ECE2006 Poster Presentations Neuroendocrinology and behaviour (70 abstracts)
Cushing’s syndrome as a model to investigate the effects on cognition of high circulating levels of glucocorticoid
N Correia 1 , S Mullally 2 , M Shahid 1 , NA Phelan 1 , S O’Mara 2 , T Kyaw Tun 1 & J Gibney 1
1Department of Endocrinology, Adelaide and Meath Hospital, incorporating the National Children’s Hospital, Tallaght, Dublin 24, Ireland; 2Trinity College Institute of Neuroscience, Dublin 2, Ireland.
Glucocorticoid (GC) excess is associated with significant brain morphological changes including loss of volume and cerebral atrophy. These effects correlate with the degree and duration of GC elevation1. The neuropsychological abnormalities associated with GC excess, however, remain poorly understood2. Patients with Cushing’s syndrome represent a useful model in which to study the effects of severe and prolonged GC excess.
We present the case of a 38 year old male (IQ=98) with confirmed Cushing’s syndrome secondary to a 3 cm adrenal adenoma, having had symptoms for 5 years. Prior to adrenalectomy, he underwent a series of cognitive function tests:
Rey figure – tests spatial memory.
Rivermead memory test – tests immediate and delayed recall.
Face-name pairs – tests associative memory.
Hamilton Anxiety and Depression Scale (HADS).
N-back Working Memory Task (1- & 2-Back).
The results show marked associative memory impairment with preservation of spatial memory, indicating a dissociation in two hippocampal-dependent functions. The HADS revealed severe anxiety and depression. These findings raise the possibility of different components of memory being processed in different areas of the hippocampus, and that GC excess affects some areas more than others. These preliminary findings provide a rationale for further studies, using cognitive testing and functional imaging, to investigate the effects of GC on hippocampal structure and function.
1. Bourdeau I, Bard C, Forget H, Boulanger Y, Cohen H & Lacroix A. Cognitive function and cerebral assessment in patients who have Cushing’s syndrome. Endocrinol Metab Clin North Am. 2005; 34(2): 357–369.
2. Whelan TB, Schteingart DE, Starkman MN & Smith A. Neuropsychological deficits in Cushing’s syndrome. J Nerv Ment Dis. 1980; 168(12): 753–757.
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Endocrine Abstracts
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