Wednesday, June 30, 2010

Irreversible Effects of Previous Cortisol Excess on Cognitive Functions in Cushing’s Disease

I am thankful to have found Laika's MedLibLog: A medical librarians exploration of the web 2.0 world and beyond.

I find this April 2010 article very troubling. In fact, as a lifetime straight A student, president of my high school honor society, magna cum laude college graduate, it may be more than troubling. It is devastatingly sad, because--from what other Cushing's patients tell me--it may indeed be true. ~mm

Irreversible Effects of Previous Cortisol Excess on Cognitive Functions in Cushing’s Disease (click here for full article)
Symptoms of Cushing’s disease are related to the effects of high levels of cortisol or other glucocorticoids on the immune system, the metabolism and the brain. Symptoms include rapid weight gain, particularly of the trunk and face (central obesity, “moon face” and buffalo neck), thinning of the skin and easy bruising, excessive hair growth, opportunistic infections, osteoporosis and high blood pressure.

Less emphasized than the clinical features are the often very disabling cognitive deficits and emotional symptoms that accompany Cushing’s disease. Cushing patients may suffer from various psychological disturbances, like insomnia, mood swings, depression and manic depression, and from cognitive decline. Several studies have shown that these glucocorticoid induced changes are accompanied by atrophy of the brain, and in particular of the hippocampal region, leading to hippocampal volume loss and a profound loss of synapses [2]. This hippocampal loss seems reversible [2], but are neurological and psychological defects also restored? This is far more important to the patient than anatomic changes.

If we listen to Cushing patients, who are “cured” and have traded Cushing’s disease for Addison’s disease, we notice that they feel better after their high levels of cortisol have normalized, but not fully cured (see two examples of ex-Cushing patients with longlasting if not irreversible health) problems in my previous post here. [added 2010-04-17)