MR Brain Spectroscopy Detects Damage In The Hippocampus Of Patients Exposed To Excess Cortisol

New research shows that patients who are “biochemically cured” of Cushing’s syndrome have levels of brain metabolites which are associated with neural damage. This will have implications for treatment of Cushing’s patients, but might also suggest that patients using high levels of glucocorticoid drugs may suffer similar long-term problems. The work was presented yesterday at the European Congress of Endocrinology in Copenhagen.

Cushing’s syndrome is an endocrine disease causing an overproduction of the stress hormone cortisol. Surgery and medical treatment can normalise cortisol levels, however recently it has been shown that “biochemically cured” patients continue to have memory problems. Now for the first time a group of researchers from the Sant Pau Hospital in Barcelona has scanned the brains of patients who had suffered from Cushing’s syndrome and found that they exhibit changed levels of brain metabolites, which are associated with memory and cognitive impairments. This finding may also have clinical implications for otherwise healthy patients who take high levels of glucocorticoid drugs for inflammatory, rheumatoid diseases, allergies and probably everyday chronic stress.

Cortisol (a glucocorticoid hormone), is naturally produced by the adrenal glands in response to stress. Long term exposure to high levels of cortisol is known to be associated with a range of cognitive impairments – this is true for Cushing’s syndrome patients, and probably would be also for those who take glucocorticoid drugs.

Eugenia Resmini and colleagues, working at the Centre for Biomedical Research on Rare Diseases (CIBERER), Sant Pau hospital in Barcelona, used proton magnetic resonance spectroscopy to measure a series of metabolites in the hippocampus of the brains of 18 patients who had been treated for Cushing’s syndrome, and compared these results to 18 healthy control subjects. They found that levels of the metabolite NAA (NAcetyl-aspartate) were significantly lower in the Cushing’s patients, indicating neural dysfunction, whereas Glx (Glutamate +Glutamine) levels were higher, suggesting that glial cells were proliferating as a repair mechanism.

According to Dr Resmini MD, PhD, Endocrinologist at the Centre for Biomedical Research on Rare Diseases (CIBERER), Hospital de Sant Pau, Barcelona, Spain:

“Patients with Cushing’s syndrome are exposed to abnormally high levels of glucocorticoids, which is associated with a wide range of cognitive impairments, as well as loss of brain volume. We studied the hippocampus, which is a critical area for learning and memory and, as it is rich in glucocorticoid receptors, is especially vulnerable to glucocorticoid overexposure. Cushing’s syndrome patients with severe memory impairment are known to have a smaller hippocampus. We have now found abnormal levels of metabolites in the hippocampi of Cushing’s patients with normal hippocampal volumes, indicating that these are early markers of glucocorticoid neurotoxicity, which would precede hippocampal volume reduction.

“Identifying these metabolites as a marker would be a way of allowing earlier diagnosis and treatment of cognitive impairments. This may also allow us to monitor patients taking glucocorticoid drugs, which have potentially damaging side effects. On the other hand, the fact that these markers are still present in Cushing’s patients after being “biochemically cured”, may show that once cognition has been damaged in Cushing’s syndrome, it may not be fully reversible. For this reason an earlier diagnosis of the disease and a rapid normalization of hypercortisolism would avoid the progression of hippocampal damage and of memory problems”.

From Medical News Today

5 Responses

  1. From Facebook: “Mary, thanks for sharing this information….”

  2. More from Facebook:

    “I just read an article on sleep deprivation and memory..very interesting. it stated (medical article from a journal) that during sleep the brain filters out memories to store and which to dispose and sleep deprivation disrupts this process. the zebra community already knows this, but it’s nice to see it in print!”

    “This is SO true for me! I kept journals of simple details because I felt like my brain didn’t work. After having a pituitary tumor removed, I still have some trouble with short term memory. I remain on an oral hydrocortisone tablet daily, as part of my pituitary gland was removed along with the tumor. (so you see mom, I don’t just have selective memory!)”

    “My memory was horrible before and just after surgery, but has been improving over the last three years since surgery. But, I have not yet returned to work to see if it can handle very large amounts of information. I still make lots of notes and write everything down, for example I write down when I take all of my medications, what doctor I saw when and what we discussed, what I’ve done day to day. That way I can look back, because I definitely won’t remember everything.”

    “Oh this is wonderful – having scientific proof of what my docs have said was “all in my head” (giggle, I guess it is). I’m printing this for my endocrinologist right now. Even though I have iatrogenic Cushing’s (from years of prednisone overdosages), it is still great to see that someone in the scientific community is working on the horrible side effects. THANK YOU for sharing this!”

  3. Thank you very much for sharing this. I too have terrible memory post Cushings Disease. Always suspected it was something to do with Cushings and here it is…some research to back it all up.

  4. […] MR Brain Spectroscopy Detects Damage In The Hippocampus Of Patients Exposed To Excess Cortisol (cushieblog.com) […]

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: