Brain metabolic alterations in Cushing's syndrome as monitored by proton magnetic resonance spectroscopy

Proton magnetic resonance spectroscopy (H-1 MRS) was used to evaluate chang es in cerebral metabolites in 13 patients with Gushing's syndrome (includin g seven with pituitary corticotroph adenomas and six with primary adrenal d isease) as compared to 40 normal subjects. Data were recorded in the fronta l, thalamic and temporal areas; quantification of the MRS signals demonstra ted a statistically significant decrease of the Cho/Cr ratio in the frontal and thalamic areas but not in the temporal area for patients with Gushing' s syndrome. The largest decrease in Cho/Cr was measured in the thalamic are a of patients with a Cushing's syndrome secondary to an adrenal disease. No statistically significant changes in the NAA/Cr ratio were measured in any of the areas studied. These results suggest that the quantification of cho line levels could be helpful for monitoring the cerebral metabolite alterat ions in patients with hypercortisolism. Copyright (C) 1999 John Wiley & Son s, Ltd.