Abstract:
BACKGROUND:Proton magnetic resonance spectroscopy ((1) H-MRS) is a sensitive, noninvasive imaging technique capable of measuring brain metabolites in vivo. Chronic exposure to endogenous hypercortisolism in Cushing's syndrome (CS) is associated with negative effects on memory and hippocampal volumes, even after biochemical cure. OBJECTIVE:To investigate metabolites in the hippocampi of CS patients and controls, using (1) H-MRS. PATIENTS AND METHODS:Eighteen right-handed cured CS patients (age 44·8 ± 12·5 years, 12·6 ± 3·8 years of education) and 18 right-handed healthy controls, matched for age (40·0 ± 11·9) and years of education (14·4 ± 3·8), underwent 3-Tesla magnetic resonance imaging (3T MRI) and (1) H-MRS including the head of each hippocampus. Concentrations of Glu (Glutamate), Glx (Glutamate + Glutamine), NAA (N-Acetyl-aspartate), total NAA (N-Acetyl-aspartate + N-Acetyl-aspartyl-Glutamate), Cho (Glycerophosphocholine and Phosphocholine compounds), Cr (Creatine) and MI (mionositol) were measured (mmol/l). Hippocampal volumes (mm(3) ) were additionally calculated using an automated procedure (FreeSurfer). RESULTS:CS patients had lower NAA than controls in the left and right hippocampus (5·2 ± 1·0 vs 6·1 ± 0·7, P < 0·05; 4·9 ± 0·8 vs 6·1 ± 0·6, P < 0·001, respectively), and lower total NAA on the right side (5·7 ± 0·9 vs 6·3 ± 0·9, P < 0·05), suggesting neuronal dysfunction/loss. CS patients had higher Glx than controls in both hippocampi (10·4 ± 1·9 vs 8·6 ± 1·4, P < 0·01; 9·9 ± 1·6 vs 8·9 ± 1·3, P < 0·05, respectively), suggesting glial proliferation, as a repair mechanism after neuronal dysfunction. No differences were found in the other brain metabolites, and there were no differences in left (3815·78 ± 502·96) and right (3980·75 ± 369·44) total hippocampal volumes between CS patients and controls (3945·08 ± 408·90 and 4108·39 ± 365·11, respectively). CONCLUSION:Persistently abnormal metabolites are evidenced in the hippocampi of CS patients despite endocrine cure. These functional alterations could be early markers of glucocorticoid neurotoxicity, preceding hippocampal volume reduction.
journal_name
Clin Endocrinol (Oxf)journal_title
Clinical endocrinologyauthors
Resmini E,Santos A,Gómez-Anson B,López-Mourelo O,Pires P,Vives-Gilabert Y,Crespo I,Portella MJ,de Juan-Delago M,Webb SMdoi
10.1111/cen.12224subject
Has Abstractpub_date
2013-11-01 00:00:00pages
700-7issue
5eissn
0300-0664issn
1365-2265journal_volume
79pub_type
杂志文章abstract:BACKGROUND:To improve the diagnostic sensitivity of PTH measurements, more data on the upper limit of the reference interval for PTH levels were requested at a recent international consensus conference. As PTH levels vary inversely with plasma 25-hydroxyvitamin D (25OHD) levels and as vitamin D insufficiency is widespr...
journal_title:Clinical endocrinology
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doi:10.1111/j.1365-2265.2010.03894.x
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journal_title:Clinical endocrinology
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doi:10.1111/cen.12730
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journal_title:Clinical endocrinology
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doi:10.1046/j.1365-2265.1998.00485.x
更新日期:1998-04-01 00:00:00
abstract:CONTEXT:Subjects with nonalcoholic fatty liver disease (NAFLD) have a high risk of developing type 2 diabetes and cardiovascular diseases. Low serum potassium concentration or low dietary potassium intake can result in metabolic disorders. OBJECTIVE:Our objective was to evaluate the association between low serum potas...
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doi:10.1111/cen.12168
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abstract::After administration of intravenous metoclopramide, a dopaminergic receptor blocking agent, no rise in thyroid stimulating hormone (TSH) could be found in patients with chronic renal failure, in contrast to non-uraemic controls. Basal TSH values were normal in the uraemic patients but the TSH response to thyrotrophin-...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1981.tb00687.x
更新日期:1981-11-01 00:00:00
abstract::Two patients with profound hypocalcaemia due to uraemia and hypoparathyroidism respectively presented with alterations of mental state as their dominant symptom. 1-Alpha-hydroxycholecalciferol (1-alpha-OHD3) was chosen as the principal therapy because of its potency and rapid action. In both patients the plasma calciu...
journal_title:Clinical endocrinology
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doi:10.1111/j.1365-2265.1976.tb01983.x
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abstract::The 'basal' plasma glucose, defined as the stable overnight concentration, has been assessed as an index of diabetes control by comparison with plasma glucose measurements during 24-h profiles in diet-treated maturity-onset diabetic patients and normal subjects. The basal plasma glucose correlated with the total (r=0....
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1981.tb00196.x
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journal_title:Clinical endocrinology
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journal_title:Clinical endocrinology
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journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1978.tb03582.x
更新日期:1978-11-01 00:00:00
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journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.2008.03177.x
更新日期:2008-08-01 00:00:00
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journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.2009.03535.x
更新日期:2009-11-01 00:00:00
abstract:OBJECTIVE:Recovery of thyroid function in patients following hypothyroidism induced by 131I therapy for Graves' disease has been described, but only a few detailed clinical and biochemical studies of this phenomenon (transient hypothyroidism) have been published. The prevalence, mechanism, and final outcome of transien...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1046/j.1365-2265.1997.d01-1737.x
更新日期:1997-01-01 00:00:00
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journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1993.tb01008.x
更新日期:1993-03-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that patients with hyperprolactinaemia due to biologically inactive macroprolactin will not show the characteristically increased dopaminergic inhibition of TSH release seen in patients with microprolactinomas secreting biologically active monomeric PRL. DESIGN:Comparison of the TSH an...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1046/j.1365-2265.2003.01887.x
更新日期:2003-11-01 00:00:00
abstract::In order to evaluate simultaneously in thyrotoxic subjects the relative contributions of insulin secretion, insulin-sensitivity (SI) and glucose-mediated (SG) glucose disposal to overall glucose tolerance, seven non-obese patients with thyrotoxicosis were studied by the minimal model analysis of the frequently sampled...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:
更新日期:1990-10-01 00:00:00
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journal_title:Clinical endocrinology
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journal_title:Clinical endocrinology
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doi:10.1111/cen.12365
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journal_title:Clinical endocrinology
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doi:10.1111/j.1365-2265.1986.tb03255.x
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更新日期:2013-08-01 00:00:00
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doi:10.1111/j.1365-2265.1993.tb00518.x
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更新日期:2015-02-01 00:00:00
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journal_title:Clinical endocrinology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2003-05-01 00:00:00
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journal_title:Clinical endocrinology
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journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1983.tb00587.x
更新日期:1983-04-01 00:00:00
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journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/cen.13928
更新日期:2019-04-01 00:00:00
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journal_title:Clinical endocrinology
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doi:10.1111/j.1365-2265.1984.tb01386.x
更新日期:1984-11-01 00:00:00
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pub_type: 杂志文章
doi:10.1111/cen.12096
更新日期:2013-06-01 00:00:00