Alicia Santos1, Eugenia Resmini2, Iris Crespo2, Patricia Pires3, Yolanda Vives-Gilabert3, Esther Granell2, Elena Valassi2, Beatriz Gómez-Anson4, M Antonia Martínez-Momblán5, Maria Mataró6, Susan M Webb2. 1. Department of Endocrinology, Hospital de la Santa Creu i Sant Pau, C/Sant Antoni Maria Claret 167, 08025 Barcelona, Spain. asantos@santpau.cat 2. Endocrinology/Medicine DepartmentsHospital Sant Pau, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER, Unidad 747), ISCIII, IIB-Sant Pau, Universitat Autònoma de Barcelona (UAB), 08193 Bellaterra (Cerdanyola del Vallès), SpainINNDACYTAvenida Europa 20, Hospitalet de Llobregat, Barcelona, SpainNeuroradiology UnitHospital Sant Pau, and IIB-Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, SpainEscola Universitària d'InfermeriaHospital Sant Pau. Universitat Autònoma de Barcelona (UAB), Barcelona, Spain andDepartment of Psychiatry and Clinical PsychobiologyPsychology Faculty, Institute for Brain, Cognition and Behaviour (IR3C), Universitat de Barcelona (UB), Barcelona, Spain. 3. INNDACYT, Avenida Europa 20, Hospitalet de Llobregat, Barcelona, Spain. 4. Neuroradiology Unit, Hospital Sant Pau, and IIB-Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain. 5. Endocrinology/Medicine DepartmentsHospital Sant Pau, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER, Unidad 747), ISCIII, IIB-Sant Pau, Universitat Autònoma de Barcelona (UAB), 08193 Bellaterra (Cerdanyola del Vallès), SpainINNDACYTAvenida Europa 20, Hospitalet de Llobregat, Barcelona, SpainNeuroradiology UnitHospital Sant Pau, and IIB-Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, SpainEscola Universitària d'InfermeriaHospital Sant Pau. Universitat Autònoma de Barcelona (UAB), Barcelona, Spain andDepartment of Psychiatry and Clinical PsychobiologyPsychology Faculty, Institute for Brain, Cognition and Behaviour (IR3C), Universitat de Barcelona (UB), Barcelona, Spain Endocrinology/Medicine DepartmentsHospital Sant Pau, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER, Unidad 747), ISCIII, IIB-Sant Pau, Universitat Autònoma de Barcelona (UAB), 08193 Bellaterra (Cerdanyola del Vallès), SpainINNDACYTAvenida Europa 20, Hospitalet de Llobregat, Barcelona, SpainNeuroradiology UnitHospital Sant Pau, and IIB-Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, SpainEscola Universitària d'InfermeriaHospital Sant Pau. Universitat Autònoma de Barcelona (UAB), Barcelona, Spain andDepartment of Psychiatry and Clinical PsychobiologyPsychology Faculty, Institute for Brain, Cognition and Behaviour (IR3C), Universitat de Barcelona (UB), Barcelona, Spain. 6. Department of Psychiatry and Clinical Psychobiology, Psychology Faculty, Institute for Brain, Cognition and Behaviour (IR3C), Universitat de Barcelona (UB), Barcelona, Spain.
Abstract
OBJECTIVE: Cushing's syndrome (CS) is associated with neuropsychological deficits. As the cerebellum plays a key role in neuropsychological functions it may be affected in CS. The aim of this study was to investigate whether patients with CS have a smaller cerebellar volume than healthy controls, and to analyse whether cerebellar volume is associated with neuropsychological performance and clinical parameters. DESIGN: A cross-sectional study was performed. METHODS: Thirty-six CS patients (15 with active CS and 21 with CS in remission) and 36 controls matched for age, sex, and education underwent neuropsychological testing, quality of life assessment, clinical evaluation, and magnetic resonance imaging brain scan. Cerebellar volumes (white matter and cortex, bilateral) were calculated using FreeSurfer Software. RESULTS: Patients with active CS showed smaller bilateral cerebellar cortex volumes than controls (left, P=0.035 and right, P=0.034), as well as a trend toward smaller right cerebellar cortex volumes than patients in remission CS (P=0.051). No differences were observed in the volume of cerebellar white matter between the three groups. Both right and left cerebellar cortex volumes correlated negatively with triglyceride levels (right: r=-0.358, P=0.002 and left: r=-0.317, P=0.005) and age at diagnosis (right: r=-0.433, P=0.008 and left: r=-0.457, P=0.005). Left cerebellar cortex volume also correlated positively with visual memory performance (r=0.245, P=0.038). Right cerebellar cortex volume positively correlated with quality-of-life scores (r=0.468, P=0.004). CONCLUSIONS: The cerebellar cortex volume is smaller in active CS patients than in controls. This finding is associated with poor visual memory and quality of life and is mostly pronounced in patients with higher triglyceride levels and older age at diagnosis.
OBJECTIVE:Cushing's syndrome (CS) is associated with neuropsychological deficits. As the cerebellum plays a key role in neuropsychological functions it may be affected in CS. The aim of this study was to investigate whether patients with CS have a smaller cerebellar volume than healthy controls, and to analyse whether cerebellar volume is associated with neuropsychological performance and clinical parameters. DESIGN: A cross-sectional study was performed. METHODS: Thirty-six CS patients (15 with active CS and 21 with CS in remission) and 36 controls matched for age, sex, and education underwent neuropsychological testing, quality of life assessment, clinical evaluation, and magnetic resonance imaging brain scan. Cerebellar volumes (white matter and cortex, bilateral) were calculated using FreeSurfer Software. RESULTS:Patients with active CS showed smaller bilateral cerebellar cortex volumes than controls (left, P=0.035 and right, P=0.034), as well as a trend toward smaller right cerebellar cortex volumes than patients in remission CS (P=0.051). No differences were observed in the volume of cerebellar white matter between the three groups. Both right and left cerebellar cortex volumes correlated negatively with triglyceride levels (right: r=-0.358, P=0.002 and left: r=-0.317, P=0.005) and age at diagnosis (right: r=-0.433, P=0.008 and left: r=-0.457, P=0.005). Left cerebellar cortex volume also correlated positively with visual memory performance (r=0.245, P=0.038). Right cerebellar cortex volume positively correlated with quality-of-life scores (r=0.468, P=0.004). CONCLUSIONS: The cerebellar cortex volume is smaller in active CS patients than in controls. This finding is associated with poor visual memory and quality of life and is mostly pronounced in patients with higher triglyceride levels and older age at diagnosis.
Authors: Phyllis W Speiser; Wiebke Arlt; Richard J Auchus; Laurence S Baskin; Gerard S Conway; Deborah P Merke; Heino F L Meyer-Bahlburg; Walter L Miller; M Hassan Murad; Sharon E Oberfield; Perrin C White Journal: J Clin Endocrinol Metab Date: 2018-11-01 Impact factor: 5.958