GLUCOCORTICOID EFFECTS IN CUSHINGS-SYNDROME APPROXIMATE COGNITIVE AGING

It is known that overproduction of steroid hormones, as is the case wi th Gushing's syndrome (CS), is associated with marked deficits in cogn itive function (Cohen et al., Journal of the International Neuropsycho logy Society, 2, 65). There are also recent reports that excess of glu cocorticoids may be implicated in both physical and cognitive degenera tion associated with aging (e.g., Lupien et al., Journal of Neuroscien ce, 14, 2893). In this study, we examined whether patterns of cognitiv e performance in CS are similar to those of all the subjects. Ten pati ents with CS were yoked to age- and education-matched control subjects and older subjects (age of CS patient +15 yr). All subjects were admi nistered tests of visuospatial processing (Block Design, Raven's stand ard matrices, Digit Symbol Substitution) and of explicit verbal memory and category fluency tasks. ANOVAs revealed differences between the a ge-matched control group and the other two groups in all three tests o f visuospatial processing only. No difference was observed between CS and older control subjects on any of the tests. The observed pattern o f deficits suggests that there are similarities in performance in CS a nd older age and that treatment of so-called visual information may be explicitly affected in both CS and older subjects. Moreover, to the e xtent that we can attribute differences and similarities in cognitive performance to differential effect of cortisol secretion, the study il lustrates the domains in cognition that may be primarily susceptible t o hormonal dysregulation.