Monday, May 3, 2010

Active Cushing's Disease Is Associated With Subtle Cognitive Impairment: Presented at ECE

By Karen Dente

PRAGUE, Czech Republic -- April 29, 2010 -- Researchers have found a correlation between Cushing's disease and cognitive impairments long after Cushing's was cured.

Results of a study were presented here during an oral session at the 12th European Congress of Endocrinology (ECE).

"We hypothesised that previous hypercortisolism in patients with Cushing's disease results in irreversible impairments in cognitive functioning," said Jitske Tiemensma, Leiden University Medical Center, Leiden, Netherlands, on April 25.

The study was designed to assess cognitive functioning using 11 tests looking at memory, global cognitive functioning, and executive functioning.

A total of 74 patients cured of Cushing's disease were matched with 74 controls. More than 80% of the patients were female and the mean age was 52 years.

Another 54 patients who were previously treated for non-functioning pituitary macroadenomas (NFMA) along with 54 matched controls were included as well.

In contrast to the NFMA patients, those cured from Cushing's disease had lower scores on the Mini-Mental State Examination (P = .001) and on the Wechsler Memory Scale (P = .050).

Patients with previous Cushing's also tended to recall fewer words on the imprinting trial (P = .013), the immediate recall trial (P = .012), and the delayed recall trial (P = .003) of the Verbal Learning Test of Rey. They also recalled more intrusions on all trials of this test (P = .002, P = .003, and P = .003, respectively).

"The results from our study indicated that irreversible effects from previous hypercortisolism remain on cognitive function, and, thus on the central nervous system," said Dr. Tiemensma.

These observations may also be of relevance for patients treated with high doses of exogenous glucocorticoids.

[Presentation title: Subtle Cognitive Impairments in Patients With Long-Term Cure of Cushing's Disease. Abstract H2.3]


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