Increased Resting-State Functional Connectivity in Patients With Autoimmune Addison Disease

Context Individuals with autoimmune Addison disease (AAD) take replacement medication for the lack of adrenal-derived glucocorticoid (GC) and mineralocorticoid hormones from diagnosis. The brain is highly sensitive to these hormones, but the consequence of having AAD for brain health has not been widely addressed.Objective The present study compared resting-state functional connectivity (rs-fc) of the brain between individuals with AAD and healthy controls.Methods Fifty-seven patients with AAD (33 female) and 69 healthy controls (39 female), aged 19 to 43 years were scanned with 3-T magnetic resonance imaging (MRI).Results Independent component and subsequent dual regression analyses revealed that individuals with AAD had stronger rs-fc compared to controls in 3 networks: the bilateral orbitofrontal cortex (OFC), the left medial visual and left posterior default mode network. A higher GC replacement dose was associated with stronger rs-fc in a small part of the left OFC in patients. We did not find any clear associations between rs-fc and executive functions or mental fatigue.Conclusion Our results suggest that having AAD affects the baseline functional organization of the brain and that current treatment strategies of AAD may be one risk factor.

Automated summary

Our study found that individuals with autoimmune Addison disease (AAD) have stronger resting-state functional connectivity (rs-fc) in the bilateral orbitofrontal cortex (OFC), left medial visual, and left posterior default mode network compared to healthy controls. Higher replacement dosage of glucocorticoid (GC) is associated with stronger rs-fc in a small part of the left OFC. There is no clear association between rs-fc and executive functions or mental fatigue.