{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T06:00:15Z","timestamp":1790402415091,"version":"4.1.0"},"reference-count":53,"publisher":"Oxford University Press (OUP)","issue":"6","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Patients with long-term remission of Cushing's disease (CD) have persistent psychological and cognitive impairments. It is unknown whether, and to what extent, these impairments are accompanied by structural abnormalities in the brain. We aim to investigate structural changes in the brain in patients with predominantly long-term remission of CD and to examine whether these changes are associated with psychological and cognitive dysfunction and clinical severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A cross-sectional, case\u2013control study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In 25 patients with predominantly long-term remission of CD and 25 matched healthy controls, grey matter volumes in the regions of interest (hippocampus, amygdala, and anterior cingulate cortex (ACC)) and in the whole brain were examined, using 3T magnetic resonance imaging and a voxel-based morphometry approach. Psychological and cognitive functioning were assessed using validated questionnaires and clinical severity was assessed using the Cushing's syndrome severity index.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with controls, patients had smaller grey matter volumes of areas in the ACC (on average 14%, <jats:italic>P<\/jats:italic>&lt;0.05) and greater volume of the left posterior lobe of the cerebellum (on average 34%, <jats:italic>P<\/jats:italic>&lt;0.05). As expected, patients with remitted CD reported more depressive symptoms (<jats:italic>P<\/jats:italic>=0.005), more anxiety (<jats:italic>P<\/jats:italic>=0.003), more social phobia (<jats:italic>P<\/jats:italic>=0.034), more apathy (<jats:italic>P<\/jats:italic>=0.002), and more cognitive failure (<jats:italic>P<\/jats:italic>=0.023) compared with controls, but the differences in grey matter volumes were not associated with psychological or cognitive measures, nor with clinical severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with predominantly long-term remission of CD showed specific structural brain abnormalities, in the presence of psychological dysfunction. Our data form a basis for future work aimed at elucidating the relation of the structural brain abnormalities and the sustained psychological deficits after long-term exposure to high cortisol levels.<\/jats:p><\/jats:sec>","DOI":"10.1530\/eje-13-0471","type":"journal-article","created":{"date-parts":[[2013,9,13]],"date-time":"2013-09-13T05:57:55Z","timestamp":1379051875000},"page":"811-819","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":85,"title":["Smaller grey matter volumes in the anterior cingulate cortex and greater cerebellar volumes in patients with long-term remission of Cushing's disease: a case\u2013control study"],"prefix":"10.1093","volume":"169","author":[{"given":"Cornelie D","family":"Andela","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven J A","family":"van der Werff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J Nienke","family":"Pannekoek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan M","family":"van den Berg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Onno C","family":"Meijer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A","family":"van Buchem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serge A R B","family":"Rombouts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roos C","family":"van der Mast","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes A","family":"Romijn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jitske","family":"Tiemensma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nienke R","family":"Biermasz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nic J A","family":"van der Wee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto M","family":"Pereira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","reference":[{"issue":"9522","key":"1_22134149","doi-asserted-by":"publisher","first-page":"1605","DOI":"10.1016\/S0140-6736(06)68699-6","volume":"367","author":"Newell-Price","year":"2006","journal-title":"Lancet","ISSN":"https:\/\/id.crossref.org\/issn\/0140-6736","issn-type":"print"},{"issue":"3","key":"2_16713338","doi-asserted-by":"publisher","first-page":"912","DOI":"10.1210\/jc.82.3.912","volume":"82","author":"Dorn","year":"1997","journal-title":"Journal of Clinical Endocrinology &amp; Metabolism","ISSN":"https:\/\/id.crossref.org\/issn\/0021-972X","issn-type":"print"},{"issue":"3","key":"3_14023058","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/0165-1781(86)90096-X","volume":"19","author":"Starkman","year":"1986","journal-title":"Psychiatry research","ISSN":"https:\/\/id.crossref.org\/issn\/0165-1781","issn-type":"print"},{"key":"4_44146376","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1159\/000314317","volume":"92","year":"2010","journal-title":"Neuroendocrinology","ISSN":"https:\/\/id.crossref.org\/issn\/0028-3835","issn-type":"print"},{"issue":"3","key":"5_42896538","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1530\/EJE-11-1095","volume":"167","year":"2012","journal-title":"European Journal of Endocrinology","ISSN":"https:\/\/id.crossref.org\/issn\/0804-4643","issn-type":"print"},{"issue":"6","key":"6_18894635","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1038\/nrn1683","volume":"6","author":"de Kloet","year":"2005","journal-title":"Nature reviews. Neuroscience","ISSN":"https:\/\/id.crossref.org\/issn\/1471-003X","issn-type":"print"},{"key":"7_45404607","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.neuropharm.2011.07.014","volume":"62","year":"2012","journal-title":"Neuropharmacology","ISSN":"https:\/\/id.crossref.org\/issn\/0028-3908","issn-type":"print"},{"issue":"5","key":"8_21478638","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1016\/j.jpsychires.2005.01.003","volume":"39","author":"Cerqueira","year":"2005","journal-title":"Journal of psychiatric research","ISSN":"https:\/\/id.crossref.org\/issn\/0022-3956","issn-type":"print"},{"issue":"1","key":"9_6325060","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1038\/271","volume":"1","author":"Lupien","year":"1998","journal-title":"Nature neuroscience","ISSN":"https:\/\/id.crossref.org\/issn\/1097-6256","issn-type":"print"},{"issue":"4","key":"10_21588634","doi-asserted-by":"publisher","first-page":"1591","DOI":"10.1210\/jc.2005-2610","volume":"91","year":"2006","journal-title":"Journal of Clinical Endocrinology &amp; Metabolism","ISSN":"https:\/\/id.crossref.org\/issn\/0021-972X","issn-type":"print"},{"issue":"5","key":"11_17038690","doi-asserted-by":"publisher","first-page":"1949","DOI":"10.1210\/jc.87.5.1949","volume":"87","author":"Bourdeau","year":"2002","journal-title":"Journal of Clinical Endocrinology &amp; Metabolism","ISSN":"https:\/\/id.crossref.org\/issn\/0021-972X","issn-type":"print"},{"issue":"9","key":"12_10055762","doi-asserted-by":"publisher","first-page":"756","DOI":"10.1016\/0006-3223(92)90079-F","volume":"32","author":"Starkman","year":"1992","journal-title":"Biological psychiatry","ISSN":"https:\/\/id.crossref.org\/issn\/0006-3223","issn-type":"print"},{"issue":"1","key":"13_6489866","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1016\/S0090-3019(99)00197-4","volume":"53","author":"Simmons","year":"2000","journal-title":"Surgical neurology","ISSN":"https:\/\/id.crossref.org\/issn\/0090-3019","issn-type":"print"},{"issue":"1","key":"14_38587676","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.eurpsy.2010.09.003","volume":"26","author":"Toffanin","year":"2011","journal-title":"European psychiatry : the journal of the Association of European Psychiatrists","ISSN":"https:\/\/id.crossref.org\/issn\/0924-9338","issn-type":"print"},{"issue":"12","key":"15_6424140","doi-asserted-by":"publisher","first-page":"1595","DOI":"10.1016\/S0006-3223(99)00203-6","volume":"46","author":"Starkman","year":"1999","journal-title":"Biological psychiatry","ISSN":"https:\/\/id.crossref.org\/issn\/0006-3223","issn-type":"print"},{"issue":"1","key":"16_23128639","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1017\/S1355617707070051","volume":"13","author":"Hook","year":"2007","journal-title":"Journal of the International Neuropsychological Society : JINS","ISSN":"https:\/\/id.crossref.org\/issn\/1355-6177","issn-type":"print"},{"issue":"3","key":"17_17485269","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1016\/S0006-3223(02)01750-X","volume":"53","author":"Starkman","year":"2003","journal-title":"Biological psychiatry","ISSN":"https:\/\/id.crossref.org\/issn\/0006-3223","issn-type":"print"},{"issue":"1-3","key":"18_28859846","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1016\/j.jad.2006.11.007","volume":"101","author":"Starkman","year":"2007","journal-title":"Journal of affective disorders","ISSN":"https:\/\/id.crossref.org\/issn\/0165-0327","issn-type":"print"},{"issue":"2","key":"19_41375884","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1210\/jc.2011-2231","volume":"97","year":"2012","journal-title":"Journal of Clinical Endocrinology &amp; Metabolism","ISSN":"https:\/\/id.crossref.org\/issn\/0021-972X","issn-type":"print"},{"issue":"6","key":"20_18882166","doi-asserted-by":"publisher","first-page":"3279","DOI":"10.1210\/jc.2004-1375","volume":"90","year":"2005","journal-title":"Journal of Clinical Endocrinology &amp; Metabolism","ISSN":"https:\/\/id.crossref.org\/issn\/0021-972X","issn-type":"print"},{"issue":"4","key":"21_40427144","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1530\/EJE-11-0307","volume":"165","year":"2011","journal-title":"European Journal of Endocrinology","ISSN":"https:\/\/id.crossref.org\/issn\/0804-4643","issn-type":"print"},{"issue":"10","key":"22_37669662","doi-asserted-by":"publisher","first-page":"E129","DOI":"10.1210\/jc.2010-0512","volume":"95","year":"2010","journal-title":"Journal of Clinical Endocrinology &amp; Metabolism","ISSN":"https:\/\/id.crossref.org\/issn\/0021-972X","issn-type":"print"},{"issue":"6","key":"23_37036965","doi-asserted-by":"publisher","first-page":"2699","DOI":"10.1210\/jc.2009-2032","volume":"95","year":"2010","journal-title":"Journal of Clinical Endocrinology &amp; Metabolism","ISSN":"https:\/\/id.crossref.org\/issn\/0021-972X","issn-type":"print"},{"issue":"4","key":"24_7858334","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1192\/bjp.134.4.382","volume":"134","author":"Montgomery","year":"1979","journal-title":"The British Journal of Psychiatry","ISSN":"https:\/\/id.crossref.org\/issn\/0007-1250","issn-type":"print"},{"issue":"5","key":"25_13981149","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1192\/bjp.148.5.599","volume":"148","author":"Snaith","year":"1986","journal-title":"The British Journal of Psychiatry","ISSN":"https:\/\/id.crossref.org\/issn\/0007-1250","issn-type":"print"},{"issue":"3","key":"26_16312249","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1017\/S0033291700035558","volume":"26","author":"Rush","year":"1996","journal-title":"Psychological medicine","ISSN":"https:\/\/id.crossref.org\/issn\/0033-2917","issn-type":"print"},{"issue":"6","key":"27_5093702","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1037\/0022-006X.56.6.893","volume":"56","author":"Beck","year":"1988","journal-title":"Journal of consulting and clinical psychology","ISSN":"https:\/\/id.crossref.org\/issn\/0022-006X","issn-type":"print"},{"issue":"3","key":"28_8029750","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1016\/0005-7967(79)90041-X","volume":"17","author":"Marks","year":"1979","journal-title":"Behaviour research and therapy","ISSN":"https:\/\/id.crossref.org\/issn\/0005-7967","issn-type":"print"},{"issue":"6","key":"29_11174757","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1176\/appi.ajp.158.6.872","volume":"158","author":"Starkstein","year":"2001","journal-title":"American Journal of Psychiatry","ISSN":"https:\/\/id.crossref.org\/issn\/0002-953X","issn-type":"print"},{"issue":"3","key":"30_19427670","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1176\/appi.neuropsych.17.3.378","volume":"17","author":"Chatterjee","year":"2005","journal-title":"Journal of Neuropsychiatry and Clinical Neurosciences","ISSN":"https:\/\/id.crossref.org\/issn\/0895-0172","issn-type":"print"},{"key":"31_28689264","first-page":"1","volume":"21","year":"1982","journal-title":"The British journal of clinical psychology \/ the British Psychological Society","ISSN":"https:\/\/id.crossref.org\/issn\/0144-6657","issn-type":"print"},{"issue":"4","key":"32_10367812","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1159\/000012396","volume":"69","author":"Sonino","year":"2000","journal-title":"Psychotherapy and psychosomatics","ISSN":"https:\/\/id.crossref.org\/issn\/0033-3190","issn-type":"print"},{"key":"33_28274280","doi-asserted-by":"crossref","first-page":"S208","DOI":"10.1016\/j.neuroimage.2004.07.051","volume":"23","year":"2004","journal-title":"NeuroImage","ISSN":"https:\/\/id.crossref.org\/issn\/1053-8119","issn-type":"print"},{"issue":"1","key":"34_11102100","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1109\/42.906424","volume":"20","author":"Zhang","year":"2001","journal-title":"IEEE transactions on medical imaging","ISSN":"https:\/\/id.crossref.org\/issn\/0278-0062","issn-type":"print"},{"issue":"2","key":"35_17281502","doi-asserted-by":"publisher","first-page":"825","DOI":"10.1016\/S1053-8119(02)91132-8","volume":"17","author":"Jenkinson","year":"2002","journal-title":"NeuroImage","ISSN":"https:\/\/id.crossref.org\/issn\/1053-8119","issn-type":"print"},{"key":"36_41615181","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.neuroimage.2008.03.061","volume":"44","year":"2009","journal-title":"NeuroImage","ISSN":"https:\/\/id.crossref.org\/issn\/1053-8119","issn-type":"print"},{"issue":"1","key":"37_35331903","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1038\/npp.2009.83","volume":"35","author":"Shin","year":"2010","journal-title":"Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology","ISSN":"https:\/\/id.crossref.org\/issn\/0893-133X","issn-type":"print"},{"issue":"4","key":"38_29839546","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1016\/j.nic.2007.07.003","volume":"17","author":"Bremner","year":"2007","journal-title":"Neuroimaging clinics of North America","ISSN":"https:\/\/id.crossref.org\/issn\/1052-5149","issn-type":"print"},{"issue":"7","key":"39_21774955","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1016\/j.biopsych.2005.07.033","volume":"59","author":"Woodward","year":"2006","journal-title":"Biological psychiatry","ISSN":"https:\/\/id.crossref.org\/issn\/0006-3223","issn-type":"print"},{"issue":"10","key":"40_38166830","doi-asserted-by":"publisher","first-page":"1002","DOI":"10.1001\/archgenpsychiatry.2010.121","volume":"67","author":"van Tol","year":"2010","journal-title":"Archives of General Psychiatry","ISSN":"https:\/\/id.crossref.org\/issn\/0003-990X","issn-type":"print"},{"issue":"6","key":"41_18971110","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1016\/S1364-6613(00)01483-2","volume":"4","author":"Bush","year":"2000","journal-title":"Trends in cognitive sciences","ISSN":"https:\/\/id.crossref.org\/issn\/1364-6613","issn-type":"print"},{"issue":"7410","key":"42_42906927","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1038\/nature11239","volume":"488","author":"Sheth","year":"2012","journal-title":"Nature; Physical Science (London)","ISSN":"https:\/\/id.crossref.org\/issn\/1476-4687","issn-type":"print"},{"issue":"2","key":"43_8290916","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1001\/archinte.1981.00340020077021","volume":"141","author":"Starkman","year":"1981","journal-title":"Archives of Internal Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/0003-9926","issn-type":"print"},{"issue":"1-2","key":"44_17615482","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/S0149-7634(03)00007-1","volume":"27","author":"Teicher","year":"2003","journal-title":"Neuroscience and biobehavioral reviews","ISSN":"https:\/\/id.crossref.org\/issn\/0149-7634","issn-type":"print"},{"key":"45_45737149","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1016\/j.neuroimage.2012.03.044","volume":"61","year":"2012","journal-title":"NeuroImage","ISSN":"https:\/\/id.crossref.org\/issn\/1053-8119","issn-type":"print"},{"issue":"6","key":"46_34889330","doi-asserted-by":"publisher","first-page":"658","DOI":"10.1001\/archgenpsychiatry.2009.52","volume":"66","author":"Spinelli","year":"2009","journal-title":"Archives of General Psychiatry","ISSN":"https:\/\/id.crossref.org\/issn\/0003-990X","issn-type":"print"},{"issue":"5940","key":"47_35349788","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1126\/science.1171203","volume":"325","author":"Dias-Ferreira","year":"2009","journal-title":"Science","ISSN":"https:\/\/id.crossref.org\/issn\/0036-8075","issn-type":"print"},{"issue":"11","key":"48_31609612","doi-asserted-by":"publisher","first-page":"902","DOI":"10.1016\/j.jpsychires.2007.10.003","volume":"42","author":"Schubert","year":"2008","journal-title":"Journal of psychiatric research","ISSN":"https:\/\/id.crossref.org\/issn\/0022-3956","issn-type":"print"},{"issue":"5","key":"49_18842398","doi-asserted-by":"publisher","first-page":"2531","DOI":"10.1210\/jc.2004-2488","volume":"90","year":"2005","journal-title":"Journal of Clinical Endocrinology &amp; Metabolism","ISSN":"https:\/\/id.crossref.org\/issn\/0021-972X","issn-type":"print"},{"issue":"7416","key":"51_43717150","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1038\/nature11405","volume":"489","author":"Hawrylycz","year":"2012","journal-title":"Nature; Physical Science (London)","ISSN":"https:\/\/id.crossref.org\/issn\/1476-4687","issn-type":"print"},{"key":"52_22187439","doi-asserted-by":"publisher","first-page":"2746","DOI":"10.2741\/2004","volume":"11","author":"Fuchs","year":"2006","journal-title":"Frontiers in bioscience : a journal and virtual library","ISSN":"https:\/\/id.crossref.org\/issn\/1093-9946","issn-type":"print"},{"issue":"4","key":"53_31309531","doi-asserted-by":"publisher","first-page":"1324","DOI":"10.1016\/j.neuroimage.2008.02.050","volume":"41","author":"Pell","year":"2008","journal-title":"NeuroImage","ISSN":"https:\/\/id.crossref.org\/issn\/1053-8119","issn-type":"print"},{"issue":"5","key":"54_5911067","doi-asserted-by":"crossref","first-page":"239","DOI":"10.3109\/10673229809000307","volume":"5","author":"Brown","year":"1998","journal-title":"Harvard review of psychiatry","ISSN":"https:\/\/id.crossref.org\/issn\/1067-3229","issn-type":"print"}],"container-title":["European Journal of Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/eje.bioscientifica.com\/view\/journals\/eje\/169\/6\/811.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/eje.bioscientifica.com\/view\/journals\/eje\/169\/6\/811.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T16:29:48Z","timestamp":1676392188000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejendo\/article\/169\/6\/811\/6661676"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,12]]},"references-count":53,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.1530\/eje-13-0471","relation":{},"ISSN":["0804-4643","1479-683X"],"issn-type":[{"value":"0804-4643","type":"print"},{"value":"1479-683X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,12]]}}}