ECE2015 Guided Posters Pituitary – Diagnosis of Cushing's disease (6 abstracts)
Altered neural processing during emotional faces in remitted Cushing's disease
Cornelie Andela 1, , Janna Marie Hoogendam 1, , Steven Van der Werff 1, , Nienke Pannekoek 1, , Henk Van Steenbergen 2, , Onno Meijer 1, , Mark Van Buchem 1, , Serge Rombouts 1, , Roos Van der Mast 1 , Nienke Biermasz 1, , Nic Van der Wee 1, & Alberto Pereira 1,
1Leiden University Medical Center, Leiden, The Netherlands; 2Institute of Psychology Leiden University, Leiden, The Netherlands; 3Leiden Institute of Brain and Cognition, Leiden, The Netherlands.
Background: Patients with long-term remission of Cushing’s disease (CD) demonstrate residual psychological complaints. At present, it is not known how previous exposure to hypercortisolism affects psychological functioning in the long-term. In foregoing Magnetic Resonance Imaging (MRI) studies, abnormalities of brain structure and resting-state connectivity were demonstrated in patients with long-term remission of CD. However, no data are available on functional alterations in the brain during the performance of emotional or cognitive tasks in these patients.
Objective: To investigate brain activation during emotion processing in patients with long-term remission of CD.
Design: A cross-sectional functional MRI study.
Methods: Processing of emotional faces versus a non-emotional control condition was examined in 21 patients with long-term remission of CD and 21 matched healthy controls. Functional MRI analyses focused on activation and connectivity of two a priori determined regions of interest: the amygdala and the medial prefrontal cortex (mPFC). In addition, we assessed psychological and cognitive functioning, and clinical disease severity.
Results: Patients with long-term remission of CD showed hypoactivation in the mPFC during processing of emotional faces in patients relative to controls. In addition, functional coupling between the mPFC and posterior cingulate cortex (PCC) was decreased. No differences were found in the activation of the amygdala.
Conclusion: The present study is the first to show alterations in brain function and functional coupling in patients with long-term remission of CD relative to matched healthy controls. These alterations in brain function may, together with abnormalities in brain structure, explain the persisting psychological morbidity these patients after long-term remission.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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