库辛综合征的认知衰退:一个系统的审查
Anila Katragadda1, Jessica Kunadia2, Polly Kirsch3
1Kansas City University College of Osteopathic Medicine, Kansas City, Missouri, USA.
Journal of neuroendocrinology
|November 7, 2024
概括
库辛综合征 (CS) 患者经常有持续的神经认知和精神问题,即使在手术后. 较高的基线皮质醇和较长的疾病持续时间预测这些持久的症状,影响生活质量.
科学领域:
- 神经内分泌学神经内分泌学
- 神经精神病学是一种神经精神病学.
- 神经外科 神经外科
背景情况:
- 库辛综合征 (CS) 显著损害神经认知功能,精神健康和生活质量.
- 在CS患者中,神经认知缺陷和精神症状可能会在手术后持续存在.
- 与非功能性垂体腺瘤 (NFPA) 和健康对照进行比较对于理解CS特异性影响至关重要.
研究的目的:
- 系统地审查和比较库辛病 (CD) /CS患者的神经认知,精神和结构性大脑变化与NFPA患者.
- 为了评估这些变化之前和之后的手术治疗.
- 确定持续的神经认知症状和CS患者生活质量下降的预测因素.
主要方法:
- 在2021年之前对英语文学 (Medline/Pubmed) 进行系统审查,遵守PRISMA指南.
- 纳入标准:关于CD/CS患者的研究,报告精神症状,发表在同行评审期刊上.
- 分析了40项符合条件的研究,涉及2603名参与者,使用验证的问卷和与NFPA对照进行比较.
主要成果:
- 患有CD/CS的患者表现出比NFPA对照组更糟糕的认知功能,特别是基线水平较高的血清皮质醇水平,即使在缓解后也持续存在.
- 失控的CS持续时间较长与认知功能较差相关.
- 虽然整体大脑体积在缓解后增加,但与对照组相比,额叶和叶体积仍然减少.
结论:
- 神经认知功能障碍,精神疾病和生活质量下降在CS中很常见,并且在治疗性手术后也可能持续存在.
- 持续症状的预测因素包括高的手术前皮质醇,更长的疾病持续时间,基线认知/神经精神疾病缺陷,以及前额/叶缩.
- 需要更大的前性研究来验证这些发现并指导管理.
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