Performances on Cognitive Functions and Brain Function and Follow-up After Different Treatments in Patients With Autonomous Cortisol Secretion: a Single-center, Prospective, Observational Study

  • End date
    Oct 1, 2026
  • participants needed
  • sponsor
    The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School
Updated on 12 May 2022
Accepts healthy volunteers


This is a single center, prospective, observational study to explore and evaluate the differences on cognitive function and brain function by functional-MRI in autonomous cortisol secretion patients, and the different treatments methods on the cognitive function and brain function in patients with autonomous cortisol secretion


Glucocorticoids, mainly cortisol, play a crucial role in the allostatic process of adjustment to stressors and can determine important changes in central nervous system structures. It is well known that Cushing's syndrome (CS) is associated with neurocognitive impairment in about two-thirds of cases. In CS the most frequent reported alterations are memory impairment (about 83% of cases) and reduced concentration (66% of cases) . Unfortunately, these alterations are only partially reversible after the hypercortisolism resolution. As so far, data related to the impact of autonomous cortisol secretion (ACS) on cognitive function are scarce and lack of magnetic resonance indicators. Few studies have studied the cognitive function changes of patients with ACS by surgical and conservative treatment. In the single center, prospective and observational study we aim to explore cognitive functions and brain function by functional-MRI in adrenal incidentaloma patients in relation to the presence of ACS and, secondly, in a group of acs patients, the effect of adrenalectomy on cognitive functions and brain function.

Condition Autonomous Cortisol Secretion, Adrenal Incidentaloma, Non-functioning Adrenal Adenomas
Treatment Cognitive function assessment; functional magnetic resonance imaging, laparoscopic adrenal surgery
Clinical Study IdentifierNCT05357456
SponsorThe Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School
Last Modified on12 May 2022


Yes No Not Sure

Inclusion Criteria

age 20-65 years
≥ 6 years of education;
complete entire cognitive function tests
adrenal lesions ≥ 1 cm in diameter
patients with non-functioning adrenal adenomas
patients with autonomous cortisol secretion

Exclusion Criteria

< 6 years of education
age < 20 years or > 65 years
maximum diameter of AI <1cm
active malignancies
with a history of thyroid disease
with a history of acute infection in the last month
central nervous system diseases, including brain trauma, intracranial hemorrhage, acute cerebral infarction, etc
contraindications of MRI examination: such as implantation of metal prosthesis in vivo, claustrophobia, etc
adrenal tuberculosis
suspected or diagnosed adrenocortical carcinoma
unable to complete entire cognitive function tests
current use of steroids or any drugs known to alter steroid synthesis or metabolism in the previous 3 months
clinical Cushing syndrome
Cushing disease
primary hyperaldosteronism
severe impairment of heart, liver, kidney and other organs
pregnant and lactating women
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