Microstructural brain changes in acromegaly: quantitative analysis by diffusion tensor imaging

Psychopathology in Acromegaly-Real and Perceived

Acromegaly is a chronic condition caused by the excessive production of growth hormone and is characterized by progressive morphological and systemic complications, as well as increased prevalence of psychopathologies, which markedly affect patients' quality of life. The advancing multimodal therapies, while significantly improving the morbidity and mortality, have limited impact on psychopathologies, which often persist despite disease remission. The most common psychopathologies in acromegaly include depression, anxiety and affective disorders, together with sexual dysfunction, which may be considered as either a consequence or potentially even a contributory factor to these psychopathologies. Approximately one-third of patients with acromegaly manifest depression, whereas two-thirds of patients display anxiety, with both conditions tending to be more prevalent and severe in younger patients with shorter duration of disease. Apparently, a major impact of psychological discomfort in women compared with men appears to be the fact that women tend to internalize whereas men tend to externalize their distress. Personality disorders also commonly associated with acromegaly, especially due to body image suffering, are linked to sexual dysfunction, which seems to affect women more than men. In summary, psychopathology in acromegaly is a major determinant of the quality of life and a complex array of psychological abnormalities are associated with acromegaly.

Left to themselves: Time to target chronic pain in childhood rare diseases

BACKGROUND

Chronic pain is prevalent among patients with rare diseases (RDs). However, little is understood about how biopsychosocial mechanisms may be integrated in the unique set of clinical features and therapeutic challenges inherent in their pain conditions.

METHODS

This review presents examples of major categories of RDs with particular pain conditions. In addition, we provide translational evidence on clinical and scientific rationale for psychosocially- and neurodevelopmentally-informed treatment of pain in RD patients.

RESULTS

Neurobiological and functional overlap between various RD syndromes and pain states suggests amalgamation and mutual modulation of the respective conditions. Emotional sequelae could be construed as an emotional homologue of physical pain mediated via overlapping brain circuitry. Given their clearly defined genetic and molecular etiologies, RDs may serve as heuristic models for unraveling pathophysiological processes inherent in chronic pain.

CONCLUSIONS

Systematic evaluation of chronic pain in patients with RD contributes to sophisticated insight into both pain and their psychosocial correlates, which could transform treatment.

Changes in olfactory function and olfactory bulb after treatment for acromegaly

PURPOSE

This study aimed to investigate the olfactory functions of the acromegaly patients and to discuss the possible causes of olfactory dysfunction in acromegaly patients.

METHODS

A case-control study was carried out in a tertiary referral center. 52 patients with acromegaly (Acromegaly group) and 52 healthy individuals (Control group) were included in the study. All acromegaly patients included in the study were in the late postoperative period. The Connecticut Chemosensory Clinical Research Center (CCCRC) test was carried out and olfactory bulb (OB) volumes were measured in both of the groups.

RESULTS

There was a significant difference between the mean CCCRC total scores of the acromegaly and control groups (p = .000). The mean of right and left OB volumes in the acromegaly group was significantly higher than the control group (p = .004) CONCLUSION: In this study, we found that acromegaly patients are likely to experience olfactory dysfunction. It is important to examine these patients' olfactory functions at the time of diagnosis and clinic follow-up.

CLINICAL TRIAL NUMBER

NCT04138537.