Abstract
There is increasing evidence that corticosteroids damage the hippocampus in mammals including primates. Hippocampal atrophy induced by corticosteroids may play an important role in the pathogenesis of a range of neuropsychiatric disorders.
Hippocampus is necessary for short-term memory consolidation and HPA axis regulation. Signs of hippocampal damage (HPA dysregulation in combination with memory impairment) are found in affective disorders, Alzheimer#s disease and in posttraumatic stress disorder.
MRI volumetry reveals reduced hippocampal volume in these diseases. Methods: To test the hypothesis that exogenous corticoids administered in a treatment setting also exert neurotoxic effects, we followed prospectively 14 non-psychiatric patients treated with corticosteroids in high doses.
They were evaluated with neuropsychological tests and also with magnetic resonance volumetry of hippocampus. Results: we failed to observe changes in hippocampal volume (Vhip) after an average of 64 or 193 days of treatment with exogenous synthetic corticosteroids.
The change in Vhip did not correlate with average daily dose of prednisone. There was a trend towards worsening in hippocampus related memory tasks and an improvement in hippocampus unrelated tasks.
Conclusion: We did not find changes in hippocampal volume during treatment with corticosteroids. There was, however, trend for decline in declarative memory (hippocampus related task) accompanied with significant improvement in psychomotor speed, attention/working memory (hippocampus unrelated tasks)