Decrease in cortisol reverses human hippocampal atrophy following treatment of Cushing’s diseaseMonica N Starkmana, , Bruno Giordanib, Stephen S Gebarskic, Stanley Berentb, M.Anthony Schorke, David E Schteingartd
a Department of Psychiatry (MNS), University of Michigan, Ann Arbor, Michigan, USA
b Neuropsychology Division, Department of Psychiatry (BG, SB), University of Michigan, Ann Arbor, Michigan, USA
c Department of Department of Radiology (SSG), University of Michigan, Ann Arbor, Michigan, USA
d Department of and Department of Internal Medicine (DES), University of Michigan Medical School, Ann Arbor, Michigan, USA
e Department of Biostatistics, School of Public Health, University of Michigan (MAS), Ann Arbor., USA
http://dx.doi.org/10.1016/S0006-3223(99)00203-6, How to Cite or Link Using DOI
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Abstract
Background: Decreased hippocampal volume is observed in patients with Cushing’s syndrome and other conditions associated with elevated cortisol levels, stress, or both. Reversibility of hippocampal neuronal atrophy resulting from stress occurs in animals. Our study investigated the potential for reversibility of human hippocampal atrophy.
Methods: The study included 22 patients with Cushing’s disease. Magnetic resonance brain imaging was performed prior to transsphenoidal microadenomectomy and again after treatment.
Results: Following treatment, hippocampal formation volume (HFV) increased by up to 10%. The mean percent change (3.2 ± 2.5) was significantly greater (p < .04) than that of the comparison structure, caudate head volume (1.5 ± 3.4). Increase in HFV was significantly associated with magnitude of decrease in urinary free cortisol (r = −.61, p < .01). This relationship strengthened after adjustments for age, duration of disease, and months elapsed since surgery (r = −.70, p < .001). There was no significant correlation between caudate head volume change and magnitude of cortisol decrease.
Conclusions: Changes in human HFV associated with sustained hypercortisolemia are reversible, at least in part, once cortisol levels decrease. While many brain regions are likely affected by hypercortisolemia, the human hippocampus exhibits increased sensitivity to cortisol, affecting both volume loss and recovery.
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so 50mg/d may not be enough. low zinc will impair d3 status. that's a personal observation, ie case study with n=1. still waiting for the relevant larger study.
I'm worried about zinc getting too high so I'm just going to stick with the low dose in multi until my next blood test. My multi has no magnesium in it so I will probably try the mag l-threonate again (until I start (hopefully) amiloride which can cause increased mag and k levels). My diet is fairly rich in mag foods so I don't really understand why my levels are dropping...maybe because I was focusing so much on potassium while on clonidine?? I've got a lot of room on the d so I'll start the 5000d3/week and get in out in the sun.