Increased Resting-State Functional Connectivity in Patients With Autoimmune Addison Disease

Abstract Context Individuals with autoimmune Addison disease (AAD) take replacement medication for the lack of adrenal-derived glucocorticoid (GC) and mineralocorticoid hormones from diagnosis. The brain is highly sensitive to these hormones, but the consequence of having AAD for brain health has no...

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Bibliographic Details
Published in:The journal of clinical endocrinology and metabolism 2024-02, Vol.109 (3), p.701-710
Main Authors: van’t Westeinde, Annelies, Padilla, Nelly, Fletcher-Sandersjöö, Sara, Kämpe, Olle, Bensing, Sophie, Lajic, Svetlana
Format: Article
Language:English
Subjects:
Addison disease
Clinical
cortex
cortisol
cushings-disease
default mode network
Endocrinology & Metabolism
Endocrinology and Diabetes
Endokrinologi och diabetes
human brain
ica-aroma
medial prefrontal
modified-release
orbitofrontal
orbitofrontal cortex
primary adrenal insufficiency
resting-state functional connectivity
robust
working-memory
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Summary:Abstract Context Individuals with autoimmune Addison disease (AAD) take replacement medication for the lack of adrenal-derived glucocorticoid (GC) and mineralocorticoid hormones from diagnosis. The brain is highly sensitive to these hormones, but the consequence of having AAD for brain health has not been widely addressed. Objective The present study compared resting-state functional connectivity (rs-fc) of the brain between individuals with AAD and healthy controls. Methods Fifty-seven patients with AAD (33 female) and 69 healthy controls (39 female), aged 19 to 43 years were scanned with 3-T magnetic resonance imaging (MRI). Results Independent component and subsequent dual regression analyses revealed that individuals with AAD had stronger rs-fc compared to controls in 3 networks: the bilateral orbitofrontal cortex (OFC), the left medial visual and left posterior default mode network. A higher GC replacement dose was associated with stronger rs-fc in a small part of the left OFC in patients. We did not find any clear associations between rs-fc and executive functions or mental fatigue. Conclusion Our results suggest that having AAD affects the baseline functional organization of the brain and that current treatment strategies of AAD may be one risk factor.
ISSN:0021-972X
1945-7197
DOI:10.1210/clinem/dgad592