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Cushings and Brain Loss

Guest Lynne Clemens

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June 24, 2002


NEW YORK (Reuters Health) - New study findings indicate that patients with Cushing's Syndrome (CS) often demonstrate brain volume loss and that correction of their elevated cortisol levels can reverse at least a portion of this loss.


While the neuropsychiatric manifestations of CS are well described, relatively little attention has been paid to the actual changes in brain morphology that occur. Furthermore, only two small studies have addressed whether these changes are reversible with appropriate therapy.


Dr. C?line Bard and colleagues from the Centre Hospitalier de l'Universit? de Montr?al, in Qu?bec, Canada, compared brain imaging studies of 38 CS patients with those of 18 patients with non-ACTH-secreting sellar tumors and 20 control subjects. The CS patients included 21 with Cushing's disease and 17 with adrenal CS.


The researchers' findings are published in the May issue of The Journal of Clinical Endocrinology and Metabolism.


Based on readings by two independent radiologists, 86% of patients with Cushing's disease and 100% of patients with adrenal CS demonstrated brain volume loss. In addition, the average third ventricle and bicaudate diameter of the pooled CS group was significantly higher than that of the control group (p = 0.001 for both).


Brain volume loss was reevaluated in 22 CS patients who underwent correction of their hypercortisolism. In 21 patients, the disorder was corrected surgically, while in one patient medical therapy was employed.


Reimaging an average of 39.7 months after eucortisolism was achieved revealed a significant improvement in third ventricle diameter and bicaudate diameter. Furthermore, the radiologists' subjective evaluation of the scans had also improved significantly.


"Signs of cerebral atrophy should be evaluated in patients" with CS, the authors emphasize. Still, "further studies will be necessary to determine whether complete reversal of brain volume loss is possible and whether these observations correlate with neuropsychological improvement."


J Clin Endocrinol Metab 2002;87:1949-1954.


Loss of Brain Volume in Endogenous Cushing?s Syndrome and Its Reversibility after Correction of Hypercortisolism

Isabelle Bourdeau, C?line Bard, Bernard No?l, Isabelle Leclerc, Marie-Pierre Cordeau, Manon B?lair, Jacques Lesage, Lucie Lafontaine and Andr? Lacroix

The Journal of Clinical Endocrinology & Metabolism Vol. 87, No. 5 1949-1954




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  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

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Guest Lynne Clemens

OMG!  Who shrunk my brain?


This helps explain alot of the problems we have, and also why we may still have some problems after surgery.


WOW! :0

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Just another reason why I always say that Cushings trashes the whole body!


Will I ever be normal again?


At least now, after a long, long time, my family and some of my co-workers understand that the changes in me aren't really me, but the disease that made me the me I am.


??? Was that a Cushie Moment or what?  baaa.gif




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