Altered spontaneous brain activity in Cushing's disease: a resting-state functional MRI study

作者：Jiang, Hong; He, Na-Ying; Sun, Yu-Hao; Jian, Fang-Fang; Bian, Liu-Guan; Shen, Jian-Kang; Yan, Fu-Hua; Pan, Si-Jian; Sun, Qing-Fang^*

来源：Clinical Endocrinology, 2017, 86(3): 367-376.

DOI：10.1111/cen.13277

• LONG-TERM REMISSION
• MAGNETIC-RESONANCE SPECTROSCOPY
• ANTERIOR CINGULATE CORTEX
• VOLUME
• ATROPHY
• FMRI
• HYPERCORTISOLISM
• FLUCTUATION
• IMPROVEMENT
• AMPLITUDE

Context and objectiveCushing's disease (CD) provides a unique and naturalist model for studying the influence of hypercortisolism on the human brain and the reversibility of these effects after resolution of the condition. This cross-sectional study used resting-state fMRI (rs-fMRI) to investigate the altered spontaneous brain activity in CD patients and the trends for potential reversibility after the resolution of the hypercortisolism. We also aim to determine the relationship of these changes with clinical characteristics and cortisol levels. @@@ Subjects and methodsActive CD patients (n = 18), remitted CD patients (n = 14) and healthy control subjects (n = 22) were included in this study. Amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) values were calculated to represent spontaneous brain activity. @@@ ResultsOur study resulted in three major findings: (i) active CD patients showed significantly altered spontaneous brain activity in the posterior cingulate cortex (PCC)/precuneus (PCu), occipital lobe (OC)/cerebellum, thalamus, right postcentral gyrus (PoCG) and left prefrontal cortex (PFC); (ii) trends for partial restoration of altered spontaneous brain activity after the resolution hypercortisolism were found in several brain regions; and (iii) active CD patients showed a significant correlation between cortisol levels and ALFF/ReHo values in the PCC/PCu, a small cluster in the OC and the right IPL. @@@ ConclusionsThis study provides a new approach to investigating brain function abnormalities in patients with CD and enhances our understanding of the effect of hypercortisolism on the human brain. Furthermore, our explorative potential reversibility study of patients with CD may facilitate the development of future longitudinal studies.

• 出版日期2017-3
• 单位上海市闵行区中心医院; 上海交通大学