Prolonged secretion of cortisol as a possible mechanism underlying stress and depressive behaviour

Qin, Dongdong; Rizak, Joshua D.; Feng, Xiaoli; Yang, Sharon S.; Lü, Longbao; Pan, Lei; Yin, Yan; Hu, Xintian

doi:10.1038/srep30187

Cited by 78 publications

(56 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Increased CRH receptor levels in some brain regions (eg, the amygdala and hippocampus) may contribute to pain and depressive mood in the absence of tissue pathology or disease state . However, the results of the relationship between cortisol and depression are inconsistent with findings in the literature …”

Section: Discussionmentioning

confidence: 92%

Cognitive Performance and the Alteration of Neuroendocrine Hormones in Chronic Tension‐Type Headache

Qü

Yu²,

Xia

et al. 2017

Pain Practice

View full text Add to dashboard Cite

& Abstract: Tension-type headache (TTH) is the most prevalent primary headache. Chronic TTH (CTTH), the most serious form of TTH, is refractory, with a high socio-economic burden. Research studies have shown patients with migraine often had cognitive impairment, but few studies have focused on the cognition in patients with CTTH. In this study, we assumed that patients with CTTH also have cognitive impairments, which are modulated by the neuroendocrine state. Participants were recruited, including patients with CTTH and healthy controls. Cognitive ability was evaluated using the Montreal Cognitive Assessment and the Nine Box Maze Test. The administration of neuroendocrine hormones has been established to be associated with cognitive performance, and we detected the hormonal changes in the hypothalamus-pituitary-adrenal axis, the hypothalamus-pituitary-thyroid axis, and gonadotropin-releasing hormone. These results showed that compared to the controls, significant cognitive impairment and neuroendocrine dysfunction were present in the patients with CTTH. We also assessed the correlations between the neuroendocrine hormones and Pittsburgh Sleep Quality Index score, 17-term Hamilton's Depression Scale score, pain intensity, and duration of pain to determine whether the neuroendocrine hormones had any associations with these symptoms of CTTH. These results showed that changes in neuroendocrine hormones were involved in these symptoms of CTTH. Intervention with the neuroendocrine state may be a strategy for CTTH treatment. &

show abstract

Section: Discussionmentioning

confidence: 92%

Cognitive Performance and the Alteration of Neuroendocrine Hormones in Chronic Tension‐Type Headache

Qü

Yu²,

Xia

et al. 2017

Pain Practice

View full text Add to dashboard Cite

show abstract

“…5 This conclusion is supported by other studies in the literature that have shown depression to be linked with increased cortisol levels, in both humans and nonhuman primates. 13,19 Additionally, in a prospective study of 243 patients undergoing elective CABG surgery, Mu et al 11 found high cortisol levels to be linked with postoperative delirium. These elevated glucocorticoid levels have been hypothesized to cause structural changes in hippocampal neurons and to perturb the hypothalamic-pituitary axis, which may predispose the brain to episodes of delirium.…”

Section: Discussionmentioning

confidence: 99%

Depression as an independent predictor of postoperative delirium in spine deformity patients undergoing elective spine surgery

Elsamadicy

Adogwa

Lydon

et al. 2017

Journal of Neurosurgery: Spine

View full text Add to dashboard Cite

OBJECTIVEDepression is the most prevalent affective disorder in the US, and patients with spinal deformity are at increased risk. Postoperative delirium has been associated with inferior surgical outcomes, including morbidity and mortality. The relationship between depression and postoperative delirium in patients undergoing spine surgery is relatively unknown. The aim of this study was to determine if depression is an independent risk factor for the development of postoperative delirium in patients undergoing decompression and fusion for deformity.METHODSThe medical records of 923 adult patients (age ≥ 18 years) undergoing elective spine surgery at a single major academic institution from 2005 through 2015 were reviewed. Of these patients, 255 (27.6%) patients had been diagnosed with depression by a board-certified psychiatrist and constituted the Depression group; the remaining 668 patients constituted the No-Depression group. Patient demographics, comorbidities, and intra- and postoperative complication rates were collected for each patient and compared between groups. The primary outcome investigated in this study was rate of postoperative delirium, according to DSM-V criteria, during initial hospital stay after surgery. The association between depression and postoperative delirium rate was assessed via multivariate logistic regression analysis.RESULTSPatient demographics and comorbidities other than depression were similar in the 2 groups. In the Depression group, 85.1% of the patients were taking an antidepressant prior to surgery. There were no significant between-group differences in intraoperative variables and rates of complications other than delirium. Postoperative complication rates were also similar between the cohorts, including rates of urinary tract infection, fever, deep and superficial surgical site infection, pulmonary embolism, deep vein thrombosis, urinary retention, and proportion of patients transferred to the intensive care unit. In total, 66 patients (7.15%) had an episode of postoperative delirium, with depressed patients experiencing approximately a 2-fold higher rate of delirium (10.59% vs 5.84%). In a multivariate logistic regression analysis, depression was an independent predictor of postoperative delirium after spine surgery in spinal deformity patients (p = 0.01).CONCLUSIONSThe results of this study suggest that depression is an independent risk factor for postoperative delirium after elective spine surgery. Further studies are necessary to understand the effects of affective disorders on postoperative delirium, in hopes to better identify patients at risk.

show abstract

“…Fortunately, the data showing that multiple antidepressants have similar effects on stress hormones in humans and rodents increases confidence that there is sufficient evolutionary conservation between species to carefully model HPA axis dysregulation in rodents to further probe MDD neurobiology. While rodent models have proved extremely valuable in gaining mechanistic insights into the pathophysiology, emerging studies using the non-human primates have begun to offer additional dimensions to the endocrine and behavioral correlates of chronic stress induced MDD (213,214). Exploring the effects of HPA axis modulation in these animal models could provide a bridge to improve our mechanistic understanding of how changes in cortisol cascade to abnormalities in metabolism, gene regulation, and immune function, all of which have been independently implicated in MDD.…”

Section: Conclusion and Future Perspectivesmentioning

confidence: 99%

Cortisol and Major Depressive Disorder—Translating Findings From Humans to Animal Models and Back

Nandam¹,

Brazel²,

Zhou³

et al. 2020

Front. Psychiatry

172

103

View full text Add to dashboard Cite

Major depressive disorder (MDD) is a global problem for which current pharmacotherapies are not completely effective. Hypothalamic-pituitary-adrenal (HPA) axis dysfunction has long been associated with MDD; however, the value of assessing cortisol as a biological benchmark of the pathophysiology or treatment of MDD is still debated. In this review, we critically evaluate the relationship between HPA axis dysfunction and cortisol level in relation to MDD subtype, stress, gender and treatment regime, as well as in rodent models. We find that an elevated cortisol response to stress is associated with acute and severe, but not mild or atypical, forms of MDD. Furthermore, the increased incidence of MDD in females is associated with greater cortisol response variability rather than higher baseline levels of cortisol. Despite almost all current MDD treatments influencing cortisol levels, we could find no convincing relationship between cortisol level and therapeutic response in either a clinical or preclinical setting. Thus, we argue that the absolute level of cortisol is unreliable for predicting the efficacy of antidepressant treatment. We propose that future preclinical models should reliably produce exaggerated HPA axis responses to acute or chronic stress a priori, which may, or may not, alter baseline cortisol levels, while also modelling the core symptoms of MDD that can be targeted for reversal. Combining genetic and environmental risk factors in such a model, together with the interrogation of the resultant molecular, cellular, and behavioral changes, promises a new mechanistic understanding of MDD and focused therapeutic strategies.

show abstract

Prolonged secretion of cortisol as a possible mechanism underlying stress and depressive behaviour

Cited by 78 publications

References 49 publications

Cognitive Performance and the Alteration of Neuroendocrine Hormones in Chronic Tension‐Type Headache

Cognitive Performance and the Alteration of Neuroendocrine Hormones in Chronic Tension‐Type Headache

Depression as an independent predictor of postoperative delirium in spine deformity patients undergoing elective spine surgery

Cortisol and Major Depressive Disorder—Translating Findings From Humans to Animal Models and Back

Contact Info

Product

Resources

About