Neuropsychiatric Findings in Cushing Syndrome and Exogenous Glucocorticoid Administration

作者：Starkman Monica N^*

来源：Endocrinology and Metabolism Clinics of North America, 2013, 42(3): 477-+.

DOI：10.1016/j.ecl.2013.05.010

• Elevated cortisol
• Cushing disease and Cushing syndrome
• Exogenous glucocorticoid administration
• Depressive disorder
• Hypomania
• Cognition
• Brain imaging
• Management

This article reviews the neuropsychiatric presentations elicited by spontaneous hypercortisolism and exogenous supraphysiologic glucocorticoids. Patients with Cushing disease and syndrome develop a depressive syndrome: irritable and depressed mood, decreased libido, disrupted sleep and cognitive decrements. Exogenous short-term glucocorticoid administration may elicit a hypomanic syndrome with mood, sleep and cognitive disruptions. Treatment options are discussed. Brain imaging and neuropsychological studies indicate elevated cortisol and other glucocorticoids are especially deleterious to hippocampus and frontal lobe. The research findings also shed light on neuropsychiatric abnormalities in conditions that have substantial subgroups exhibiting elevated and dysregulated cortisol: aging, major depressive disorder and Alzheimer disease.

• 出版日期2013-9