Nervous System Diseases

Heart and Blood Diseases

All Conditions

Neoplasms

Gland and Hormone Related Diseases

Rare Diseases

Stroke

Adrenocortical Adenoma

Adenoma

Adrenal Gland Neoplasms

Cerebrovascular Disorders

Brain Diseases

Central Nervous System Diseases

Vascular Diseases

Adrenal Cortex Neoplasms

Endocrine Gland Neoplasms

Adrenal Cortex Diseases

Adrenal Gland Diseases

Endocrine System Diseases

Adenoma of the Adrenal Gland

Anti-Inflammatory Agents

All Drugs and Chemicals

Vasoconstrictor Agents

Respiratory System Agents

Hydrocortisone

Hydrocortisone 17-butyrate 21-propionate

Hydrocortisone acetate

Hydrocortisone hemisuccinate

Epinephrine

Racepinephrine

Epinephryl borate

Patients with cerebral infarction, and enrolled in our emergency or clinical department.

Patients with intracerebral hemorrhage, and enrolled in our emergency or clinical department.

Patients with subarachnoid hemorrhage, and enrolled in our emergency or clinical department.

Hao Yan, Dr.

Tong W Ou, Dr.

Adrenal incidentalomas (AIs) are commonly encountered in transsection imaging which purpose not for suspected adrenal disease. However, part of AIs in patients is associated with Stroke. Stroke is a diseases which could cause of disability and death worldwide. In clinical practice, detailed information about the association between stroke and AIs is not available. In this study, the investigators aimed to investigate the risk for disability and death in the large group of stroke patients with AIs.

Background:

Adrenal incidentalomas (AIs) are commonly encountered in transsection imaging which purpose not for suspected adrenal disease. However, part of AIs in patients is associated with Stroke . The investigators aimed to investigate the risk for disability and death in the large group of stroke patients with AIs.

Objective:

To measure the association between stroke and levels of autonomous cortisol secretion in patients with AIs.

Design:

Part 1, Retrospective cohort study.

From April 1, 2021, to September 30, 2021, cohort patients with stroke were recruited in this study. The investigators assess the standardised incidence rate of AIs in all patients. Meanwhile, detail information about stroke disease、patient and AIs characteristics were record.

Part 2, Prospective cohort study.

From Mar 1, 2022, to Feb 29, 2024, cohort patients with stroke plane to recruit in this study. All patient receive the plasma cortisol level after a 1-mg dexamethasone suppression test. The investigators assess the standardised incidence rate of AIs in all patients. Meanwhile, detail information about stroke disease、patient and AIs characteristics would be record.

Association Between Stroke and Adrenal Incidentalomas

If Adrenal Incidentalomas Have the Influences to Occur and Progress in Patients With Stroke

un-decided if corporation for multi-centers study in the future.

Assess the standardised incidence rate of AIs in all patients with stroke

Plasma cortisol level after a 1-mg dexamethasone suppression test

Maximal axial diameter of adrenal incidentalomas by computed tomography scan; Millimetre as a metric unit of length in this study

Xuanwu Hospital, Beijing

Neoplasms, Glandular and Epithelial

Neoplasms by Histologic Type

Antineoplastic Agents

Antiemetics

Gastrointestinal Agents

Dexamethasone

Dexamethasone acetate

Adrenergic Agents

Adrenergic alpha-Agonists

Adrenergic Agonists

Neurotransmitter Agents

Adrenergic beta-Agonists

Bronchodilator Agents

Anti-Asthmatic Agents

Mydriatics

Sympathomimetics

Patients admitted to the hospital with adrenal incidentalomas are evaluated for adrenal function, and then ACS patients are diagnosed based on the serum cortisol ≥ 50 nmol/L following the 1 mg dexamethasone suppression test and without any other signs or symptoms of cortisol excess.Patients with ACS will undergo a physical exam, cognitive function test as well as structural and functional brain MRI at baseline and 12 months after their surgery or conservative treatment.

Patients admitted to the hospital with adrenal incidentalomas are evaluated for adrenal function, and then non-functioning adrenal adenomas patients are diagnosed based on the serum cortisol \< 50 nmol/L following the 1 mg dexamethasone suppression test .Patients with non-functioning adrenal adenomas will undergo a physical exam, cognitive function test as well as structural and functional brain MRI at baseline.

Cognitive function assessment; functional magnetic resonance imaging

Only a subgroup of the autonomous cortisol secretion patients will have the laparoscopic adrenal surgery

laparoscopic adrenal surgery

Dalong Zhu, MD,PhD

PIng Li, MD,PhD

Ping Li, MD,PhD

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.

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

A Single Center, Prospective, Observational Study to Explore and Evaluate the Differences of Cognitive Function and Brain Function Between Non-functioning Adrenal Adenomas and Autonomous Cortisol Secretion Patients, and the Different Treatments Methods on Cognitive Function and Brain Function in Patients With Autonomous Cortisol Secretion

Self-reported information(education in years)

The MoCA is a Global cognitive screening test designed to assist Health Professionals in detection of mild cognitive impairment.

The MMSE is a cognitive screening test designed to assist Health Professionals in detection of mild cognitive impairment.

The RBANS is a cognitive screening test designed to assist Health Professionals in evaluation of multiple cognitive subdomains

Patients were given 1 mg dexamethasone orally at 24:00 am, and the cortisol levels were measured at 8:00 am the following morning

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Association Between Stroke and Adrenal Incidentalomas	NCT05237817	Stroke Adrenal Inciden...		18 Years - 100 Years	Xuanwu Hospital, Beijing
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	NCT05357456	Autonomous Cort... Adrenal Inciden... Non-functioning...	Cognitive funct... laparoscopic ad...	20 Years - 65 Years	The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School
Association Between Stroke and Adrenal Incidentalomas	NCT05237817	Stroke Adrenal Inciden...		18 Years - 100 Years	Xuanwu Hospital, Beijing

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