%0 Journal Article
%T Reversibility of Impaired Large-Scale Functional Brain Networks in Cushing's Disease after Surgery Treatment: A Longitudinal Study.
%A Cheng H
%A Gao L
%A Jing R
%A Hou B
%A Guo X
%A Yao Y
%A Feng M
%A Xing B
%A Feng F
%A Fan Y
%J Neuroendocrinology
%V 114
%N 3
%D 2024 Nov 1
%M 37913760
%F 5.135
%R 10.1159/000534789
%X <B>BACKGROUND: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>These findings suggest that CD patients have aberrant FNs that are partially reversible toward normal after treatment.