Neuropsychological Deficits in Cushing??s Syndrome

Abstract

In contrast to well documented reports of medical symptoms in Cushing''s syndrome (an endocrine disorder with the hallmark of corticoid overproduction), vague and infrequent references to associated mental changes reflect the subjective nature of previous clinical studies of psychological symptoms. This report presents neuropsychological test findings of 35 Cushing''s syndrome patients before initiation of medical therapy, and documents the frequency, nature and severity of deficits. Performances on the Michigan Neuropsychological Test Battery revealed equivocal or no signs of neuropsychological deficits in 13 patients. Ten other patients had few and mild deficits, 8 had moderate and more frequent signs of impairment, and 4 had frequent and marked deficits in language and nonlanguage tests of higher (cognitive) and/or lower (sensory and/or motor) level cerebral functions. Varying degrees of diffuse bilateral cerebral dysfunction were indicated in two-thirds of this population. Impairment was more frequent and severe in nonverbal visual-ideational and visual memory functions. This pattern of deficits is similar to that in patients with other types of diffuse bilateral neuropathological processes such as toxicity, anoxia and infectious cerebral disorders.