White matter variations in congenital adrenal hyperplasia: possible implications for glucocorticoid treatment.

IF 4.1 Q1 CLINICAL NEUROLOGY
Brain communications Pub Date : 2024-09-26 eCollection Date: 2024-01-01 DOI:10.1093/braincomms/fcae334
Eileen Luders, Debra Spencer, Christian Gaser, Ajay Thankamony, Ieuan A Hughes, Umasuthan Srirangalingam, Helena Gleeson, Karson T F Kung, Ryan P Cabeen, Melissa Hines, Florian Kurth
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Abstract

Congenital adrenal hyperplasia has been reported to manifest with white matter aberrations. However, many previous studies included only small samples, restricted their analyses to females, lacked a control group and/or did not correct for brain size. Here, we examined the largest sample to date, comprising 53 male and female participants with congenital adrenal hyperplasia, who were matched with 53 male and female controls in terms of sex, age, education, and verbal intelligence. The four groups were compared with respect to their total white matter as well as white matter hyperintensities while applying brain size corrections. For both measures, total white matter and white matter hyperintensities, there were no significant sex differences or group-by-sex interactions. However, individuals with congenital adrenal hyperplasia had significantly smaller total white matter volumes compared to controls. Our findings align with previous reports of white matter variations in congenital adrenal hyperplasia. The absence of a group-by-sex interaction suggests that white matter variations in congenital adrenal hyperplasia may not be attributable to prenatal androgens. Instead, they may be a result of the condition itself and/or its treatment with glucocorticoids. The latter aspect warrants follow-up, particularly given that glucocorticoids are employed not only in congenital adrenal hyperplasia but also in other medical conditions.

先天性肾上腺皮质增生症的白质变异:对糖皮质激素治疗的可能影响。
据报道,先天性肾上腺皮质增生症表现为白质畸变。然而,之前的许多研究仅包含少量样本,分析对象仅限于女性,缺乏对照组和/或未对大脑大小进行校正。在这里,我们研究了迄今为止最大的样本,包括53名患有先天性肾上腺皮质增生症的男性和女性参与者,他们在性别、年龄、教育程度和语言智能方面与53名男性和女性对照组相匹配。在进行脑尺寸校正的同时,对四组患者的白质总量和白质高密度进行了比较。在白质总量和白质高密度这两项指标上,没有明显的性别差异或组间交互作用。然而,与对照组相比,先天性肾上腺皮质增生症患者的白质总体积明显较小。我们的研究结果与之前有关先天性肾上腺皮质增生症白质变异的报道一致。研究结果显示,先天性肾上腺皮质增生症患者的白质变化可能与产前雄激素无关。相反,它们可能是疾病本身和/或糖皮质激素治疗的结果。鉴于糖皮质激素不仅用于先天性肾上腺皮质增生症,也用于其他病症,后一方面的研究值得跟进。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.00
自引率
0.00%
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审稿时长
6 weeks
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