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Journal Article 2008; 29(3): 385-390 PubMed PMID: 18580847 Citation  Keywords:  5-Hydroxytryptophan, Adolescent, Analysis of Variance, Autistic Disorder:blood, Dehydroepiandrosterone Sulfate:blood, Humans, Hydrocortisone:blood, Male, Psychiatric Status Rating Scales, Serotonin:blood, Single-Blind Method,.   

BACKGROUND: Autism is accompanied by peripheral and central disorders in the metabolism of serotonin (5-HT). The present study examines plasma dehydroepiandrosterone-sulphate (DHEA-S) and the cortisol/DHEA-S ratio following administration of L-5-hydroxytryptophan (5-HTP), the direct precursor of 5-HT, to autistic patients.

METHODS: Plasma DHEA-S levels were determined both before and after administration of 5-HTP or placebo, on two consecutive days in a single blind order in 18 male autistic patients and 22 matched healthy controls.

RESULTS: The 5-HTP-induced DHEA-S responses were significantly higher in autistic patients than in controls. In baseline conditions, the cortisol/DHEA-S ratio was significantly higher in autistic patients than in controls.

DISCUSSION: The results suggest that autism is accompanied by a major disequilibrium in the serotonergic system. The increased Cortisol (neurotoxic) versus DHEA-S (neuroprotective) ratio suggests that an increased neurotoxic potential occurs in autism.

CONCLUSIONS: It is concluded that a disequilibrium in the peripheral and central turnover of serotonin and an increased neurotoxic capacity by glucocorticoids are important pathways in autism....

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Journal Article 2008; 29(2): 235-239 PubMed PMID: 18404142 Citation  Keywords:  Adult, Depressive Disorder:blood, Dissociative Disorders:blood, Female, Humans, Hydrocortisone:blood, Hypothalamo-Hypophyseal System:physiopathology, Male, Middle Aged, Pituitary-Adrenal System:physiopathology, Somatoform Disorders:blood, Stress, Physiolo.   

OBJECTIVE: According to recent findings neuroendocrine response related to dissociative symptoms is related to dysregulation of the hypothalamus-pituitary-adrenal (HPA) axis but HPA axis functioning as related to dissociation is only partially understood.

METHOD: With the aim to test the relationship between basal serum cortisol and dissociative symptoms measured as somatoform and psychic dissociation we performed clinical testing and biochemical analysis in 30 inpatients with diagnosis of unipolar depression (mean age 41.46, SD=13.68).

RESULTS: The results show that cortisol as an index of HPA axis functioning manifests significant relationship to somatoform dissociative symptoms (r=-0.40; p=0.014).

CONCLUSIONS: The result indicates relationship between HPA-axis reactivity and somatoform dissociative symptoms in unipolar depressive patients and suggests that somatoform dissociation presents a defense mechanism related to a passive coping response....

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Comparative Study 2008; 29(1): 141-145 PubMed PMID: 18283269 Citation  Keywords:  Adolescent, Adrenocorticotropic Hormone:blood, Blood Pressure:physiology, Child, Child, Preschool, Female, Humans, Hydrocortisone:blood, Lipids:blood, Male, Metabolic Syndrome X:blood, Obesity:blood, Risk Factors,.   

OBJECTIVES: The aim of this study was to investigate the relationship between the varying degrees of obesity and blood glucocorticoid levels in obese children and adolescents with and without metabolic syndrome features.

METHODS: We studied 241 obese children and adolescents aged between 2 and 17.6 years; 127 boys and 114 girls. All children underwent an oral glucose tolerance test. Measurements included blood pressure, cortisol, ACTH, and lipid profiles. The diagnosis of metabolic syndrome was defined according to the criteria adapted from World Health Organisation and National Cholesterol Education Program Adult Treatment Panel-III guidelines.

RESULTS: Blood cortisol and ACTH levels were higher in patients with MS than without MS (p = 0.02). ACTH levels increased with weight (r = 0.13, p = 0.02), systolic blood pressure (r = 0.21, p = 0.002), diastolic blood pressure (r = 0.17, p = 0.01), fasting glucose (r = 0.17, p = 0.01). Cortisol production was only correlated with systolic blood pressure (r = 0.12, p = 0.05).

CONCLUSIONS: Results from the present study indicates that there may be a link between cortisol production and the metabolic syndrome in obese children and adolescents....

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Case Reports 2007; 28(6): 745-748 PubMed PMID: 18063931 Citation  Keywords:  Adrenal Insufficiency:blood, Adrenocorticotropic Hormone:blood, Empty Sella Syndrome:blood, Female, Hormone Replacement Therapy, Humans, Hydrocortisone:blood, Hypoglycemia:blood, Hyponatremia:blood, Methylprednisolone:therapeutic use, Middle Aged, Pituita.   

: Isolated ACTH deficiency is an uncommon cause of secondary adrenocortical insufficiency and accompaniment with primary empty sella has been reported in several cases. We present a case of isolated ACTH deficiency associated with empty sella. A sixty-two year old woman was admitted to our endocrine clinic with complaints of weakness, fatigue, weight loss, nausea, vomiting, and lack of appetite for about one month. Physical examination indicated orthostatic hypotension and epigastric tenderness. Laboratory investigations revealed hypoglycemia, hyponatremia and anemia, in addition low plasma cortisole and ACTH levels. Serum cortisole responses to short and prolonged ACTH stimulation were tested and partial and accurate responses were obtained, respectively. Plasma ACTH and serum cortisole levels failed to respond after intravenous injection of human corticotropin releasing hormone. Other hypophysial hormone levels were within the normal reference ranges. Although cranial and abdominal computerized tomography images were evaluated as normal, cranial magnetic resonance imaging of the pituitary gland revealed 'primary empty sella turcica'. Replacement therapy with methylprednisolon resulted in the improvement of hypoglycemia, hyponatremia and clinical symptoms. Based on these results, the patient was diagnosed as isolated ACTH deficiency and was scheduled for follow up by our outpatient clinic. Our report is consistent with other reports pointing out that primary empty sella may be responsible for pathogenesis of isolated ACTH deficiency....

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Journal Article 2007; 28(5): 610-613 PubMed PMID: 17984936 Citation  Keywords:  Adjustment Disorders:blood, Adrenocorticotropic Hormone:blood, Adult, Anxiety Disorders:blood, Circadian Rhythm:physiology, Crime Victims:psychology, Dehydroepiandrosterone:blood, Depressive Disorder:blood, Female, Humans, Hydrocortisone:blood, MMPI, Male.   

OBJECTIVES: Evidence in the literature suggests stress-related changes of hypothalamus-pituitary-adrenal (HPA) axis in mobbing. We investigated the association between HPA activity and psychological profiles in mobbing, using a multidisciplinary approach.

DESIGN: Forty-eight victims of mobbing were evaluated by a working group of the Departments of Occupational Medicine, Psychiatry and Internal Medicine. After an informed consent, a detailed occupational history, a psychiatric interview with Minnesota Multiphasic Personality Inventory 2 (MMPI-2) administration and a blood sample (8:00 AM) for the determination of basal adrenocorticotropin (ACTH), cortisol and dehydroepiandrosterone sulphate (DHEAS) plasma levels were collected. Twenty-six patients received an overnight dexamethasone (dex) test.

RESULTS: Mean ACTH, cortisol and DHEAS levels were within normal ranges. The dex-test response was normal, with a significant hormone suppression (ACTH p<0.001, cortisol p<0.001, DHEAS p<0.001). The correlations between basal hormones and the psychometric scales of MMPI-2 revealed that cortisol was significantly and negatively related to Psychasthenia (Pt, p=0.003) and Depression (D, p=0.006), while DHEAS showed a significant negative correlation to Hysteria (Hy, p=0.008). Basal ACTH levels were not significantly related to psychometric scales.

CONCLUSION: A significant inverse correlation between morning plasma cortisol levels and psychometric parameters in victims of mobbing with adjustment disorders was observed. A larger group of patients is necessary to identify and validate a cut-off cortisol level that may become an innovative biological parameter for the diagnosis and follow-up in victims of mobbing....

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Journal Article 2007; 28(4): 449-455 PubMed PMID: 17693983 Citation  Keywords:  5-Hydroxytryptophan:administration & dosage, Adolescent, Adult, Analysis of Variance, Antidepressive Agents, Second-Generation:administration & dosage, Autistic Disorder:blood, Case-Control Studies, Child, Humans, Hydrocortisone:blood, Male, Prolactin:blo.   

: Some studies have suggested that disorders in the central serotonergic function may play a role in the pathophysiology of autistic disorder. In order to assess the central serotonergic turnover in autism, this study examines the cortisol and prolactin responses to administration of L-5-hydroxy-tryptophan (5-HTP), the direct precursor of 5-HT in 18 male, post-pubertal, Caucasian autistic patients (age 13-19 y.; I.Q.>55) and 22 matched healthy volunteers. Serum cortisol and prolactin were determined 45 and 30 minutes before administration of 5-HTP (4 mg/kg in non enteric-coated tablets) or an identical placebo in a single blind order and, thereafter, every 30 minutes over a 3-hour period. The 5-HTP-induced increases in serum cortisol were significantly lower in autistic patients than in controls, whereas there were no significant differences in 5-HTP-induced prolactin responses between both study groups. In baseline conditions, no significant differences were found in serum cortisol and prolactin between autistic and normal children. The results suggest that autism is accompanied by a central serotonergic hypoactivity and that the latter could play a role in the pathophysiology of autism....

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Comparative Study 2007; 28(4): 433-437 PubMed PMID: 17693981 Citation  Keywords:  Adolescent, Adult, Endocrine System:physiology, Female, Humans, Hydrocortisone:blood, Male, Odorants, Olfactory Pathways:physiology, Sex Characteristics, Testosterone:blood,.   

OBJECTIVES: This study aimed to verify the influence of odor on the endocrine system (Cortisol, Testosterone).

MATERIAL AND METHODS: Three odors (Musk, Rose and Floral) and air were given to 16 healthy volunteers (8 males, 8 females), and cortisol (C) and testosterone (T) levels were measured before and after stimulation.

RESULTS: Each odor decreased levels of C, indicating that odor can attenuate stress. In males, T decreased with Musk, but increased with Floral. In females, T significantly increased with Musk, but decreased with Rose and Floral.

CONCLUSIONS: These results indicate that influences on hormone levels depend on the type of odor, and sex differences exist in response to odors....

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Clinical Trial 2007; 28(2): 106-109 PubMed PMID: 17435679 Citation  Keywords:  Adult, Cognition:physiology, Depressive Disorder:blood, Electrocardiography, Female, Gyrus Cinguli:physiopathology, Heart Rate, Humans, Hydrocortisone:blood, Male, Middle Aged, Neuropsychological Tests, Task Performance and Analysis,.   

OBJECTIVE: According to recent findings detecting a cognitive conflict is related to activation of anterior cingulate cortex (ACC) and central autonomic network. Several recent findings also suggest the hypothesis that the cognitive conflict is related to specific nonlinear chaotic changes of the neural signal. This conflict related activation elicits autonomic responses which can be assessed by psychophysiological measures such as heart rate variability calculated as beat to beat R-R intervals (RRI).

METHOD: The present study used Stroop word-colour test as an experimental approach to psychophysiological study of cognitive conflict in connection with RRI measurement, assessment of serum cortisol and calculation of largest Lyapunov exponents in nonlinear data analysis of RRI time series in 30 patients with unipolar depression.

RESULTS: Significant correlation -0.45 (p<0.01) between largest Lyapunov exponents during conflicting Stroop task and serum cortisol levels has been found.

CONCLUSIONS: The study indicates that a defect of neural inhibition during conflicting Stroop task is closely related to decreased serum cortisol levels which probably reflect defense psychological mechanisms....

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