Abstract
Background
Perinatal exposure to glucocorticoids and elevated endogenous glucocorticoid levels during childhood can have detrimental effects on the developing brain. Here, we examined the impact of glucocorticoid treatment during childhood on brain volumes.
Methods
A total of 30 children and adolescents with rheumatic or nephrotic disease previously treated with glucocorticoids and 30 controls matched on age, sex, and parent education underwent magnetic resonance imaging (MRI) of the brain. Total cortical gray and white matter, brain, intracranial volume, and total cortical thickness and surface area were derived from MRI scans.
Results
Patients had significantly smaller gray and white matter and total brain volumes relative to healthy controls. Brain volume differences disappeared when accounting for intracranial volume, as patients had relatively smaller intracranial volumes. Group differences were mainly driven by the children with rheumatic disease. Total cortical thickness and cortical surface area did not significantly differ between groups. We found no significant associations between glucocorticoid-treatment variables and volumetric measures.
Conclusion
Observed smaller total brain, cortical gray, and white matter volumes in children and adolescents previously treated with glucocorticoids compared with that in healthy controls may reflect both developmental and degenerative processes. Prospective longitudinal studies are warranted to clarify whether findings are related to treatment or disease.
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Acknowledgements
Our greatest acknowledgment is directed toward all participating children and their parents. Furthermore, The Danish Research Council for Independent Research, the Lundbeck Foundation, and The Ville Heise Foundation are acknowledged for kindly funding the study.
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Financial disclosure: Hartwig Siebner has received honoraria as speaker from Lundbeck A/S, Denmark, Biogen Idec, Denmark, Genzyme, Denmark, and MerckSerono, Denmark, honoraria from Elsevier Publishers, Amsterdam, The Netherlands, and Springer Publishing, Stuttgart, Germany, and travel support from MagVenture, Denmark. The remaining authorsdeclare no conflict of interest.
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All phases of this study were kindly supported by The Danish Council for Independent Research (grant number: 09-071546), The Lundbeck Foundation (grant number: R48-A4968), and The Ville Heise Foundation.
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Holm, S., Madsen, K., Vestergaard, M. et al. Total brain, cortical, and white matter volumes in children previously treated with glucocorticoids. Pediatr Res 83, 804–812 (2018). https://doi.org/10.1038/pr.2017.312
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DOI: https://doi.org/10.1038/pr.2017.312
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