Department of Women's and Children's Health, Karolinska Institutet, Pediatric Endocrinology Unit, Karolinska University Hospital, SE-171 76 Stockholm, Sweden.
Department of Molecular Medicine and Surgery, Karolinska Institutet and Department of Endocrinology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden.
Psychoneuroendocrinology. 2022 Jun;140:105714. doi: 10.1016/j.psyneuen.2022.105714. Epub 2022 Mar 10.
Sub-optimal replacement of glucocorticoids (GC) in autoimmune Addison's disease (AAD) may affect cognitive functioning. The present study therefore sought to investigate cognitive performance and self-reported problems with executive functions in a cohort of young adult patients with AAD.
67 patients with AAD (39 females), mean age 32 yrs. (range 19-41), and 80 control participants (43 females), mean age 29 yrs. (range 19-43), completed neuropsychological tests estimating verbal and non-verbal intellectual ability, learning, memory and executive functioning, in addition to self-report scales assessing problems with executive functions, fatigue and symptoms of anxiety and depression.
Patients performed within the average range on all cognitive tests compared to population norms. However, female AAD patients reported more problems than controls with both hot (emotion regulation) and cold (cognitive regulation) executive functions in daily life. Moreover, experienced problems with executive functions in both male and female patients were associated with increased mental fatigue and lower GC replacement doses.
Despite average performance in neuropsychological tests by both sexes, young adult female patients with AAD experience problems with executive functions in daily life. Coping with mental fatigue and optimization of pharmacotherapy may be important factors to be addressed in order to provide timely support for patients. Future research is needed to further determine other risk factors for experiencing executive function impairments in AAD.
自身免疫性艾迪生病（AAD）中糖皮质激素（GC）替代不足可能会影响认知功能。因此，本研究旨在调查年轻成年 AAD 患者队列的认知表现和自我报告的执行功能障碍问题。
67 名 AAD 患者（39 名女性），平均年龄 32 岁（范围 19-41），80 名对照参与者（43 名女性），平均年龄 29 岁（范围 19-43），完成了神经心理学测试，评估了言语和非言语智力能力、学习、记忆和执行功能，以及自我报告量表，评估执行功能障碍、疲劳以及焦虑和抑郁症状的问题。
与人群正常值相比，患者在所有认知测试中的表现均处于平均范围内。然而，女性 AAD 患者在日常生活中报告的热执行功能（情绪调节）和冷执行功能（认知调节）问题比对照组更多。此外，男性和女性患者体验到的执行功能障碍问题与精神疲劳增加和 GC 替代剂量降低有关。
尽管男女患者在神经心理学测试中的表现均处于平均水平，但年轻成年女性 AAD 患者在日常生活中会出现执行功能障碍问题。应对精神疲劳和优化药物治疗可能是为患者提供及时支持的重要因素。需要进一步的研究来确定 AAD 中出现执行功能障碍的其他风险因素。
