A clinical profile of memory impairment in humans due to endogenous glucocorticoid excess.
OBJECTIVE
Glucocorticoid excess is commonly related to neuropsychiatric and neurological disorders, with memory impairment typically found among these disorders. The objective of this study is to offer a clinical profile of memory deficits resulting from exposure to chronic stress-level elevations of endogenous glucocorticoids in patients with Cushing's Syndrome (CS).


METHODS
Thirty female participants of matching age and education level were studied: 15 had untreated CS (mean age 38 +/- 14) and 15 were healthy. In all patients, CS was confirmed by histology of the lesion after surgery.


METHODS
Different learning and memory processes were assessed using an adapted version of Luria's Memory Words-Revised task (LMW-R). Participants' performances were measured in an immediate condition and, 30 min later, in a delayed condition. Attentional and executive functions were also evaluated.


RESULTS
Our data show that chronic exposure to elevated levels of cortisol is clinically associated with significant working memory deficits, which included less shot-term memory volume, slow learning rate, memory contamination and no accurate perception of own performance. Patients also show impairment in the delayed recall task. No relation was detected between learning and delayed conditions. CS group did not differ significantly from control group in basic attentional and executive functioning.


CONCLUSIONS
Our clinical profile of memory deficits related to CS relates chronic exposure to hypercortisolemia to impaired attentional-dependent working memory and delayed recall process, suggesting that cortisol levels play a critical role in the modulation of learning and memory. Possible damage to hippocampus and extrahippocampal areas is discussed.
León-Carrión
José
J
Human Neuropsychology Laboratory, University of Seville, Seville, Spain. jleoncarrion@us.es
Atutxa
Ainara Madrazo
AM
Mangas
Miguel Angel
MA
Soto-Moreno
Alfonso
A
Pumar
Alfonso
A
Leon-Justel
Antonio
A
Martín-Rodriguez
Juan Francisco
JF
Venegas
Eva
E
Domínguez-Morales
M Rosario
MR
Leal-Cerro
Alfonso
A
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D003480:Cushing Syndrome / Q000150:complications* / Q000378:metabolism* / Q000523:psychology; D005260:Female; D005938:Glucocorticoids / Q000378:metabolism*; D006624:Hippocampus / Q000503:physiopathology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000652:urine; D007859:Learning Disabilities / Q000209:etiology / Q000378:metabolism / Q000523:psychology; D008569:Memory Disorders / Q000209:etiology* / Q000378:metabolism* / Q000523:psychology; D008875:Middle Aged; D009483:Neuropsychological Tests; D012649:Self Concept; D055815:Young Adult
D005938:Glucocorticoids; D006854:Hydrocortisone