PDF(Pubmed)
Abstract：
BACKGROUND: Chronic exposure to excessive endogenous cortisol leads to brain changes in Cushing\'s disease (CD). However, it remains unclear how CD affects large-scale functional networks (FNs) and whether these effects are reversible after treatment. This study aimed to investigate functional network changes of CD patients and their reversibility in a longitudinal cohort.
METHODS: Active CD patients (N = 37) were treated by transsphenoidal pituitary surgery and reexamined 3 months later. FNs were computed from resting-state fMRI data of the CD patients and matched normal controls (NCs, N = 37). A pattern classifier was built on the FNs to distinguish active CD patients from controls and applied to FNs of the CD patients at the 3-month follow-up. Two subgroups of endocrine-remitted CD patients were identified according to their classification scores, referred to as image-based phenotypically (IBP) recovered and unrecovered CD patients, respectively. The informative FNs identified by the classification model were compared between NCs, active CD patients, and endocrine-remitted patients as well as between IBP recovered and unrecovered CD patients to explore their functional network reversibility.
RESULTS: All 37 CD patients reached endocrine remission after treatment. The classification model identified three informative FNs, including cerebellar network (CerebN), fronto-parietal network (FPN), and default mode network. Among them, CerebN and FPN partially recovered toward normal at 3 months after treatment. Moreover, the informative FNs were correlated with 24-h urinary-free cortisol and emotion scales in CD patients.
CONCLUSIONS: These findings suggest that CD patients have aberrant FNs that are partially reversible toward normal after treatment.
METHODS: Active CD patients (N = 37) were treated by transsphenoidal pituitary surgery and reexamined 3 months later. FNs were computed from resting-state fMRI data of the CD patients and matched normal controls (NCs, N = 37). A pattern classifier was built on the FNs to distinguish active CD patients from controls and applied to FNs of the CD patients at the 3-month follow-up. Two subgroups of endocrine-remitted CD patients were identified according to their classification scores, referred to as image-based phenotypically (IBP) recovered and unrecovered CD patients, respectively. The informative FNs identified by the classification model were compared between NCs, active CD patients, and endocrine-remitted patients as well as between IBP recovered and unrecovered CD patients to explore their functional network reversibility.
RESULTS: All 37 CD patients reached endocrine remission after treatment. The classification model identified three informative FNs, including cerebellar network (CerebN), fronto-parietal network (FPN), and default mode network. Among them, CerebN and FPN partially recovered toward normal at 3 months after treatment. Moreover, the informative FNs were correlated with 24-h urinary-free cortisol and emotion scales in CD patients.
CONCLUSIONS: These findings suggest that CD patients have aberrant FNs that are partially reversible toward normal after treatment.
摘要：
背景：长期暴露于过量的内源性皮质醇会导致库欣病（CD）的大脑变化。然而,目前尚不清楚CD如何影响大规模功能网络,以及这些影响在治疗后是否可逆.本研究旨在研究纵向队列中CD患者的功能网络变化及其可逆性。
方法：活动性CD患者（N=37）行经蝶窦垂体手术治疗，3个月后复查。从CD患者和匹配的正常对照的静息状态fMRI数据计算功能网络(FNs,N=37）。在FN上构建模式分类器以区分活性CD患者与对照,并在3个月随访时应用于CD患者的FN。根据其分类评分确定内分泌缓解CD患者的两个亚组，称为基于图像的表型恢复和未恢复的CD患者，分别。通过分类模型识别的信息性FN在NCs之间进行了比较，活跃的CD患者，和内分泌缓解患者以及基于图像的表型恢复和未恢复的CD患者之间，以探索其功能网络可逆性。
结果：治疗后37例CD患者均达到内分泌缓解。分类模型确定了三个信息丰富的FN，包括小脑网络(CerebN)，额顶叶网络(FPN)，和默认模式网络(DMN)。其中,CerebN和FPN在治疗后三个月部分恢复正常。此外，CD患者的信息性FN与24hUFC和情绪量表相关。
结论：这些研究结果表明，CD患者具有异常的功能网络，在治疗后可部分逆转至正常。
方法：活动性CD患者（N=37）行经蝶窦垂体手术治疗，3个月后复查。从CD患者和匹配的正常对照的静息状态fMRI数据计算功能网络(FNs,N=37）。在FN上构建模式分类器以区分活性CD患者与对照,并在3个月随访时应用于CD患者的FN。根据其分类评分确定内分泌缓解CD患者的两个亚组，称为基于图像的表型恢复和未恢复的CD患者，分别。通过分类模型识别的信息性FN在NCs之间进行了比较，活跃的CD患者，和内分泌缓解患者以及基于图像的表型恢复和未恢复的CD患者之间，以探索其功能网络可逆性。
结果：治疗后37例CD患者均达到内分泌缓解。分类模型确定了三个信息丰富的FN，包括小脑网络(CerebN)，额顶叶网络(FPN)，和默认模式网络(DMN)。其中,CerebN和FPN在治疗后三个月部分恢复正常。此外，CD患者的信息性FN与24hUFC和情绪量表相关。
结论：这些研究结果表明，CD患者具有异常的功能网络，在治疗后可部分逆转至正常。
