Long-Term Cognitive Impairments and Attentional Deficits in Patients with Cushing's Disease and Cortisol-Producing Adrenal Adenoma in Remission
Long-Term Cognitive Impairments and Attentional Deficits in Patients with Cushing's Disease and Cortisol-Producing Adrenal Adenoma in Remission
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DOI：
10.1210/jc.2012-1945
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发表时间：
2012-09-01
影响因子：
5.8
通讯作者：
Johannsson, Gudmundur
中科院分区：
文献类型：
--
作者：
Ragnarsson, Oskar;Berglund, Peter;Johannsson, Gudmundur
内容：活动性库欣综合征（CS）患者的认知功能受损。目的：研究长期缓解期CS患者的认知功能。设计：我们进行了一项横断面、病例对照、单中心研究。患者：55例既往接受过库欣病（n = 43）和皮质醇生成性肾上腺腺瘤（n = 12）治疗的患者和55例年龄匹配的对照，方法：采用标准化神经心理学测试和注意力网络测试对工作记忆、注意力、信息处理速度、语言流畅性和阅读速度进行研究，并对警觉、定向和执行控制进行研究。疲劳影响量表和综合精神病理评定量表被用来评估疲劳和情感disorder.Results：中位数（四分位数范围）缓解持续时间为13（5-19）年，平均+/- SD随访年龄为54 +/- 14年。与对照组相比，患者在疲劳影响量表上的得分更高，表明疲劳的负担更大，并且在抑郁和焦虑的综合精神病理学评定量表子量表上的得分更高。在多变量分析中，与对照组相比，注意力、空间定向、警觉性、工作记忆、语言流畅性和阅读速度均降低，与情感障碍和疲劳评分无关。结果没有整体差异，在长期缓解的患者之间的库欣病和皮质醇产生adrenaladenoma.Conclusion：CS患者在缓解期有认知功能受损，不能解释的共存的情感障碍或慢性疲劳。认知和注意力缺陷的模式表明，大脑功能的参与比以前所提出的更全面。（临床内分泌代谢杂志97：E1640-E1648，2012）
Context: Cognitive function is impaired in patients with active Cushing's syndrome (CS).Objective: The aim was to study cognitive function in patients with CS in long-term remission.Design: We conducted a cross-sectional, case-controlled, single center study.Patients: Fifty-five patients previously treated for Cushing's disease (n = 43) and cortisol-producing adrenal adenoma (n = 12) and 55 controls matched for age, gender, and educational level participated in the study.Methods: Working memory, attention, information-processing speed, verbal fluency, and reading speed were studied using standardized neuropsychological testing and alerting, orienting, and executive control using the Attentional Network Test. Fatigue impact scale and the comprehensive psychopathological rating scale were used to evaluate fatigue and affective disorder.Results: Median (interquartile range) duration of remission was 13 (5-19) yr and the mean +/- SD age at follow-up was 54 +/- 14 yr. Compared to controls, patients had a higher score on the fatigue impact scale, indicating greater burdens of fatigue, and a higher score on the comprehensive psychopathological rating scale subscales for depression and anxiety. In a multivariate analysis, attention, spatial orienting, alerting, working memory, verbal fluency, and reading speed were all diminished in comparison to controls, independent of scores for affective disorder and fatigue. No overall difference in outcome was seen between patients in long-term remission for Cushing's disease and cortisol-producing adrenal adenoma.Conclusion: Patients with CS in remission have impaired cognitive function that cannot be explained by the coexistence of affective disorder or chronic fatigue. The pattern of cognitive and attentional deficits suggests a more global involvement of the brain function than has previously been suggested. (J Clin Endocrinol Metab 97:E1640-E1648, 2012)