Brain metabolite abnormalities in ventromedial prefrontal cortex are related to duration of hypercortisolism and anxiety in patients with Cushing’s syndrome

Iris Crespo, Alicia Santos, Beatriz Gómez-Ansón, Olga López-Mourelo, Patricia Pires, Yolanda Vives-Gilabert, Susan M. Webb, Eugenia Resmini

Research output: Contribution to journalArticleResearchpeer-review

12 Citations (Scopus)

Abstract

© 2016, Springer Science+Business Media New York. Chronic exposure to excessive glucocorticoid (GC) concentration in Cushing’s syndrome (CS) can affect the brain structurally and functionally; ventromedial prefrontal cortex (vmPFC) is rich in GC receptors and therefore particularly vulnerable to excessive GC concentration. Proton magnetic resonance spectroscopy (1H-MRS) is a sensitive, non-invasive imaging technique that provides information on brain metabolites in vivo. Our aim was to investigate metabolite concentrations in vmPFC of CS patients and their relationship with clinical outcome. Twenty-two right-handed CS patients (7 active/15 in remission, 19 females, 41.6 ± 12.3 years) and 22 right-handed healthy controls (14 females, 41.7 ± 11 years) underwent brain MRI and 1H-MRS exams at 3 Tesla. Concentrations of glutamate (Glu), glutamate + glutamine (Glx), creatine (Cr), N-Acetyl-aspartate (NAA), N-Acetyl-aspartate + N-acetylaspartylglutamate (total NAA), choline-containing compounds (Cho) and myoinositol (MI) were determined. Moreover, anxiety and depressive symptoms were evaluated with the State-Trait Anxiety Inventory (STAI) and the Beck Depression Inventory-II (BDI-II) test, respectively. CS patients had lower concentrations of glutamate and total NAA in the vmPFC than healthy controls (8.6 ± 1.2 vs. 9.3 ± 0.7 mmol/L, and 6.4 ± 0.8 vs. 6.8 ± 0.4 mmol/L, respectively; p < 0.05). Duration of hypercortisolism was negatively correlated with total NAA (r = −0.488, p < 0.05). Moreover, the concentration of total NAA was negatively correlated with anxiety state (r = −0.359, p < 0.05). Brain metabolites are abnormal in the vmPFC of patients with CS. Decreased total NAA and glutamate concentrations indicate neuronal dysfunction that appear to be related with duration of hypercortisolism and anxiety.
Original languageEnglish
Pages (from-to)848-856
JournalEndocrine
Volume53
Issue number3
DOIs
Publication statusPublished - 1 Sep 2016

Keywords

  • Anxiety
  • Brain metabolites
  • Cushing’s syndrome
  • Spectroscopy
  • Ventromedial prefrontal cortex

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