Examining cortisol rhythmicity and responsivity to stress in children with Tourette syndrome
Examining cortisol rhythmicity and responsivity to stress in children with Tourette syndrome
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DOI：
10.1016/j.psyneuen.2008.03.014
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发表时间：
2008-07-01
影响因子：
3.7
通讯作者：
Levine, S.
中科院分区：
文献类型：
--
作者：
Corbett, B. A.;Mendoza, S. P.;Levine, S.
背景：多发性抽动症(TS)以运动和声带痉挛为特征，常因应激而加重。下丘脑-垂体-肾上腺皮质(HPA)轴是了解TS的主要应激反应系统。方法：对7-13岁TS患儿(N=20)和健康对照组(N=16)进行皮质醇昼夜节律测定。连续3天在家中采集唾液样本。通过检测模拟和真实MRI扫描的皮质醇来评估HPA的反应性。结果：昼夜节律性的结果显示，TS组的夜间皮质醇有轻微降低的趋势。相比之下，TS组对应激源的反应具有更高的皮质醇水平。夜间皮质醇水平与抽动严重程度呈显著负相关，夜间皮质醇水平与焦虑程度呈显著负相关。结论：TS患儿在MRI环境下表现为皮质醇升高，支持HPA反应性增强模型。晚间皮质醇降低可能是慢性日常压力的结果。或者，皮质醇与报告的焦虑和抽搐之间的负关联可能反映了抽搐表达的基于生物学的抗焦虑特性。综上所述，这些结果清楚地表明HPA轴参与了TS的神经病理。(C)2008爱思唯尔有限公司。保留所有权利。
Background: Tourette syndrome (TS) is characterized by motor and vocal tics, which are often exacerbated by stress. The hypothalamic-pituitary-adrenocortical (HPA) axis, a major stress response system is thus of interest for understanding TS.Methods: Diurnal cortisol rhythms were estimated in medication-free children 7-13 years with TS (N = 20) and healthy age-matched controls (N = 16). Salivary samples were collected on 3 consecutive days from the home. HPA responsivity was assessed by examining cortisol in response to a mock and real MRI scan.Results: The results of diurnal rhythmicity revealed a trend showing marginally lower evening cortisol for the TS group. By contrast, the TS group had higher cortisol levels in response to the stressor. There were strong, negative correlations between evening cortisol and tic severity as well as diurnal cortisol and anxiety.Conclusions: The children with TS showed increased cortisol in response to the MRI environment, supporting a model of enhanced HPA responsivity. The lower evening cortisol may be the result of chronic daily stress. Alternatively, the negative associations between cortisol and reported anxiety and tics may reflect biologically based anxiolytic properties of tic expression. Taken together, the results clearly implicate involvement of the HPA axis in the neuropathology of TS. (c) 2008 Elsevier Ltd. All rights reserved.