{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:02:25Z","timestamp":1787025745564,"version":"build-2736575974"},"reference-count":76,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2015,11]]},"abstract":"\n OBJECT<\/jats:title>\n Cushing\u2019s disease (CD) may cause atrophy of different regions of the human brain, mostly affecting the hippocampus and the cerebellum. This study evaluates the use of 3-T MRI of newly diagnosed patients with CD to detect atrophic degeneration with voxel-based volumetry.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n Subjects with newly diagnosed, untreated CD were included and underwent 3-T MRI. Images were analyzed using a voxelwise statistical test to detect reduction of brain parenchyma. In addition, an atlas-based volumetric study for regions likely to be affected by CD was performed.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Nineteen patients with a mean disease duration of 24 months were included. Tumor markers included adre-nocorticotropic hormone (median 17.5 pmol\/L), cortisol (949.4 nmol\/L), and dehydroepiandrosterone sulfate (5.4 \u03bcmol\/L). The following values are expressed as the mean \u00b1 SD. The voxelwise statistical test revealed clusters of significantly reduced gray matter in the hippocampus and cerebellum, with volumes of 2.90 \u00b1 0.26 ml (right hippocampus), 2.89 \u00b1 0.28 ml (left hippocampus), 41.95 \u00b1 4.67 ml (right cerebellar hemisphere), and 42.11 \u00b1 4.59 ml (left cerebellar hemisphere). Healthy control volunteers showed volumes of 3.22 \u00b1 0.25 ml for the right hippocampus, 3.23 \u00b1 0.25 ml for the left hippocampus, 50.87 \u00b1 4.23 ml for the right cerebellar hemisphere, and 50.42 \u00b1 3.97 ml for the left cerebellar hemisphere.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Patients with untreated CD show significant reduction of gray matter in the cerebellum and hippocampus. These changes can be analyzed and objectified with the quantitative voxel-based method described in this study.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2015.8.focus15324","type":"journal-article","created":{"date-parts":[[2015,11,1]],"date-time":"2015-11-01T02:36:31Z","timestamp":1446345391000},"page":"E5","source":"Crossref","is-referenced-by-count":35,"title":["Hippocampal and cerebellar atrophy in patients with Cushing\u2019s disease"],"prefix":"10.3171","volume":"39","author":[{"given":"Till","family":"Burkhardt","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"L\u00fcdecke","sequence":"additional","affiliation":[{"name":"Psychiatry, University Medical Center Hamburg-Eppendorf; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lothar","family":"Spies","sequence":"additional","affiliation":[{"name":"jung diagnostics GmbH, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linus","family":"Wittmann","sequence":"additional","affiliation":[{"name":"Psychiatry, University Medical Center Hamburg-Eppendorf; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manfred","family":"Westphal","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Flitsch","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus15324","series-title":"Pituitary","first-page":"333","article-title":"Evaluation of depression, quality of life and body image in patients with Cushing\u2019s disease","volume":"16","author":"Alcalar","year":"2013"},{"key":"b2-focus15324","series-title":"Anat Embryol (Berl)","first-page":"343","article-title":"Cytoarchitectonic mapping of 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endogenous Cushing\u2019s syndrome and its reversibility after correction of hypercortisolism","volume":"87","author":"Bourdeau","year":"2002"},{"key":"b7-focus15324","series-title":"Expert Rev Neurother","first-page":"393","article-title":"Functional neuroimaging in post-traumatic stress disorder","volume":"7","author":"Bremner","year":"2007"},{"issue":"2","key":"b8-focus15324","series-title":"Neurosurg Focus","first-page":"E6","article-title":"Cavernous sinus sampling in patients with Cushing\u2019s disease","volume":"38","author":"Burkhardt","year":"2015"},{"key":"b9-focus15324","series-title":"Acta Neurochir (Wien)","first-page":"479","article-title":"DHEA(S)\u2014a novel marker in Cushing\u2019s disease","volume":"155","author":"Burkhardt","year":"2013"},{"key":"b10-focus15324","series-title":"J Psychiatr Res","first-page":"451","article-title":"Corticosteroid status influences the volume of the rat cingulate cortex\u2014a magnetic resonance imaging 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SPM toolbox for combining probabilistic cytoarchitectonic maps and functional imaging data","volume":"25","author":"Eickhoff","year":"2005"},{"key":"b15-focus15324","series-title":"Neuroimage","first-page":"313","article-title":"Unbiased average age-appropriate atlases for pediatric studies","volume":"54","author":"Fonov","year":"2011"},{"key":"b16-focus15324","series-title":"Nature","first-page":"391","article-title":"An anatomically comprehensive atlas of the adult human brain transcriptome","volume":"489","author":"Hawrylycz","year":"2012"},{"key":"b17-focus15324","series-title":"AJNR Am J Neuroradiol","first-page":"711","article-title":"Pitfalls in the use of voxel-based morphometry as a biomarker: examples from Huntington disease","volume":"31","author":"Henley","year":"2010"},{"key":"b18-focus15324","series-title":"Neuroimage","first-page":"2216","article-title":"Intra- and interscanner variability of automated voxel-based volumetry based on a 3D probabilistic atlas of human cerebral structures","volume":"49","author":"Huppertz","year":"2010"},{"key":"b19-focus15324","series-title":"Front Neuroendocrinol","first-page":"72","article-title":"Chronic stress: implications for neuronal morphology, function and neuro-genesis","volume":"28","author":"Jo\u00ebls","year":"2007"},{"key":"b20-focus15324","series-title":"Clin Endocrinol (Oxf)","first-page":"715","article-title":"A prospective study of psychiatric and psychological aspects of Cushing\u2019s syndrome","volume":"45","author":"Kelly","year":"1996"},{"key":"b21-focus15324","series-title":"Neuroimage","first-page":"900","article-title":"Age- and sex-related effects on the neuro-anatomy of healthy elderly","volume":"26","author":"Lema\u00eetre","year":"2005"},{"key":"b22-focus15324","series-title":"Pharmacopsychiatry","first-page":"192","article-title":"Psychiatric phenomenology in Cushing\u2019s disease","volume":"25","author":"Loosen","year":"1992"},{"key":"b23-focus15324","series-title":"J Neurooncol","first-page":"151","article-title":"Cushing\u2019s disease: a surgical view","volume":"54","author":"L\u00fcdecke","year":"2001"},{"key":"b24-focus15324","series-title":"Physiol Rev","first-page":"873","article-title":"Physiology and neurobiology of stress and adaptation: central role of the brain","volume":"87","author":"McEwen","year":"2007"},{"key":"b25-focus15324","series-title":"Neuropharmacology","first-page":"3","article-title":"Stress and anxiety: structural plasticity and epigenetic regulation as a consequence of stress","volume":"62","author":"McEwen","year":"2012"},{"key":"b26-focus15324","series-title":"J Clin Endocrinol Metab","first-page":"2531","article-title":"Children experience cognitive decline despite reversal of brain atrophy one year after resolution of Cushing syndrome","volume":"90","author":"Merke","year":"2005"},{"key":"b27-focus15324","series-title":"Acta Neurochir (Wien)","first-page":"1637","article-title":"Health-related quality of life and 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