Department of Neurosurgery, Rui-Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Neurosurgery, Rui-Jin Lu-Wan Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Eur J Endocrinol. 2021 Apr;184(4):565-574. doi: 10.1530/EJE-20-1139.
Cushing's disease (CD) is a rare clinical syndrome characterized by chronic exposure to hypercortisolism due to an adrenocorticotropic hormone-secreting pituitary adenoma. The adverse effects of chronic exposure to hypercortisolism on the human brain remain unclear. The purpose of this study was to assess the prevalence of cerebral microbleeds (CMBs) in CD patients and their associations with clinical characteristics.
In this study, 48 active CD patients, 39 remitted CD patients, and 52 healthy control (HC) subjects underwent MRI. CD patients also underwent neuropsychological testing and clinical examinations. The number, locations, and volumes of CMBs were assessed on quantitative susceptibility mapping (QSM) images and with the Microbleed Anatomical Rating Scale. The correlation between CMBs and clinical characteristics was explored.
The prevalence of CMBs among active and remitted CD patients was higher than that among HCs (16.3%, 20.5%, and 3.3%, respectively). Moreover, the age of CD patients with CMBs were much younger than HCs with CMBs. Furthermore, the increased number of CMBs in active CD patients was associated with increased cerebrospinal fluid (CSF) volumes in remitted CD patients.
Chronic exposure to hypercortisolism may be relevant to CMBs and significantly correlated with altered brain volumes in CD.
库欣病（CD）是一种罕见的临床综合征，其特征为由于促肾上腺皮质激素分泌垂体腺瘤而导致的慢性暴露于皮质醇增多症。慢性暴露于皮质醇增多症对人脑的不良影响尚不清楚。本研究旨在评估 CD 患者脑微出血（CMB）的患病率及其与临床特征的关系。
本研究纳入了 48 例活动期 CD 患者、39 例缓解期 CD 患者和 52 例健康对照（HC）受试者，所有受试者均接受了 MRI 检查。CD 患者还接受了神经心理学测试和临床检查。在定量磁化率图（QSM）图像上使用微出血解剖评分量表评估 CMB 的数量、位置和体积，并探讨了 CMB 与临床特征之间的相关性。
活动期和缓解期 CD 患者的 CMB 患病率高于 HC（分别为 16.3%、20.5%和 3.3%）。此外，CMB 阳性的 CD 患者的年龄明显小于 CMB 阳性的 HC 患者。此外，活动期 CD 患者 CMB 数量的增加与缓解期 CD 患者脑脊液（CSF）体积的增加有关。
慢性暴露于皮质醇增多症可能与 CMB 有关，并与 CD 患者的脑容积改变显著相关。
