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Hippocampal volume, cognitive functions, depression, anxiety, and quality of life in patients with Cushing's syndrome

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CONTEXT: Cushing's syndrome (CS) is associated with hippocampal atrophy and psychopathology. Objective: The primary objective of this systematic review was to assess hippocampal volume in CS patients. The secondary objectives were to assess cognitive functioning, depressive-, and anxiety symptoms, and quality of life (QoL) in CS patients.

DATA SOURCES: PubMed, Embase, Cochrane, LILACs, and Scopus were searched for relevant studies until 1st of May 2019.

STUDY SELECTION: The current study includes either case-control studies comparing CS patients with healthy controls, or studies assessing CS patients before and after surgery. The initial search resulted in 18 studies fulfilling the inclusion criteria.

DATA EXTRACTION: Data extraction regarding all outcomes was performed independently by two reviewers. Quality assessment was assessed by using the Newcastle-Ottawa Scale for case-control studies.

DATA SYNTHESIS: Meta-analysis were performed using a random effect model. The right hippocampal volume in CS was reduced by 0·68 SMD (95% CI; -1·12 to -0·24; p=0·002; I2=0%) compared to healthy controls, but with no increase in hippocampal volume after surgery. CS patients presented with more depressive symptoms, impaired cognitive functions, and reduced health related QoL (HRQoL), which all responded favourably to surgery. The data did not support the presence of anxiety in CS patients.

CONCLUSIONS: The current study does not suggest an overall reduction of hippocampal volume in CS patients. However, most cognitive domains were significantly affected and responded favorably to surgery. Depressive symptoms as well as reduced HRQoL were present in CS patients and improved after surgery.

Original languageEnglish
JournalThe Journal of clinical endocrinology and metabolism
ISSN0021-972X
DOIs
Publication statusPublished - 1 Oct 2019

ID: 57539940