Michaud Kathy, Forget Hélène, Cohen Henri
Department of Psychology, Carleton University, Canada.
Brain Cogn. 2009 Oct;71(1):1-8. doi: 10.1016/j.bandc.2009.02.013. Epub 2009 May 9.
Cumulative exposure to glucocorticoid hormones (GC) over the lifespan has been associated with cognitive impairment and may contribute to physical and cognitive degeneration in aging. The objective of the present study was to examine whether the pattern of cognitive deficits in patients with Cushing's syndrome (CS), a disorder characterized by chronic exposure to elevated levels of glucocorticoids (GC), is similar to that observed in older individuals. Ten subjects with CS were compared to sex-, age-, and education-matched healthy controls and older subjects (age of CS subjects+15 yr). All participants were administered tests to assess attention, visuospatial processing, learning and memory, reasoning, concept formation and verbal fluency. MANCOVAs with depression scores as covariate and polynomial contrasts revealed that the age-matched control group performed better than the CS and older subject groups in visual target detection, trail making test, stroop task, digit symbol substitution, block design, object assembly, visual reproduction, spatial memory and similarities. The CS and older subjects performed similarly on these tasks. Further, a principal component analysis revealed two significant factors, representing general cognitive function and verbal memory explaining 39.9% and 10.0% of the variance, respectively. Additional MANCOVAs with depression as a covariate revealed that CS and older control subjects showed impaired performance on general cognitive function compared to age-matched controls. These results suggest that hypersecretion of GCs has "aging-like" effects on cognitive performance in individuals with CS.
一生中累积接触糖皮质激素（GC）与认知障碍有关，可能导致衰老过程中的身体和认知衰退。本研究的目的是检验库欣综合征（CS）患者（一种以长期暴露于高水平糖皮质激素（GC）为特征的疾病）的认知缺陷模式是否与老年人中观察到的模式相似。将10名CS患者与性别、年龄和教育程度相匹配的健康对照者以及老年受试者（CS患者年龄 + 15岁）进行比较。所有参与者都接受了评估注意力、视觉空间处理、学习和记忆、推理、概念形成和语言流畅性的测试。以抑郁评分作为协变量的多变量协方差分析和多项式对比显示，在视觉目标检测、连线测验、斯特鲁普任务、数字符号替换、积木设计、物体拼凑、视觉再现、空间记忆和相似性方面，年龄匹配的对照组比CS组和老年受试者组表现更好。CS组和老年受试者在这些任务上表现相似。此外，主成分分析揭示了两个显著因素，分别代表一般认知功能和言语记忆，分别解释了39.9%和10.0%的方差。以抑郁作为协变量的额外多变量协方差分析显示，与年龄匹配的对照组相比，CS组和老年对照组在一般认知功能方面表现受损。这些结果表明，GC分泌过多对CS患者的认知表现有“衰老样”影响。
