Response to Corticotropin-Releasing Hormone Infusion in Cocaine-Dependent Individuals
Response to Corticotropin-Releasing Hormone Infusion in Cocaine-Dependent Individuals
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DOI：
10.1001/archgenpsychiatry.2009.9
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发表时间：
2009-04-01
影响因子：
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通讯作者：
Kreek, Mary Jeanne
中科院分区：
文献类型：
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作者：
Brady, Kathleen T.;McRae, Aimee L.;Kreek, Mary Jeanne
背景：促肾上腺皮质激素释放激素（CRH）通过下丘脑-垂体-肾上腺轴和其他脑应激系统参与与可卡因依赖相关的情绪失调。我们对可卡因依赖者对CRH的反应知之甚少。目的：主要目的是检查可卡因依赖个体和对照组的下丘脑-垂体-肾上腺轴以及对CRH的主观和生理反应。设计：病例对照研究。环境：受试者被送入普通临床研究中心进行测试，并通过尿液药物筛选证实禁欲。参与者：参与者为男性对照组（n= 23），女性对照组（n= 24），可卡因依赖男性（n= 28）和可卡因依赖女性（n= 25）。对其他物质（咖啡因或尼古丁除外）有依赖或患有严重抑郁症、创伤后应激障碍、双相情感障碍、精神病或饮食障碍的个体被排除在外。干预：受试者静脉注射1 μ g/kg的CRH。主要结局指标：主要结局包括血浆促肾上腺皮质激素水平、皮质醇水平、心率和主观测量。结果：可卡因依赖者表现出较高的应激水平(P
Context: Corticotropin-releasing hormone (CRH), through the hypothalamic pituitary adrenal axis and other brain stress systems, is involved in the emotional dysregulation associated with cocaine dependence. Little is known about the response of cocaine-dependent individuals to CRH administration.Objective: The primary objective was to examine the hypothalamic-pituitary-adrenal axis and the subjective and physiologic response to CRH in cocaine-dependent individuals and controls.Design: A case-control study.Setting: Subjects were admitted to a General Clinical Research Center for testing and abstinence was verified with a urine drug screening.Participants: Participants were male controls (n= 23), female controls ( n= 24), cocaine-dependent men ( n= 28), and cocaine-dependent women ( n= 25). Individuals with dependence on other substances ( except caffeine or nicotine) or with major depression, posttraumatic stress disorder, bipolar disorder, or psychotic or eating disorders were excluded.Intervention: Subjects received 1 mu g/kg of CRH intravenously.Main Outcome Measures: Primary outcomes included plasma corticotropin levels, cortisol levels, and heart rate and subjective measurements.Results: Cocaine-dependent individuals exhibited higher stress ( P