Session: SAT 26-40-Glucocorticoid Actions & Disease
Poster Board SAT-32
Objective: To investigate structural changes in the brain of patients after long-term remission of CD.
Design: A cross-sectional study.
Patients and Methods: In 25 patients in long-term remission of CD and 25 matched healthy controls, grey matter volume of the regions of interest (hippocampus, amygdala, anterior cingulate cortex) and the whole brain were examined, using 3T Magnetic Resonance Imaging and a voxel based morphometry (VBM) approach. In addition, we assessed psychological and cognitive functioning using validated questionnaires, and clinical severity using the Cushing's syndrome Severity Index.
Results: Compared to controls, patients had significantly smaller grey matter volumes of areas in the anterior cingulate cortex (on average 14%, P<0.05) and significantly greater volumes in the left posterior lobe of the cerebellum (on average 34%, P<0.05). There were no significant differences in grey matter volumes in the hippocampus and amygdala. As expected CD patients demonstrated more depressive symptoms (P=0.005), more anxiety (P=0.003) and more apathy (P=0.002) compared to controls, but the differences in grey matter volumes were not associated with clinical severity, nor with measures of psychological or cognitive dysfunction.
Conclusion: Patients in long-term remission of CD showed structural abnormalities in the brain, with smaller ACC volumes and an asymmetric enlargement of the posterior lobe of the cerebellum, in the presence of increased depressive symptoms, anxiety, and apathetic behavior. This indicates incomplete recovery of the central nervous system despite successful treatment for CD.
Nothing to Disclose: CDA, SJAV, JNP, SMV, OCM, MAB, SARBR, RCV, JAR, JT, NRB, NJAV, AMP
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