In the present study the cognitive performance of 25 patients with Cushing's disease (CD) was extensively evaluated in comparison with normal control subjects, matched one by one. The results indicate a selective impairment of memory functions: the number of patients showing a significantly impaired mnesic performance increases with age. Moreover, the neuropsychological impairment tends to recover in those cases who underwent further controls after surgical treatment. The neuropsychological data are discussed in the light of recent evidence in the literature concerning the effects of adrenal steroids on the brain.
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"On the other hand, another study  concluded that, generally speaking, increased cortisol levels due to stress-induced HPA axis over activity have been associated with cognitive impairment as stress-induced HPA axis overactivity and increased cortisol levels may cause hippocampal damage and, subsequently, cognitive decline. Furthermore, patients with Cushing's syndrome more often present with cognitive impairment . Finally, one of the side-effects of treatment with synthetic corticosteroids is cognitive deterioration  "
[Show abstract][Hide abstract] ABSTRACT: Autism is a disorder of early childhood characterized by social impairment, communication abnormalities and stereotyped behaviors. The hypothalamic-pituitary-adrenocortical (HPA) axis deserves special attention, since it is the basis for emotions and social interactions that are affected in autism.
To assess basal and stimulated plasma cortisol, and adrenocorticotropic hormone (ACTH) levels in autistic children and their relationship to disease characteristics.
Fifty autistic children were studied in comparison to 50 healthy age-, sex- and pubertal stage- matched children. All subjects were subjected to clinical evaluation and measurement of plasma cortisol (basal and stimulated) and ACTH. In addition, electroencephalography (EEG) and intelligence quotient (IQ) assessment were done for all autistic children.
Sixteen% of autistic patients had high ACTH, 10% had low basal cortisol and 10% did not show adequate cortisol response to ACTH stimulation. Autistic patients had lower basal (p = 0.032) and stimulated cortisol (p = 0.04) and higher ACTH (p = 0.01) than controls. Childhood Autism Rating Scale (CARS) score correlated positively with ACTH (r = 0.71, p = 0.02) and negatively with each of basal (r = -0.64, p = 0.04) and stimulated cortisol (r = -0.88, p < 0.001). Hormonal profile did not differ in relation to EEG abnormalities, IQ and self- aggressive symptoms.
The observed hormonal changes may be due to a dysfunction in the HPA axis in autistic individuals. Further studies are warranted regarding the role of HPA axis dysfunction in the pathogenesis of autism.
Full-text · Article · Oct 2010 · Italian Journal of Pediatrics
"man & Cutler , 1995 ) show reduced hippo - campal volume . Moreover , patients suffering from Cushing ' s disease suffer from explicit declarative memory deficits , as evidenced by landmark studies of Monica Starkman and co - workers ( e . g . , Starkman & Schteingart , 1981 ; Starkman , Giordani , Berent , Schork , & Schteingart , 2001 ; see also Mauri et al . , 1993 ) . It should be noted , however , that surgical treatment of Cushing ' s disease leads to a rapid normalization of cortisol levels . More importantly , memory im - pairments also disappear and hippocampal volume normalizes ( Starkman , Giordani , Gebarski , Berent , Schork , & Schteingart , 1999 ; Starkman , Giordani , Ge - barski , & "
"It has been suggested that abnormalities in hypothalamic–pituitary– adrenal (HPA) axis function may cause or exacerbate both neurocognitive impairment and depressive symptoms (McQuade and Young, 2000; Sapolsky, 2000). Indirect evidence for this link is found in conditions, such as Cushing's syndrome, which are characterized by a chronic elevation of endogenous cortisol levels and have consistently been shown to be associated with significant neurocognitive impairment (Forget et al, 2000; Mauri et al, 1993; Starkman et al, 2001; Whelan et al, 1980) and a high incidence of depression, which notably resolves with correction of the hypercortisolaemia (Dorn et al, 1997). "
[Show abstract][Hide abstract] ABSTRACT: High cortisol levels are found in severe mood disorders, particularly bipolar disorder. Hypercortisolaemia may cause or exacerbate both neurocognitive impairment and depressive symptoms. We hypothesized that antiglucocorticoid treatments, particularly corticosteroid receptor antagonists, would improve neurocognitive functioning and attenuate depressive symptoms in this disorder. To test this hypothesis, 20 bipolar patients were treated with 600 mg/day of the corticosteroid receptor antagonist mifepristone (RU-486) or placebo for 1 week in a double-blind crossover design. Over the total 6 weeks of the study, neurocognitive and neuroendocrine function were evaluated at baseline, days 21 and 42. Mood symptoms were evaluated weekly. Nineteen subjects completed the protocol; there were no drop-outs due to adverse events. Following treatment with mifepristone, selective improvement in neurocognitive functioning was observed. Spatial working memory performance was significantly improved compared to placebo (19.8% improvement over placebo). Measures of verbal fluency and spatial recognition memory were also improved after mifepristone. Beneficial effects on mood were found; Hamilton Depression Rating Scale scores were significantly reduced compared to baseline (mean reduction of 5.1 points) as were Montgomery-Asberg Depression Rating Scale scores (mean reduction of 6.05 points). No significant change occurred after placebo. These data require replication but provide preliminary evidence that glucocorticoid receptor antagonists may have useful cognitive-enhancing and possibly antidepressant properties in bipolar disorder.