Effects of cortisol on cognition in major depressive disorder, posttraumatic stress disorder and borderline personality disorder - 2014 Curt Richter Award Winner
Effects of cortisol on cognition in major depressive disorder, posttraumatic stress disorder and borderline personality disorder - 2014 Curt Richter Award Winner
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DOI：
10.1016/j.psyneuen.2014.10.009
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发表时间：
2015-01
影响因子：
3.7
通讯作者：
K. Wingenfeld;O. Wolf
中科院分区：
文献类型：
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作者：
K. Wingenfeld;O. Wolf
应激激素影响广泛的认知功能，包括记忆表现和执行功能。众所周知，糖皮质激素增强记忆巩固，但损害记忆提取。虽然糖皮质激素受体（GR）是主要的作用机制，但盐皮质激素受体（MR）的作用也受到重视。虽然重性抑郁症（MDD）以及边缘型人格障碍（BPD）的特点似乎是皮质醇释放增强与HPA轴反馈敏感性降低，在创伤后应激障碍（PTSD）的情况相反。尽管事实上，改变GR功能已被讨论这些疾病只有很少的研究已经调查了糖皮质激素对认知性能的影响，在这些patients.In一系列的研究中，我们调查了糖皮质激素对认知（即陈述性记忆，工作记忆和反应抑制）在不同的精神障碍，如MDD，PTSD和BPD的影响。虽然在MDD患者皮质醇管理未能影响记忆检索，PTSD和BPD患者表现出增强，而不是皮质醇管理后受损的记忆检索。这些结果表明这些疾病对皮质醇的敏感性改变。我们最近在社会认知领域的一项研究结果强调了MR的重要性。我们发现，在健康参与者和BPD女性中，通过氟氢可的松刺激MR，情感同理心得到增强。本文旨在整合这些发现，并讨论潜在的机制和影响。
Stress hormones influence a wide range of cognitive functions, including memory performance and executive function. It is well established that glucocorticoids enhance memory consolidation but impair memory retrieval. While most of the effects have been attributed to glucocorticoid receptors (GR), the importance of mineralocorticoid receptors (MR) has been also emphasized.Dysfunctions in hypothalamic–pituitary–adrenal (HPA) axis have been reported for several mental disorders. While major depressive disorder (MDD) as well as borderline personality disorder (BPD) seem to be characterized by enhanced cortisol release in concert with a reduced feedback sensitivity of the HPA axis, in posttraumatic stress disorder (PTSD) a contrary picture has been reported. Despite the fact that altered GR function has been discussed for these disorders only very few studies have investigated the effects of glucocorticoids on cognitive performance in these patients so far.In a series of studies, we investigated the effects of glucocorticoids on cognition (i.e. declarative memory, working memory and response inhibition) in different mental disorders such as MDD, PTSD and BPD. While in patients with MDD cortisol administration failed to effect memory retrieval, patients with PTSD and BPD showed enhanced rather than impaired memory retrieval after cortisol administration. These results indicate an altered sensitivity to cortisol in these disorders. Results from one of our recent studies in the field of social cognition underline the importance of the MR. We found that emotional empathy was enhanced through stimulation of the MR via fludrocortisone in healthy participants and women with BPD. This review aims to integrate these findings and discuss potential mechanisms and implications.