David Baxter PhD
Late Founder
Glucocorticoid receptor dysfunction may explain memory problems in depression
By David Douglas, Modern Medicine
May 26, 2011
Hydrocortisone impairs memory in healthy subjects but not in patients with major depressive disorder (MDD), and German researchers suspect that's because central glucocorticoid receptor function is reduced in depression.
In an April 19th online paper in the Journal of Clinical Psychiatry, Dr. Katja Wingenfeld of University Medical Center Hamburg-Eppendorf and colleagues observe that MDD has been associated with hypercortisolism, reduced glucocorticoid feedback sensitivity, and impaired memory function. Many patients have hypothalamic-pituitary-adrenal axis (HPA) dysregulation.
"Surprisingly," say the investigators, "only a few studies have investigated the association between HPA axis functioning and memory performance in depression."
Their report describes a double-blind crossover study of 44 patients and 51 healthy controls. Baseline cortisol levels did not differ between patients and controls, suggesting comparable cortisol release.
Subjects received either placebo or 10 mg of hydrocortisone orally before declarative memory testing.
Each participant was tested twice with parallel versions of a word list paradigm and the Logical Memory Test from the Wechsler Memory Scale.
In both memory tests, patients with MDD performed worse than controls.
For example, after placebo, depressed patients showed a significantly poorer retrieval performance compared to controls. The increase of cortisol after hydrocortisone treatment did not influence their results.
But unlike the depressed patients, the controls showed impaired memory performance after hydrocortisone administration.
The researchers concede that "many patients in our study were medicated, which might have influenced HPA-axis functioning, glucocorticoid sensitivity, and memory performance."
Nevertheless, Dr. Wingenfeld told Reuters Health by email that "our results further strengthen the hypothesis of reduced central glucocorticoid receptor functioning in MDD."
"In fact," she concluded, "the corticosteroid receptor hypothesis of depression has stimulated pharmacologic research to strive for new antidepressant agents that act directly on different sites within the HPA axis."
SOURCE: J Clin Psychiatry / Document Archive
J Clin Psychiatry 2011.
By David Douglas, Modern Medicine
May 26, 2011
Hydrocortisone impairs memory in healthy subjects but not in patients with major depressive disorder (MDD), and German researchers suspect that's because central glucocorticoid receptor function is reduced in depression.
In an April 19th online paper in the Journal of Clinical Psychiatry, Dr. Katja Wingenfeld of University Medical Center Hamburg-Eppendorf and colleagues observe that MDD has been associated with hypercortisolism, reduced glucocorticoid feedback sensitivity, and impaired memory function. Many patients have hypothalamic-pituitary-adrenal axis (HPA) dysregulation.
"Surprisingly," say the investigators, "only a few studies have investigated the association between HPA axis functioning and memory performance in depression."
Their report describes a double-blind crossover study of 44 patients and 51 healthy controls. Baseline cortisol levels did not differ between patients and controls, suggesting comparable cortisol release.
Subjects received either placebo or 10 mg of hydrocortisone orally before declarative memory testing.
Each participant was tested twice with parallel versions of a word list paradigm and the Logical Memory Test from the Wechsler Memory Scale.
In both memory tests, patients with MDD performed worse than controls.
For example, after placebo, depressed patients showed a significantly poorer retrieval performance compared to controls. The increase of cortisol after hydrocortisone treatment did not influence their results.
But unlike the depressed patients, the controls showed impaired memory performance after hydrocortisone administration.
The researchers concede that "many patients in our study were medicated, which might have influenced HPA-axis functioning, glucocorticoid sensitivity, and memory performance."
Nevertheless, Dr. Wingenfeld told Reuters Health by email that "our results further strengthen the hypothesis of reduced central glucocorticoid receptor functioning in MDD."
"In fact," she concluded, "the corticosteroid receptor hypothesis of depression has stimulated pharmacologic research to strive for new antidepressant agents that act directly on different sites within the HPA axis."
SOURCE: J Clin Psychiatry / Document Archive
J Clin Psychiatry 2011.
