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Basal hypothalamic pituitary adrenal axis activity and hippocampal volumes: the SMART-Medea study.
Biol Psychiatry. 2010 Jun 15; 67(12):1191-8.BP

Abstract

BACKGROUND

It has frequently been hypothesized that high levels of glucocorticoids have deleterious effects on the hippocampus and increase risk for cognitive decline and dementia, but no large-scale studies in humans have examined the direct relation between hippocampal volumes and hypothalamic-pituitary-adrenal axis activity.

METHODS

Cross-sectional analyses within the Second Manifestations of ARTerial disease-Magnetic Resonance (SMART)-Medea study, an ancillary study to the SMART-MR study on brain changes on magnetic resonance imaging (MRI) among patients with arterial disease. In 575 patients (mean age 62 +/- 9 years), diurnal cortisol rhythm was assessed with six saliva samples, collected at awakening; at 30, 45, and 60 min thereafter; and at 10 pm and 11 pm. A low dose of dexamethasone (.5 mg) was administered at 11 pm, and saliva was sampled the next morning at awakening. Volumetric measurements of the hippocampus were performed on a three-dimensional fast field echo T1-weighted scan with isotropic voxels.

RESULTS

Mean total relative hippocampal volume was 6.0 +/- .7 mL. Linear regression analyses, adjusted for age, sex, vascular risk factors, and global brain atrophy showed that participants with higher evening levels and higher awakening levels after dexamethasone had smaller hippocampal volumes [B per SD (4.2) increase = -.09 mL; 95% confidence interval -.15 to -.03 mL and B per SD (2.5) increase = -.07 mL; 95% confidence interval -.13 to -.01 mL, respectively]. The awakening response was not significantly associated with hippocampal volumes.

CONCLUSIONS

In this population, higher evening cortisol levels and reduced suppression after dexamethasone were associated with smaller hippocampal volumes, independent of total brain volume. The cortisol response after awakening was not associated with hippocampal volume.

Authors+Show Affiliations

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. a.j.g.knoops@umcutrecht.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20299006

Citation

Knoops, Arnoud J G., et al. "Basal Hypothalamic Pituitary Adrenal Axis Activity and Hippocampal Volumes: the SMART-Medea Study." Biological Psychiatry, vol. 67, no. 12, 2010, pp. 1191-8.
Knoops AJ, Gerritsen L, van der Graaf Y, et al. Basal hypothalamic pituitary adrenal axis activity and hippocampal volumes: the SMART-Medea study. Biol Psychiatry. 2010;67(12):1191-8.
Knoops, A. J., Gerritsen, L., van der Graaf, Y., Mali, W. P., & Geerlings, M. I. (2010). Basal hypothalamic pituitary adrenal axis activity and hippocampal volumes: the SMART-Medea study. Biological Psychiatry, 67(12), 1191-8. https://doi.org/10.1016/j.biopsych.2010.01.025
Knoops AJ, et al. Basal Hypothalamic Pituitary Adrenal Axis Activity and Hippocampal Volumes: the SMART-Medea Study. Biol Psychiatry. 2010 Jun 15;67(12):1191-8. PubMed PMID: 20299006.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Basal hypothalamic pituitary adrenal axis activity and hippocampal volumes: the SMART-Medea study. AU - Knoops,Arnoud J G, AU - Gerritsen,Lotte, AU - van der Graaf,Yolanda, AU - Mali,Willem P Th M, AU - Geerlings,Mirjam I, Y1 - 2010/03/17/ PY - 2009/07/06/received PY - 2009/12/16/revised PY - 2010/01/08/accepted PY - 2010/3/20/entrez PY - 2010/3/20/pubmed PY - 2010/10/26/medline SP - 1191 EP - 8 JF - Biological psychiatry JO - Biol Psychiatry VL - 67 IS - 12 N2 - BACKGROUND: It has frequently been hypothesized that high levels of glucocorticoids have deleterious effects on the hippocampus and increase risk for cognitive decline and dementia, but no large-scale studies in humans have examined the direct relation between hippocampal volumes and hypothalamic-pituitary-adrenal axis activity. METHODS: Cross-sectional analyses within the Second Manifestations of ARTerial disease-Magnetic Resonance (SMART)-Medea study, an ancillary study to the SMART-MR study on brain changes on magnetic resonance imaging (MRI) among patients with arterial disease. In 575 patients (mean age 62 +/- 9 years), diurnal cortisol rhythm was assessed with six saliva samples, collected at awakening; at 30, 45, and 60 min thereafter; and at 10 pm and 11 pm. A low dose of dexamethasone (.5 mg) was administered at 11 pm, and saliva was sampled the next morning at awakening. Volumetric measurements of the hippocampus were performed on a three-dimensional fast field echo T1-weighted scan with isotropic voxels. RESULTS: Mean total relative hippocampal volume was 6.0 +/- .7 mL. Linear regression analyses, adjusted for age, sex, vascular risk factors, and global brain atrophy showed that participants with higher evening levels and higher awakening levels after dexamethasone had smaller hippocampal volumes [B per SD (4.2) increase = -.09 mL; 95% confidence interval -.15 to -.03 mL and B per SD (2.5) increase = -.07 mL; 95% confidence interval -.13 to -.01 mL, respectively]. The awakening response was not significantly associated with hippocampal volumes. CONCLUSIONS: In this population, higher evening cortisol levels and reduced suppression after dexamethasone were associated with smaller hippocampal volumes, independent of total brain volume. The cortisol response after awakening was not associated with hippocampal volume. SN - 1873-2402 UR - https://www.unboundmedicine.com/medline/citation/20299006/Basal_hypothalamic_pituitary_adrenal_axis_activity_and_hippocampal_volumes:_the_SMART_Medea_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0006-3223(10)00067-3 DB - PRIME DP - Unbound Medicine ER -