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Patterns of cognitive change over time and relationship to age following successful treatment of Cushing's disease

Published online by Cambridge University Press:  13 December 2006

JULIE N. HOOK ,
BRUNO GIORDANI ,
DAVID E. SCHTEINGART ,
KENNETH GUIRE ,
JODIE GILES ,
KELLEY RYAN ,
STEPHEN S. GEBARSKI ,
SCOTT A. LANGENECKER  and
MONICA N. STARKMAN
JULIE N. HOOK
Affiliation:
Department of Psychiatry, University of Michigan Health Systems, Ann Arbor, Michigan Julie N. Hook PhD is now an Assistant Professor at Rush University
BRUNO GIORDANI
Affiliation:
Department of Psychiatry, University of Michigan Health Systems, Ann Arbor, Michigan
DAVID E. SCHTEINGART
Affiliation:
Department of Internal Medicine, University of Michigan Health Systems, Ann Arbor, Michigan
KENNETH GUIRE
Affiliation:
Department of Biostatistics and Natural Sciences, University of Michigan, Ann Arbor, Michigan
JODIE GILES
Affiliation:
Department of Psychiatry, University of Michigan Health Systems, Ann Arbor, Michigan
KELLEY RYAN
Affiliation:
Department of Psychiatry, University of Michigan Health Systems, Ann Arbor, Michigan
STEPHEN S. GEBARSKI
Affiliation:
Department of Radiology, University of Michigan Health Systems, Ann Arbor, Michigan
SCOTT A. LANGENECKER
Affiliation:
Department of Psychiatry, University of Michigan Health Systems, Ann Arbor, Michigan
MONICA N. STARKMAN
Affiliation:
Department of Psychiatry, University of Michigan Health Systems, Ann Arbor, Michigan
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Abstract

Chronically elevated levels of cortisol have been associated with changes in cognitive functioning and brain morphology. Using Cushing's disease as a model to assess the effects of high levels of cortisol on cognitive functioning, 27 patients with Cushing's disease were examined at baseline and three successive follow-up periods up to 18 months after successful surgical treatment. At all follow-up periods, patients were administered cognitive tests as well as measures of plasma and urinary free cortisol. Structural MRIs and a depression measure were taken at baseline and one-year follow-up. Results showed that there is a specific pattern of significant cognitive and morphological improvement following successful treatment. Verbal fluency and recall showed recovery, although brief attention did not. Age of participants was a significant factor as to when recovery of function occurred; younger patients regained and sustained their improvement in cognitive functioning more quickly than older participants. Improvement in verbal recall also was associated with a decrease in cortisol levels as well as an increase in hippocampal formation volume one year after treatment. Overall, these findings suggest that at least some of the deleterious effects of prolonged hypercortisolemia on cognitive functioning are potentially reversible, up to at least 18 months post treatment. (JINS, 2007, 13, 21–29.)

Keywords

CortisolHippocampusMemoryNeuropsychologyElderlyMagnetic Resonance Imaging
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 13 , Issue 1 , January 2007 , pp. 21 - 29
Copyright
© 2007 The International Neuropsychological Society

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