Circadian cortisol and fatigue severity in relapsing-remitting multiple sclerosis
Circadian cortisol and fatigue severity in relapsing-remitting multiple sclerosis
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DOI：
10.1016/j.psyneuen.2015.03.010
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发表时间：
2015-06-01
影响因子：
3.7
通讯作者：
Schlotz, Wolff
中科院分区：
文献类型：
--
作者：
Powell, Daniel J. H.;Moss-Morris, Rona;Schlotz, Wolff
皮质醇是免疫系统、能量代谢和压力的关键调节因子，但它与复发缓解型多发性硬化症(RRMS)患者所经历的疲劳的相关性仍不确定。我们采用病例对照的生态学瞬时评估设计，研究了RRMS的皮质醇分泌活性及其与个体间和个体内(日常)疲劳严重程度的关系。在进行日常生活的同时，38名RRMS患者和38名健康对照参与者在连续4个工作日的战略时间点采集唾液样本，以测量皮质醇觉醒反应(CAR；觉醒后0、30和45min)和每日皮质醇斜率(DC；6个准随机样本，在1000h至2000h之间提供)。回想起的疲劳是在基线上测量的，日常疲劳是根据每个DCS样本提供的瞬时疲劳评级的平均值来测量的。多水平建模发现，RRMS患者的汽车输出比对照组更大，RRMS患者的回忆疲劳与较低的清醒皮质醇水平和较大的唤醒反应有关。从日常来看，这辆车与RRMS中的当天疲劳水平没有关联。皮质醇似乎在RRMS经历的疲劳中起到了作用，但它是否是一个原因尚不清楚。(C)2015年提交人。爱思唯尔有限公司出版。
Cortisol is a key regulator of the immune system, energy metabolism, and stress, yet its relevance to fatigue experienced by people with relapsing-remitting multiple sclerosis (RRMS) remains uncertain. We examined cortisol secretory activity in RRMS and its association with fatigue severity between-individuals and within-individuals (day-to-day) using a case-control ecological momentary assessment design. While undergoing usual daily routines, 38 people with RRMS and 38 healthy control participants provided saliva samples at strategic time-points over 4 consecutive weekdays to measure the cortisol awakening response (CAR; 0, 30, and 45 min after awakening) and the diurnal cortisol slope (DCS; 6 quasi-random samples provided between 1000 h and 2000h). Recalled fatigue was measured at baseline, and daily fatigue was measured as the mean average of momentary fatigue ratings provided alongside each DCS sample. Multilevel modeling found CAR output was greater in RRMS than controls, and recalled fatigue in RRMS was associated with both lower waking cortisol level and larger awakening response. Day-to-day, the CAR was not associated with same-day fatigue levels in RRMS. Cortisol appears to have a role in fatigue experienced in RRMS, but whether it is a causal factor remains unclear. (C) 2015 The Authors. Published by Elsevier Ltd.