Altered gray and white matter microstructure in Cushing's disease: A diffusional kurtosis imaging study

Area of Science:

• Neuroimaging
• Endocrinology
• Neurology

Background:

• Chronic hypercortisolism negatively impacts brain structure and function.
• Cushing's disease (CD) offers a unique model to study hypercortisolism's effects on the brain.

Purpose of the Study:

• To investigate microstructural brain alterations in CD patients using Diffusional Kurtosis Imaging (DKI).
• To correlate these microstructural changes with clinical characteristics of CD.

Main Methods:

• Cross-sectional study comparing 15 active CD patients with 15 healthy controls.
• Diffusional Kurtosis Imaging (DKI) and voxel-based analyses (VBA) were employed.
• Correlations between DKI parameters and clinical data were analyzed.

Main Results:

• CD patients showed significantly altered diffusivity parameters in the left medial temporal lobe (MTL) white matter (WM) and gray matter (GM).
• Increased radial diffusivity (RD) in the left hippocampus/parahippocampal gyrus correlated positively with CD clinical severity.
• Altered kurtosis parameters were observed in the cerebellum and frontal lobe.

Conclusions:

• DKI provides valuable microstructural information in both WM and GM of CD patients.
• Impairment in the left MTL may contribute to memory and cognitive deficits observed in CD.
• DKI can complement clinical assessments in managing Cushing's disease.