Total brain, cortical and white matter volumes in children previously treated with glucocorticoids

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:
Thirty 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 grey and white matter, brain, and intracranial volume, and total cortical thickness and surface area were derived from the MRI scans.

RESULTS:
Patients had significantly smaller grey and white matter and total brain volumes relative to healthy controls. Brain volume differences disappeared when accounting for intracranial volume, since 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 grey and white matter volumes in children and adolescents previously treated with glucocorticoids compared to healthy controls may reflect both developmental and degenerative processes. Prospective longitudinal studies are warranted to clarify whether findings are related to treatment or disease.