Amygdala volume in patients receiving chronic corticosteroid therapy.
BACKGROUND
Hippocampal volume reduction and declarative memory deficits are reported in humans and animals exposed to exogenous corticosteroids. The amygdala is another brain structure involved in the stress response that has important interactions with the hypothalamic-pituitary-adrenal axis. To our knowledge, no studies in animals or humans have examined the impact of exogenous corticosteroid administration on the amygdala. We assessed amygdala volume in patients receiving chronic prescription corticosteroid therapy and control subjects with similar medical histories not receiving corticosteroids.


METHODS
Fifteen patients on long-term prednisone therapy and 13 control subjects of similar age, gender, ethnicity, education, height, and medical history were assessed with magnetic resonance imaging. Amygdala volume was manually traced and compared between groups using a two-way analysis of variance (ANOVA). Correlations between amygdala volume, age, and corticosteroid dose/duration were assessed using Pearson's correlation coefficient.


RESULTS
Compared with control subjects, corticosteroid-treated patients had significantly smaller amygdala volumes. Right amygdala volume correlated significantly with age in control subjects and with duration of corticosteroid therapy in patients.


CONCLUSIONS
Patients receiving chronic corticosteroid therapy had smaller amygdala volumes than control subjects that correlated with duration of corticosteroid therapy. These findings suggest that corticosteroid exposure may be associated with changes in the amygdala as well as hippocampus.
Brown
E Sherwood
ES
Psychoneuroendocrine Research Program, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas 75390-8849, USA. Sherwood.Brown@UTSouthwestern.edu
Woolston
Dixie J
DJ
Frol
Alan B
AB
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects* / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000679:Amygdala / Q000033:anatomy & histology* / Q000187:drug effects*; D000893:Anti-Inflammatory Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D001249:Asthma / Q000188:drug therapy*; D002908:Chronic Disease; D004334:Drug Administration Schedule; D005260:Female; D007839:Functional Laterality / Q000187:drug effects; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000033:anatomy & histology / Q000187:drug effects; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000033:anatomy & histology / Q000187:drug effects; D011241:Prednisone / Q000009:adverse effects* / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D011241:Prednisone