Association of Hypothalamic-Pituitary-Adrenal Axis Function with Neuropsychological Performance in Children with Mild/Moderate Asthma

Abstract

The present study examines the relationship between hypothalamic-pituitary-adrenal (HPA) axis function and child psychological/neuropsychological function in a group of children with mild to moderate asthma. The goal of the study was to determine whether child neuropsychological functioning and psychological functioning were associated with cortisol production in response to adrenocorticotropic hormone(ACTH) stimulation when assessed as area under the curve. Data for this study were gathered from 63 children who participated in an ancillary study within the Childhood Asthma Management Program (CAMP) during the pre-randomization phase of the CAMP trial. At 2 of the 8 CAMP clinical centers participants completed an ACTH stimulation test after an overnight stay in the General Clinical Research Center. Gender differences on baseline cortisol and change in cortisol 30 minutes after infusion of ACTH were present. Results further indicated significant associations between cortisol production and measures of child neuropsychological function. Stepwise multiple regression analysis revealed that cortisol change could be predicted by measures of gender, working memory, and arousal maintenance, providing support for the hypothesis that cortisol plays a modest role in the neuropsychological function of children with mild and moderate asthma. In contrast, cortisol production was not associated with child reports of psychological functioning. Limitations to the methods employed in this study are discussed.

The academic attainment of students with disabilities in UK higher education

“…Each of these conditions may affect higher mental function (and hence academic attainment), although the evidence is clearer for type 1 (insulin-dependent) diabetes (Brands et al 2005), which is the more common form in children and young adults, than for type 2 (non-insulin-dependent) diabetes (Ryan and Geckle 2000), and it is clearer for epilepsy (Elger, Helmstaedter, and Kurthen 2004) than for asthma (Annett et al 2005). As Richardson (1990) noted in the case of diabetes, the nature of any intellectual impairment in these conditions could in principle be organic (due to the disruption of cerebral functioning), iatrogenic (due to the medication used to control these conditions) or psychogenic (due to changes in personality or cognitive style as a consequence of living with a chronic, life-threatening disease).…”

The effects of stress and stress hormones on human cognition: Implications for the field of brain and cognition

“…A meta-analysis of randomized controlled trials has provided firm confirmation that they can indeed (Conn & Poynard, 1994). In general, prednisone has been most frequently implicated in causing psychiatric side effects (for a review, see Hall, Popkin, Stickney, & Gardner, 1979), but other less widely used steroids such as methylprednisone (Greeves, 1984;Perry, Tsuang, & Hwang, 1984), dexamethasone (Bick, 1983), and even inhaled beclomethasone (Annett, Stansbury, Kelly, & Strunk, 2005;Kreus, Viljanen, Kujala, & Kreus, 1975) have also been reported to induce mental disturbances. Most patients exhibiting side effects are between 21 and 60 years of age (Ling, Perry, & Tsuang, 1981), but adverse mental changes are also being reported in children de La Riva, 1958;Sullivan & Dickerman, 1979), and older individuals (Varney, Alexander, & MacIndoe, 1984).…”

Children’s context inappropriate anger and salivary cortisol.

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