Endocrine Abstracts

Background: Patients with Cushing’s syndrome (CS) in remission often suffer from impaired quality of life and cognitive dysfunction. Mental fatigue is characterized by mental exhaustion which appears especially during sensory stimulation or following mentally strenuous tasks. Other typical features are long recovery time for restoration of mental energy, irritability, impaired memory and concentration and sensitivity to stress, light and noise. The primary aim of this study was to investigate the occurrence of mental fatigue by using the recently developed mental fatigue scale (MFS) in patients with CS in remission. The secondary aim was to examine whether the more demanding parts C and D of the trail making test (TMT) are more sensitive, compared to the conventional parts A and B, to evaluate speed proceeding, visual search, motor performance and executive functioning.

Methods: This was a cross-sectional study including 51 patients with CS in remission and 51 controls, matched by age, gender and education. All subjects completed the self-administrated MFS and performed all four parts of the TMT.

Results: The mean (±S.D.) age of patients and controls was 52.5±14.6 years and 53.6±13.9 years (P=0.7), respectively. The median time in remission was 12 (4–18) years. The patients had higher scores on all components of the MFS, indicating worse outcome, except for sensitivity to noise. The mean total score on the MFS was 13.5±7.4 in the patients compared to 7.8±4.9 (P<0.001) in controls. After adjustment for fatigue, depression and anxiety the patients performed worse on part D of the TMT (P<0.05) but not on parts A, B and C.

Conclusions: Mental fatigue is common in patients with CS in remission. The most demanding part of the TMT, part D, is more useful to capture cognitive deficits in patients with CS in remission compared to the conventional parts A and B.

Disclosure: This project received financial support from the Swedish federal government under the LUA/ALF agreement and The Health and Medical Care Committee of the Regional Executive Board, Region Vastra Gotaland.