Cortical thickness abnormalities in long-term remitted Cushing's disease

Area of Science:

• Neuroscience
• Endocrinology
• Radiology

Background:

• Long-term remitted Cushing's disease (LTRCD) patients often experience persistent psychological and cognitive deficits.
• Previous research focused on gray matter volume; cortical thickness and surface area offer further neuroanatomical insights.

Purpose of the Study:

• To investigate cortical thickness and surface area differences in LTRCD patients compared to healthy controls.
• To explore the relationship between cortical changes, psychological symptoms, and disease characteristics.

Main Methods:

• Structural 3T MRI scans from 25 LTRCD patients and 25 healthy controls.
• FreeSurfer software for segmenting T1-weighted images and extracting cortical thickness/surface area.
• Paired t tests for region of interest (anterior cingulate cortex) and whole-brain analyses; validated scales for symptom assessment.

Main Results:

• LTRCD patients exhibited reduced cortical thickness in the left caudal anterior cingulate cortex (ACC) and right rostral ACC.
• Whole-brain analysis revealed thinner cortices in the left caudal ACC, left cuneus, left posterior cingulate cortex, right rostral ACC, and bilateral precuneus.
• No significant differences in cortical surface area were found; some cortical thickness reductions inversely correlated with anxiety, depression, and disease duration.

Conclusions:

• Prolonged exposure to excess glucocorticoids in Cushing's disease may lead to cortical thinning in emotion and cognition-related brain structures.
• Cortical thinning, particularly in the ACC, may underlie persistent neurocognitive and psychological deficits in LTRCD patients.