Cushing's Syndrome and Steroid Dementia

Recent Pat Endocr Metab Immune Drug Discov. 2016;10(1):50-55. doi: 10.2174/1872214810666160809113021.

Abstract

Cushing's Syndrome (CS) is associated with a specific spectrum of dementia-like symptoms, including psychiatric disorders, such as major depression, anxiety and mania, and neurocognitive alterations, like impairment of memory and concentration. This pattern of clinical complications, which significantly impair the health-related quality of life of CS patients, is sometimes referred to as "steroid dementia syndrome" (SDS). The SDS is the result of anatomical and functional anomalies in brain areas involved in the processing of emotion and cognition, which are only partially restored after the biochemical remission of the disease. Therefore, periodical neuropsychiatric evaluations are recommended in all CS patients, and a long-term follow-up is required after normalization of hypercortisolism. Recent evidences demonstrate that three classes of drugs (glucocorticoid receptor antagonists, steroidogenesis inhibitors, and pituitary tumor-targeted drugs), which are used for medical treatment of CS, can rapidly relief neuropsychiatric symptoms of SDS. Furthermore, several psychoactive medications have demonstrated effectiveness in the treatment of symptoms induced by the acute or chronic glucocosteroid administration. In this paper, a review of the current and future patents for the treatment and prevention of CS and SDS will be presented.

Publication types

  • Review

MeSH terms

  • Animals
  • Brain / drug effects
  • Brain / metabolism*
  • Brain / physiopathology
  • Cognition*
  • Cushing Syndrome / complications*
  • Cushing Syndrome / drug therapy
  • Cushing Syndrome / metabolism
  • Dementia / drug therapy
  • Dementia / etiology*
  • Dementia / metabolism
  • Dementia / psychology
  • Drug Discovery
  • Emotions*
  • Hormone Antagonists / therapeutic use
  • Humans
  • Hydrocortisone / metabolism*
  • Molecular Targeted Therapy
  • Quality of Life
  • Receptors, Glucocorticoid / antagonists & inhibitors
  • Receptors, Glucocorticoid / metabolism
  • Signal Transduction / drug effects
  • Steroid Hydroxylases / antagonists & inhibitors
  • Steroid Hydroxylases / metabolism
  • Steroid Synthesis Inhibitors / therapeutic use

Substances

  • Hormone Antagonists
  • Receptors, Glucocorticoid
  • Steroid Synthesis Inhibitors
  • Steroid Hydroxylases
  • Hydrocortisone