A clinical profile of memory impairment in humans due to endogenous glucocorticoid excess
A clinical profile of memory impairment in humans due to endogenous glucocorticoid excess
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DOI：
10.1111/j.1365-2265.2008.03355.x
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发表时间：
2009-02-01
影响因子：
3.2
通讯作者：
Leal-Cerro, Alfonso
中科院分区：
文献类型：
--
作者：
Leon-Carrion, Jose;Madrazo Atutxa, Ainara;Leal-Cerro, Alfonso
糖皮质激素过量通常与神经精神和神经障碍有关，记忆障碍通常出现在这些障碍中。这项研究的目的是提供库欣综合征(CS)患者因长期应激水平升高而导致记忆障碍的临床特征。30名年龄和教育水平匹配的女性参与者被研究：15名未经治疗的CS(平均年龄38+/-14岁)和15名健康女性。所有患者均经手术后病变组织学证实为CS。采用Luria记忆单词修订任务(LMW-R)的改编版本评估不同的学习和记忆过程。参与者在即刻状态下和30分钟后的延迟状态下测量其表现。我们的数据显示，长期暴露在皮质醇水平升高的情况下，临床上与显著的工作记忆缺陷有关，包括短期记忆量减少、学习速度慢、记忆污染和对自己表现的不准确感知。患者在延迟回忆任务中也表现出障碍。没有发现学习和延迟条件之间的联系。CS组在基本注意和执行功能方面与对照组没有显著差异。我们与CS相关的记忆缺陷的临床特征与长期暴露于高皮质醇血症与注意力依赖型工作记忆受损和延迟回忆过程有关，表明皮质醇水平在学习和记忆的调节中起着关键作用。讨论了对海马区和海马区的可能损害。
Glucocorticoid excess is commonly related to neuropsychiatric and neurological disorders, with memory impairment typically found among these disorders. The objective of this study is to offer a clinical profile of memory deficits resulting from exposure to chronic stress-level elevations of endogenous glucocorticoids in patients with Cushing's Syndrome (CS).Thirty female participants of matching age and education level were studied: 15 had untreated CS (mean age 38 +/- 14) and 15 were healthy. In all patients, CS was confirmed by histology of the lesion after surgery.Different learning and memory processes were assessed using an adapted version of Luria's Memory Words-Revised task (LMW-R). Participants' performances were measured in an immediate condition and, 30 min later, in a delayed condition. Attentional and executive functions were also evaluated.Our data show that chronic exposure to elevated levels of cortisol is clinically associated with significant working memory deficits, which included less shot-term memory volume, slow learning rate, memory contamination and no accurate perception of own performance. Patients also show impairment in the delayed recall task. No relation was detected between learning and delayed conditions. CS group did not differ significantly from control group in basic attentional and executive functioning.Our clinical profile of memory deficits related to CS relates chronic exposure to hypercortisolemia to impaired attentional-dependent working memory and delayed recall process, suggesting that cortisol levels play a critical role in the modulation of learning and memory. Possible damage to hippocampus and extrahippocampal areas is discussed.