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ORIGINAL RESEARCH article

Front. Endocrinol.
Sec. Adrenal Endocrinology
Volume 15 - 2024 | doi: 10.3389/fendo.2024.1373101
This article is part of the Research Topic Comorbidities and Sexual Dimorphism in Patients with Adrenal Incidentaloma View all articles

Comparable cognitive impairment was detected in MACS and CS and alleviated after remission of hypercortisolism in MACS

Provisionally accepted
Mengsi Liu Mengsi Liu 1,2Zhaoyang Tian Zhaoyang Tian 1Wenji Zhao Wenji Zhao 1Zhou Zhang Zhou Zhang 1Yuan Lou Yuan Lou 1Ziwei Zhang Ziwei Zhang 1Fan Yang Fan Yang 1Dalong Zhu Dalong Zhu 1,2Ping Li Ping Li 1*
  • 1 Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
  • 2 Department of Endocrinology, Nanjing Drum Tower Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Graduate School of Peking Union Medical College, Nanjing, China, Nanjing, China

The final, formatted version of the article will be published soon.

    Context: Few studies have directly compared the cognitive characteristics of patients with mild autonomous cortisol secretion (MACS) and Cushing's syndrome (CS). The effect of surgical or conservative treatment on cognitive function in patients with MACS is still unclear.Objective: To compare the differences in cognitive function between patients with MACS and CS and evaluate the effect of surgery or conservative treatment on cognitive function.We prospectively recruited 59 patients with nonfunctional adrenal adenoma (NFA), 36 patients with MACS, and 20 patients with adrenal CS who completed the global cognition and cognitive subdomains assessments. Seventeen MACS patients were re-evaluated for cognitive function after a 12-month follow-up period; of these, eleven underwent laparoscopic adrenalectomy and six received conservative treatment.Results: Patients with MACS and CS performed worse in the global cognition and multiple cognitive domains than those with NFA (all P<0.05). No statistical difference was found in cognitive functions between patients with MACS and CS. Logistic regression analysis showed that patients with MACS (odds ratio [OR]=3.738, 95% confidence intervals [CI]: 1.329-10.515, P=0.012) and CS (OR=6.026, 95% CI: 1.411-25.730, P=0.015) were associated with an increased risk of immediate memory impairment. Visuospatial/constructional, immediate and delayed memory scores of MACS patients were significantly improved at 12 months compared with pre-operation in the surgical treatment group (all P<0.05), whereas there was no improvement in the conservative treatment group.: Patients with MACS have comparable cognitive impairment as patients with CS. Cognitive function was partially improved in patients with MACS after adrenalectomy. The current data support the inclusion of cognitive function assessment in the clinical management of patients with MACS.

    Keywords: Adrenal incidentalomas, Mild autonomous cortisol secretion, Cushing's syndrome, cognitive impairment, Adrenalectomy

    Received: 19 Jan 2024; Accepted: 15 Jul 2024.

    Copyright: © 2024 Liu, Tian, Zhao, Zhang, Lou, Zhang, Yang, Zhu and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Ping Li, Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China

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