Clinical Report: Persistent Steroid Modifications in Cushing’s Disease Post-Remission
Overview
This study investigates neurosteroid profiles in patients with Cushing's disease (CD) and their association with psychological symptoms. It finds persistent alterations in neurosteroids even after biochemical remission.
Background
Cushing's disease is linked to high rates of psychiatric disorders, with significant prevalence of depression and anxiety that can persist post-remission. Neurosteroids play a role in mood regulation.
Data Highlights
Measure
CD (Active)
CD (Remission)
NFA
Depression Score (DASS-21)
14
Not reported
7.5
Stress Score (DASS-21)
17
Not reported
8.5
7-OH-pregnenolone (ng/mL)
121
Not reported
22.5
Key Findings
Patients with CD had higher depression and stress scores compared to NFA controls.
Five neurosteroids were identified as discriminatory, with four elevated in CD and one decreased.
7-OH-pregnenolone levels increased further in remission despite biochemical normalization.
Neurosteroid alterations did not correlate with cortisol or ACTH levels.
DHEA positively correlated with depression and stress, while allopregnanolone correlated negatively.
Clinical Implications
The findings indicate that mood disorders in CD may not be adequately addressed by simply reducing cortisol levels.
Conclusion
Cushing's disease is associated with lasting neurosteroid alterations that persist beyond biochemical remission.
