Higher levels of basal serial CSF cortisol in combat veterans with posttraumatic stress disorder
Higher levels of basal serial CSF cortisol in combat veterans with posttraumatic stress disorder
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DOI：
10.1176/appi.ajp.162.5.992
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发表时间：
2005-05-01
影响因子：
17.7
通讯作者：
Geracioti, TD
中科院分区：
文献类型：
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作者：
Baker, DG;Ekhator, NN;Geracioti, TD
目的：创伤后应激障碍(PTSD)患者的基础外周皮质醇测定结果各不相同。作者的目标是测定患有和不患有创伤后应激障碍的受试者的脑脊液皮质醇浓度。方法：从蛛网膜下腔导管和静脉导管中取出脑脊液，间隔6小时测定每小时血浆ACTH和皮质醇浓度以及8名匹配的健康志愿者每小时血浆ACTH和皮质醇浓度。结果：PTSD受试者的平均脑脊液皮质醇浓度(3.18 ng/ml，SD=0.33)显著高于正常志愿者(2.33 ng/ml，SD=0.50)。这在很大程度上是由于脑脊液皮质醇浓度升高所致。两组间血浆ACTH和外周(血浆或尿液游离)皮质醇水平均无差异。脑脊液促肾上腺皮质激素释放激素与脑脊液皮质醇浓度呈显著正相关。结论：退伍军人创伤后应激障碍患者外周血皮质醇指数正常，但中枢神经系统皮质醇暴露高于正常对照组。
Objective: Results of basal peripheral cortisol measures in posttraumatic stress disorder ( PTSD) have been variable. The authors' goal was to measure CSF cortisol concentrations, which more accurately reflect brain glucocorticoid exposure, in subjects with or without PTSD.Method: CSF was withdrawn from a subarachnoid catheter and plasma from a venous catheter, both indwelling, over a 6-hour interval to determine hourly plasma ACTH and cortisol concentrations and hourly CSF cortisol levels in eight well-characterized combat veterans with PTSD and eight matched healthy volunteers.Results: Mean CSF cortisol concentrations were significantly higher in the subjects with PTSD (3.18 ng/ml, SD = 0.33) than in the normal volunteers (2.33 ng/ml, SD = 0.50), largely due to higher CSF cortisol concentration nadirs. No group differences were observed in either plasma ACTH or peripheral ( plasma or urinary free) cortisol. CSF corticotropin-releasing hormone and CSF cortisol concentrations were positively and significantly correlated.Conclusions: Despite normal peripheral cortisol indexes in the veterans with PTSD, their CNS exposure to cortisol was greater than that of normal comparison subjects.