel-wise comparison of functional brain responses in patients and controls was performed. During episodic-memory encoding, patients displayed lower functional brain responses in the left and right prefrontal gyrus (p < 0.001) and in the right inferior occipital gyrus (p < 0.001) compared with controls. There was a trend towards lower functional brain responses in the left posterior hippocampus in patients (p = 0.05). During episodic-memory retrieval, the patients displayed lower functional brain responses in several brain areas with the most predominant difference in the right prefrontal cortex (p < 0.001). During the working memory task, patients had lower response in the prefrontal cortices bilaterally (p < 0.005). Patients, but not controls, had lower functional brain response during a more complex working memory task compared with a simpler one. In conclusion, women with CS in long-term remission have reduced functional brain responses during episodic and working memory testing. This observation extends previous findings showing long-term adverse effects of severe hypercortisolaemia on brain function.

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