3D-T1 image of Cushing disease

Background: The adverse effects of hypercortisolism on total human brain
had been highlighted in previous neuroscience studies of Cushing’s disease
(CD). However, the regional alterations associated with hypercortisolism
remains unclear. The present study was carried out to examine gray matter
(GM) alterations according to the different stages of chronic
hypercortisolism exposure. Design: Although longitudinal studies have been
traditionally used to address the question of reversibility of brain
alterations in CD, these studies would probably ignore the irreversible
alterations induced by hypercortisolism. Thus, information from
cross-sectional neuroimaging studies may provide more useful contributions
to further clarify this issue. Methods: To examine the GM alterations
during hypercortisolism exposure and after resolution of the condition,
ROI-based GM volumes (GMvs) of active and two biochemically remitted CD
patient groups, as well as those of healthy control subjects were compared
using the F test of one-way ANOVA. Results: Cross-sectional analysis
demonstrated significant altered GMvs in most of the brain sub-regions.
Moreover, different relationship between clinical characteristic and
regional GMvs and diverse trends after resolution of hypercortisolism were
found in CD patients, which suggested different response to the
hypercortisolism in different brain sub-regions. Conclusion: Our study
enhances the understanding of the structural alterations due to
hypercortisolism. Furthermore, our study may facilitate the development of
future studies with neuropsychological tests.