Loss of brain volume in endogenous Cushing's syndrome and its reversibility after correction of hypercortisolism.
Chronic exposure to excess glucocorticoids results in cognitive and psychological impairment. A few studies have indicated that cerebral atrophy can be found in patients with Cushing's syndrome (CS), but its evolution after cure has not been studied extensively. We report the presence of apparent cerebral atrophy in CS and its reversibility after the correction of hypercortisolism. Thirty-eight patients with CS, including 21 with Cushing's disease and 17 with adrenal CS were studied. The control groups consisted of 18 patients with other non-ACTH-secreting sellar tumors and 20 normal controls. Twenty-two patients with CS were reevaluated after cure. Subjective loss of brain volume was present in 86% of patients with Cushing's disease and 100% of patients with adrenal CS. The values for third ventricle diameter, bicaudate diameter, and subjective evaluation were significantly increased in CS groups in comparison with the control group (P < or = 0.001). Imaging reevaluated at 39.7 +/- 34.1 months after achieving eucortisolism showed an improvement of the third ventricle diameter (P = 0.001), bicaudate diameter (P < 0.0005), and subjective evaluation (P = 0.05). We conclude that brain volume loss is highly prevalent in CS and is at least partially reversible following correction of hypercortisolism.
Bourdeau
Isabelle
I
Department of Medicine and Department of Diagnostic Radiology, Division of Endocrinology, Centre Hospitalier de l'Université de Montréal, Montréal, Canada H2W 1T8.
Bard
Céline
C
Noël
Bernard
B
Leclerc
Isabelle
I
Cordeau
Marie-Pierre
MP
Bélair
Manon
M
Lesage
Jacques
J
Lafontaine
Lucie
L
Lacroix
André
A
D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology*; D003480:Cushing Syndrome / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D006854:Hydrocortisone