The relationship of endogenous ACTH levels to visual-attentional functioning in patients with congenital adrenal hyperplasia

Abstract

The within subject experimental approach of either doubling cortisone medication dose or withdrawing steroid treatment for 36 hr preceding behavioral testing was found to induce corresponding significantly elevated or suppressed plasma ACTH levels, as measured by radioimmunoassay, in six of eight adults diagnosed as having congenital adrenal hyperplasia (CAH). During the session characterized by elevated ACTH levels, the CAH patients exhibited significantly reduced median reaction times on the Sternberg Item Recognition Task. Their response pattern was suggestive of facilitated visual attentional functioning and/or overt motor response capacity rather than alteration of simple cognitive processing. Moreover, Sternberg performance was significantly correlated with endogenous ACTH levels but not with levels of plasma cortisol or cortisone replacement medication. This enhancement of performance paralleled a previous finding of improved performance on the Sternberg paradigm by normal adults following exogenous administration of ACTH 4-10 (Ward et al., 1979). Further analysis of the Sternberg performance suggests that other variables such as mineralocorticoid treatment, type of CAH impairment, and sex may act to moderate the degree of ACTH-related facilitation on this task. Performance on other visual and verbal attention and memory tasks, found earlier to be sensitive indices of exogenous administration of ACTH 4-10 and related fragments, was not significantly altered by manipulation of endogenous ACTH levels in these CAH patients.

ACTH and Attention in Humans:A Review

“…Improvements of memory functions, in this task, are reflected by supe rior RTs for the larger set sizes, only. Recently, Veith et al [1985] confirmed these promising results in patients with congenital adrenal hyperplasia. Sternberg reaction performance, in this experiment, improved in a consis tent manner across all four target set sizes when ACTH secretion was enhanced by prior withdrawal of steroid replacement medication.…”

“…Accord ingly, ACTH peptides did not affect delayed recall per formance in several other studies Schneider et al. 1981;Veith et al. 1985].…”

Identification of Candidate Genes for Dyslexia Susceptibility on Chromosome 18

“…The melanocortins are involved in skin physiology, behaviour, learning and memory [54], [55], [56]. ACHT, or peptides derived from it, are implicated in attention, visual attention, analytical thinking, spatial awareness and musical ability [57], [58], [59], [60]. MC5R is a single exon gene less than 1 kb in length.…”

Quality of Life and Cognitive Function in Patients with Pituitary Insufficiency

“…Visual attention and the associated motor responses have also been found to improve when with pubertal delay were found to increase self-reported aggressive behaviour in boys and girls, respectively [59]. ACTH levels were raised [52]. In MPHD patients, the observed subnormal perceptual-motor skills were attri-Moderate concentrations of oestradiol have been associated with positive effects on mood and behaviour, whereas buted to ACTH deficiency on the basis of the inverse correlation between hydrocortisone replacement dose and a lack of oestradiol is tied to depression and emotional lability.…”