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Elevated resting-state connectivity in the medial temporal lobe and the prefrontal cortex among patients with Cushing's syndrome in remission

Journal article
Authors Andreas Stomby
Alireza Salami
Per Dahlqvist
Johan Arild Evang
Mats Ryberg
Jens Bollerslev
Tommy Olsson
Gudmundur Johannsson
Oskar Ragnarsson
Published in European journal of endocrinology
Volume 180
Issue 5
Pages 329-338
Publication year 2019
Published at Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
Pages 329-338
Language en
Subject categories Radiology, Nuclear Medicine and Medical Imaging, Clinical neurophysiology, Endocrinology


Objective Cushing's syndrome is associated with long-term cognitive deficits and affective symptoms such as depression and anxiety. The alterations in brain function underlying these deficits after Cushing's syndrome are unclear and therefore we aimed to explore alterations in resting-state functional connectivity in patients with Cushing's syndrome in remission. Design Cross-sectional case-control study. Methods Nineteen women with Cushing's syndrome in remission for a median time of 7 years (IQR: 6-10) and a mean age of 45 years were included at three university clinics. These patients and 38 age-matched female controls underwent brain imaging at a single center. The main outcome measure was functional connectivity at rest, measured with functional magnetic resonance imaging. Results The medial temporal lobe (MTL) and prefrontal cortex networks, exhibited elevated functional connectivity among patients compared to controls. The degree of elevated functional connectivity in the MTL was negatively associated with time in remission. Conclusions Resting-state functional connectivity within glucocorticoid receptor-rich regions, particularly the MTL and medial prefrontal cortex, was increased in patients. These differences in connectivity may provide a neural basis for the cognitive deficits and affective symptoms commonly experienced by patients with Cushing's syndrome in remission.

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