This is a single center, prospective, observational study to explore and evaluate the differences on cognitive function and brain function by functional-MRI in autonomous cortisol secretion patients, and the different treatments methods on the cognitive function and brain function in patients with autonomous cortisol secretion
Glucocorticoids, mainly cortisol, play a crucial role in the allostatic process of adjustment to stressors and can determine important changes in central nervous system structures. It is well known that Cushing's syndrome (CS) is associated with neurocognitive impairment in about two-thirds of cases. In CS the most frequent reported alterations are memory impairment (about 83% of cases) and reduced concentration (66% of cases) . Unfortunately, these alterations are only partially reversible after the hypercortisolism resolution. As so far, data related to the impact of autonomous cortisol secretion (ACS) on cognitive function are scarce and lack of magnetic resonance indicators. Few studies have studied the cognitive function changes of patients with ACS by surgical and conservative treatment. In the single center, prospective and observational study we aim to explore cognitive functions and brain function by functional-MRI in adrenal incidentaloma patients in relation to the presence of ACS and, secondly, in a group of acs patients, the effect of adrenalectomy on cognitive functions and brain function.
Study Type
OBSERVATIONAL
Enrollment
62
cognitive function measurement
Only a subgroup of the autonomous cortisol secretion patients will have the laparoscopic adrenal surgery
Department of Endocrinology, Drum Tower Hospital affiliated to Nanjing University Medical School
Nanjing, Jiangsu, China
RECRUITINGParticipants' personal information
Self-reported information(education in years)
Time frame: 1 day
Physical assessments
BMI(body mess index) in kg/m\^2
Time frame: 1 day
Imaging examinations
Adrenal adenoma size in cm
Time frame: 1 day
Montreal Cognitive Assessment (MoCA)
The MoCA is a Global cognitive screening test designed to assist Health Professionals in detection of mild cognitive impairment.
Time frame: 20 minutes
Mini-Mental State Examination (MMSE)
The MMSE is a cognitive screening test designed to assist Health Professionals in detection of mild cognitive impairment.
Time frame: 20 minutes
Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)
The RBANS is a cognitive screening test designed to assist Health Professionals in evaluation of multiple cognitive subdomains
Time frame: 1 hour
Rest Functional MRI of the brain function.
Rs-fMRI
Time frame: 40 minutes
Screening for adrenal cortisol hypersecretion
Patients were given 1 mg dexamethasone orally at 24:00 am, and the cortisol levels were measured at 8:00 am the following morning
Time frame: 1 day
Changes from basline global cognitive functions
MoCA
Time frame: 12 months after the laparoscopic adrenal surgery (for patients with autonomous cortisol secretion who are willing to operate)]
Changes from basline multiple cognitive subdomains
RBANS
Time frame: 12 months after the laparoscopic adrenal surgery (for patients with autonomous cortisol secretion who are willing to operate)]
Change from baseline Functional magnetic resonance imagine
Rs-fMRI
Time frame: 12 months after the laparoscopic adrenal surgery (for patients with autonomous cortisol secretion who are willing to operate)]
Changes from basline global cognitive functions
MoCA
Time frame: 12 months after the conservative treatment (for patients with autonomous cortisol secretion who are not willing to operate)]
Changes from basline multiple cognitive subdomains
RBANS
Time frame: 12 months after the conservative treatment (for patients with autonomous cortisol secretion who are not willing to operate)]
Change from baseline Functional magnetic resonance imagine
Rs-fMRI
Time frame: 12 months after the conservative treatment (for patients with autonomous cortisol secretion who are not willing to operate)]
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