Imaging cerebral microbleeds in Cushing's disease evaluated by quantitative susceptibility mapping: An observational cross-sectional study

Abstract

Design: Cushing's disease (CD) is a rare clinical syndrome characteriz ed by chronic exposure to hypercortisolism due to an adrenocorticotropic hormone-secreting pituitary adenoma. The adverse effects of chronic exposure to hypercortisolism on the human brain remain unclear. The purpose of this study was to assess the prevalence of cerebral microbleeds (CMBs) in CD patients and their associatio ns with clinical characteristics. Methods: In this study, 48 active CD patients, 39 remitted CD patients, and 52 healthy control (HC) subjects underwent MRI. CD patients also underwent neuropsychological testing and clinical examinations. The number, locations, and volumes of CMBs were assessed on quantitative susceptibility ma pping (QSM) images and with the Microbleed Anatomical Rating Scale. The correlation between CMBs and clini cal characteristics was explored. Results: The prevalence of CMBs among active and remitted CD patients w as higher than that among HCs (16.3%, 20.5%, and 3.3%, respectively). Moreover, the age of CD patient s with CMBs were much younger than HCs with CMBs. Furthermore, the increased number of CMBs in active CD patients was associated with increased cerebrospinal fluid (CSF) volumes in remitted CD patients. Conclusions: Chronic exposure to hypercortisolism may be relevant to CMBs a nd significantly correlated with altered brain volumes in CD.