Assessment of brain and hippocampal volume in patients with Cushing's disease

The purpose of this study was to assess the volumes of the hippocampus, grey matter, and the whole brain in patients with active Cushing's disease compared to a control group.

We included 36 patients diagnosed with Cushing's disease, with pituitary magnetic resonance imaging (MRI) performed as a standard preoperative assessment. The sample size of the control group was 26 persons. MRI studies were acquired with a 3.0 Tesla MR scanner equipped with a 24-channel head coil. The MRI study protocol included a pre-contrast 3D T1-weighted gradient sequence. Volumetric segmentation of the brain structures was performed using version 6.0 of the FreeSurfer software.

We observed statistically significant reduction in the grey matter volume in the study group as compared to the control group (p < 0.001), with no significant differences in the volume of the whole brain (p = 0.104), left hippocampus (p = 0.790), and right hippocampus (p = 0.517). There was a strong positive correlation between grey matter volume and brain volume (r = 0.75, p < 0.001), independent of the study group.

The study showed unevenly distributed brain atrophy in patients suffering from Cushing's disease, with no significant hippocampal atrophy. Significant atrophy was observed within the grey matter, potentially constituting a preliminary stage of whole-brain atrophy.