Jiang Hong, He Na-Ying, Sun Yu-Hao, Jian Fang-Fang, Bian Liu-Guan, Shen Jian-Kang, Yan Fu-Hua, Pan Si-Jian, Sun Qing-Fang
Department of Neurosurgery, Rui-Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Department of Radiology, Rui-Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Brain Res. 2017 Jun 15;1665:80-87. doi: 10.1016/j.brainres.2017.04.007. Epub 2017 Apr 21.
Exposure to chronic hypercortisolism has multiple adverse effects on brain biology in humans. Cushing's disease (CD) represents a unique and natural human model for examining the effects of hypercortisolism on the brain. This cross-sectional study used Diffusional Kurtosis Imaging (DKI) to investigate the microstructure alterations in both white matter (WM) and gray matter (GM) of CD patients and to determine the relationship of these changes with clinical characteristics. DKI images were obtained from 15 active CD patients. DKI parametric maps were estimated through voxel-based analyses (VBA) and compared with 15 healthy controls matched for age, sex and education. In addition, correlations were analyzed between the altered DKI parameters and clinical characteristics. Compared with healthy controls, CD patients mainly exhibited significantly altered diffuse parameters in the GM and WM of the left medial temporal lobe (MTL). The mean values of increased radial diffusivity (RD) of CD patients in GM of the left hippocampus/parahippocampal gyrus correlated positively with the clinical severity of CD. Additionally, we also found altered kurtosis parameters in the cerebellum and frontal lobe. DKI imaging of CD patients could represent complementary information in both white matter and gray matter. The impairment of the left MTL might explain some part of the memory and cognition impairments in CD patients.
长期暴露于高皮质醇血症对人类大脑生物学有多种不良影响。库欣病（CD）是研究高皮质醇血症对大脑影响的独特且自然的人类模型。这项横断面研究使用扩散峰度成像（DKI）来研究CD患者白质（WM）和灰质（GM）的微观结构改变，并确定这些变化与临床特征的关系。从15名活动性CD患者获取了DKI图像。通过基于体素的分析（VBA）估计DKI参数图，并与15名年龄、性别和教育程度相匹配的健康对照进行比较。此外，分析了改变的DKI参数与临床特征之间的相关性。与健康对照相比，CD患者主要在左侧内侧颞叶（MTL）的GM和WM中表现出明显改变的扩散参数。CD患者左侧海马体/海马旁回GM中径向扩散率（RD）增加的平均值与CD的临床严重程度呈正相关。此外，我们还发现小脑和额叶的峰度参数发生了改变。CD患者的DKI成像可在白质和灰质中提供补充信息。左侧MTL的损伤可能解释了CD患者记忆和认知障碍的部分原因。
