Targeting hypothalamic-pituitary-adrenal axis hormones and sex steroids for improving cognition in major mood disorders and schizophrenia: a systematic review and narrative synthesis

Soria, Virginia; González-Rodríguez, Alexandre; Huerta‐Ramos, Elena; Usall, Judith; Gómez, Jesús V. Cobo; Bioque, Miquel; Barbero, Juan David; García-Rizo, Clemente; Tost, Meritxell; Monreal, José Antonio; Labad, Javier

doi:10.1016/j.psyneuen.2018.04.012

Cited by 58 publications

(40 citation statements)

References 125 publications

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“…The results have generally been positive, suggesting that between 20 and 80% of depressed individuals exhibit some form of HPA-axis hyperactivation [16]. In addition, drugs targeting hormones related to the HPA-axis have been shown to have beneficial effects on depressive symptoms [53]. Likewise, an abundance of studies has indicated that depressed individuals tend to exhibit elevated plasma concentrations of pro-inflammatory cytokines such as CRP [17].…”

Section: Discussionmentioning

confidence: 99%

“…To illustrate, since different symptoms may be characterised by distinct biological dysregulations, the efficacy of antidepressants is likely to be affected by the specific symptom profile of patients. In additon, drugs that pharmacologically modify neuroendocrine and inflammatory processes might be particularly effective for individuals with higher levels of somatic symptoms [53,56].…”

Section: Discussionmentioning

confidence: 99%

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Persistent depressive symptoms, HPA-axis hyperactivity, and inflammation: the role of cognitive-affective and somatic symptoms

2019

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Hypothalamic-pituitary-adrenal (HPA)-axis hyperactivity and inflammation are thought to be prominent in the aetiology of depression. Although meta-analyses have confirmed this relationship, there is considerable variability in the effect sizes across studies. This could be attributed to a differential role of such biological systems in somatic versus cognitive-affective depressive symptoms which remains largely unexplored. Furthermore, most longitudinal research to date has focused on transient rather than persistent depressive symptoms. In the current study, we investigated the associations of hair cortisol and plasma C-reactive protein (CRP) with the longitudinal persistence and dimensions (cognitive-affective versus somatic) of depressive symptoms over a 14-year period using Trait-State-Occasion (TSO) structural equation modelling. The data came from a large sample of older adults from the English Longitudinal Study of Ageing. Depressive symptoms were assessed from wave 1 (2002-03) to wave 8 (2016-17). Hair cortisol (N = 4761) and plasma CRP (N = 5784) were measured in wave 6 (2012-13). Covariates included demographic, socioeconomic, lifestyle, chronic disease, and medication data. Our results revealed that higher cortisol and CRP levels were significantly associated with persistent depressive symptoms across the study period. Notably, both biomarkers exhibited stronger relationships with somatic than with cognitive-affective symptoms. The associations with somatic symptoms were also independent of relevant confounding factors. In contrast, their associations with cognitive-affective symptoms were weak after adjustment for all covariates. These distinct associations reveal the importance of considering symptom-specific effects in future studies on pathophysiological mechanisms. Ultimately, this will have the potential to advance the search for biomarkers of depression and facilitate more targeted treatments.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Persistent depressive symptoms, HPA-axis hyperactivity, and inflammation: the role of cognitive-affective and somatic symptoms

2019

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“…In the aspect of molecular structure, sex hormones and glucocorticoids both belong to neurosteroids. For example, mifepristone achieves its antiprogesterone effect by competing to bind to progesterone receptor while it also shows the ability of attaching to glucocorticoid receptors (62,63). Affected by the concentration of these hormones, nonspecific receptors may produce different biological effects, which can better explain the higher morbidity of neuroendocrine diseases in women.…”

Section: Discussionmentioning

confidence: 99%

Functional Status of Hypothalamic–Pituitary–Thyroid and Hypothalamic–Pituitary–Adrenal Axes in Hospitalized Schizophrenics in Shanghai

Zhu

Tao

et al. 2020

Front. Psychiatry

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Objective: Neuroendocrine dysfunction is related to the pathogenesis of mental disorders, but conclusions from clinical research lack consistency. We aimed to investigate the neuroendocrinal pathophysiology and its correlation with clinical symptoms in patients with schizophrenia. Methods:The present cross-sectional study included 486 inpatients with schizophrenia admitted at a psychiatric hospital in Shanghai within one year, and 154 healthy controls (HC) matched on age and gender. The serum hemoconcentrations of thyroid-stimulating hormone (TSH), total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3), free thyroxine (FT4), adrenocorticotrophic hormone (ACTH), and cortisol (COR) were measured via electrochemical luminescence immunoassay. Pathophysiological conversions of neuroendocrine were then associated with gender, age, age at onset, antipsychotic treatment using hierarchical multiple linear regression.Results: When compared to HC, the schizophrenia group showed elevated ACTH and COR levels and decreased TT3 and TT4 levels (p's < 0.05). First-episode patients showed lower TSH and higher FT3 and FT4 (p's < 0.05) compared to recurrent patients. Female patients showed higher TSH and lower TT3, FT3, and ACTH levels (p's < 0.05) compared to males. We observed the area under the curve (AUC) of the predictive model to distinguish between schizophrenia and HC to be 0.737 among total samples and between first-episode and recurrent schizophrenia to be 0.890 among subgroups.Conclusions: Decreased TT3 and TT4 and elevated ACTH and COR levels appear to be associated with schizophrenia symptoms. The chronic recurrent trait of schizophrenia Frontiers in Psychiatry | www.frontiersin.org

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“…During the COVID-19 pandemic, environmental stress such as the fear to be affected, quarantine, the experience of breath difficulty, or all kinds of complains in patients leads to different psychiatric disorders as similar to those in SARS epidemic (Maunder 2009). Under these situations, stressor-dependent corticotrophin-releasing hormone (CRH) is released from hypothalamic paraventricular nucleus (PVN) neurons in susceptible individuals and further activates the hypothalamicpituitary-adrenal (HPA) axis by binding to the CRH receptors in the anterior pituitary gland to stimulate the release of adrenocorticotropic hormone (ACTH) (Futch et al 2017;Kumar et al 2013;Sanders and Nemeroff 2016;Soria et al 2018). The increase of serum ACTH promotes the elevation of concentration of glucocorticoids in the blood (Curtin et al 2009;Noisakran et al 1998).…”

Section: Possible Mechanisms Of Psychiatric Symptomsmentioning

confidence: 99%

Involvement of the Nervous System in SARS-CoV-2 Infection

2020

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As a severe and highly contagious infectious disease, coronavirus disease 2019 (COVID-19) has caused a global pandemic. Several case reports have demonstrated that the respiratory system is the main target in patients with COVID-19, but the disease is not limited to the respiratory system. Case analysis indicated that the nervous system can be invaded by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and that 36.4% of COVID-19 patients had neurological symptoms. Importantly, the involvement of the CNS may be associated with poor prognosis and disease worsening. Here, we discussed the symptoms and evidence of nervous system involvement (directly and indirectly) caused by SARS-CoV-2 infection and possible mechanisms. CNS symptoms could be a potential indicator of poor prognosis; therefore, the prevention and treatment of CNS symptoms are also crucial for the recovery of COVID-19 patients.

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Targeting hypothalamic-pituitary-adrenal axis hormones and sex steroids for improving cognition in major mood disorders and schizophrenia: a systematic review and narrative synthesis

Cited by 58 publications

References 125 publications

Persistent depressive symptoms, HPA-axis hyperactivity, and inflammation: the role of cognitive-affective and somatic symptoms

Persistent depressive symptoms, HPA-axis hyperactivity, and inflammation: the role of cognitive-affective and somatic symptoms

Functional Status of Hypothalamic–Pituitary–Thyroid and Hypothalamic–Pituitary–Adrenal Axes in Hospitalized Schizophrenics in Shanghai

Involvement of the Nervous System in SARS-CoV-2 Infection

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