Purpose To present a systematic review of the presence and severity of neuropsychological impairment in the six main neuropsychological domains (attention, executive function, language, visuospatial processing, intelligence, and memory) in patients with Cushing’s disease (CD) and/or Cushing’s Syndrome (CS) at various stages of the illness. The work aims to identify neuropsychological leverage points for focused diagnosis and rehabilitation in CS/CD patients. Methods A pubmed literature search was performed and augmented by searching the reference lists of review articles identified by this search strategy. After excluding irrelevant hits, we systematically extracted data from 27 studies for each main neuropsychological domain, differentiating between active disease, short- and long-term remission. Results The literature gives evidence for neuropsychological impairment in all domains in Cushing patients with active disease. The most consistent impairments concerned memory and visuo-spatial processing, whereas the data are discordant for all other domains. Significant improvement of neuropsychological function – although not returning to normal in all domains – is shown in short-term and long-term remission of the disease. However, the published literature is thin, suffering from repetitive subsample analyses publishing, methodological concerns as lack of control for confounders such as depression. Conclusions Memory is the most extensively investigated domain in CS/CD patients and impairment is most prominent in active disease. Patients should be counseled that neuropsychological function will improve with normalization of hypercortisolism and over time. More studies with more stringent methodological criteria, larger patient samples and controlling for confounders are required to enhance our understanding of neuropsychological function in patients with CS/CD.

中文翻译：

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库欣病和库欣综合征患者的神经心理功能

目的 对库欣病 (CD) 和/或库欣综合征患者在六个主要神经心理领域（注意力、执行功能、语言、视觉空间处理、智力和记忆）中神经心理障碍的存在和严重程度进行系统评价。 CS）在疾病的不同阶段。这项工作旨在确定神经心理学杠杆点，用于 CS/CD 患者的重点诊断和康复。方法 通过搜索由该搜索策略确定的评论文章的参考列表，执行并扩充了发表的文献搜索。在排除不相关的命中后，我们系统地提取了每个主要神经心理学领域的 27 项研究的数据，区分活动性疾病、短期和长期缓解。结果 文献提供了患有活动性疾病的库欣患者所有领域的神经心理障碍的证据。最一致的损伤涉及记忆和视觉空间处理，而所有其他领域的数据不一致。神经心理功能的显着改善——尽管并未在所有领域恢复正常——表现为疾病的短期和长期缓解。然而，已发表的文献很少，遭受重复的子样本分析出版，方法学上的担忧，因为缺乏对抑郁症等混杂因素的控制。结论 记忆是 CS/CD 患者中研究最广泛的领域，而在活动性疾病中受损最为突出。应告知患者神经心理功能会随着皮质醇增多症的正常化和时间的推移而改善。需要更多具有更严格方法学标准、更大患者样本和控制混杂因素的研究，以增强我们对 CS/CD 患者神经心理功能的理解。