Treatment-seeking inpatient cocaine abusers show hypothalamic dysregulation of both basal prolactin and cortisol secretion
Treatment-seeking inpatient cocaine abusers show hypothalamic dysregulation of both basal prolactin and cortisol secretion
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DOI：
10.1159/000072797
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发表时间：
2003-09-01
影响因子：
4.1
通讯作者：
Hess, J
中科院分区：
文献类型：
--
作者：
Contoreggi, C;Herning, RI;Hess, J
可卡因导致可卡因滥用者的神经内分泌异常，脑下垂体应激激素的分泌为大脑中的应激系统提供了一个窗口。对物质滥用者和对照组参与者进行为期3周的激素评估。滥用者的基础催乳素水平在第1周显著升高，3周后恢复正常。无论是促甲状腺激素释放激素刺激试验还是L多巴抑制试验，催乳素的分泌都没有发现差异。在第1周和第2周，与对照组相比，基础下午皮质醇分泌显著增加。下午皮质醇分泌升高是中枢应激激活的敏感指标。这些结果表明，在可卡因戒断过程中，下丘脑而不是脑垂体主要发生了变化。数据表明，在可卡因戒断过程中，多巴胺-催乳素和下丘脑-垂体-肾上腺(HPA)轴都受到影响。随着药物被开发来调节功能失调的应激系统的激活，未来关于药物滥用、戒断、渴求和复发的治疗研究应该使用更复杂的下丘脑垂体功能测试，特别是HPA轴，因为这些信息可能会成为诊断和预测临床反应的指南。版权所有(C)2003 S.Karger AG，巴塞尔。
Cocaine causes neuroendocrine aberrations in cocaine abusers with pituitary stress hormone secretion providing a window to the stress system in the brain. Substance abusers and control participants were hormonally profiled for 3 weeks. Abusers showed significant basal elevations in prolactin in week 1 with normalization over the 3 weeks. No differences in prolactin secretion were seen with either thyrotropin-releasing hormone stimulation or L-dopa suppression testing. Basal afternoon cortisol secretion was significantly elevated during weeks 1 and 2 comparing abusers to controls. Elevated afternoon cortisol secretion is a sensitive indicator of central stress activation. These results point to the hypothalamus, not the pituitary gland, as being primarily altered in cocaine withdrawal. The data demonstrate that both the dopamine-prolactin and hypothalamic-pituitary-adrenal (HPA) axes are affected during cocaine cessation. As medications are developed to modulate activation of a dysfunctional stress system, future therapeutic studies of substance abuse, withdrawal, craving and relapse should employ more sophisticated tests of hypothalamic pituitary function, especially the HPA axis, as this information may be a guide in the diagnosis and predict clinical responses. Copyright (C) 2003 S. Karger AG, Basel.