Glucocorticoid therapy-induced memory deficits: Acute versus chronic effects
Glucocorticoid therapy-induced memory deficits: Acute versus chronic effects
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DOI：
10.1523/jneurosci.4893-07.2008
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发表时间：
2008-03-26
影响因子：
5.3
通讯作者：
de Quervain, Dominique J. -F.
中科院分区：
文献类型：
--
作者：
Coluccia, Daniel;Wolf, Oliver T.;de Quervain, Dominique J. -F.
糖皮质激素水平长期升高的情况通常与陈述性记忆缺陷有关。大量证据表明，长期接触糖皮质激素可能通过累积和长期影响海马区的功能和形态而导致认知损害。然而，由于在保留测试时升高的糖皮质激素水平也已知对记忆恢复有直接损害作用，这种对恢复过程的剧烈激素影响可能导致长期接触糖皮质激素后发现的记忆缺陷。为了研究这一问题，我们检测了24例类风湿关节炎患者的记忆功能和海马体体积，这些患者接受了长期(5.3+/-1.0岁，平均+/-SE)的低至中剂量泼尼松(7.5+/-0.8 mg，平均+/-SE)或不使用糖皮质激素的治疗。在两组中，在双盲、安慰剂对照的交叉设计中，在糖皮质激素水平升高或基础糖皮质激素水平升高的条件下，对24小时前学习的单词的延迟回忆进行评估。尽管在这一患者群体中的研究结果没有提供证据表明长期服用泼尼松对记忆能力或海马体体积本身的有害影响，但在保留测试之前1小时，无论是类固醇组还是非类固醇组，急性服用泼尼松都会损害单词记忆。因此，这些发现表明，在糖皮质激素水平长期升高的情况下观察到的记忆缺陷，至少部分是由于糖皮质激素对记忆提取的急性和可逆性影响。
Conditions with chronically elevated glucocorticoid levels are usually associated with declarative memory deficits. Considerable evidence suggests that long- term glucocorticoid exposure may cause cognitive impairment via cumulative and long- lasting influences on hippocampal function and morphology. However, because elevated glucocorticoid levels at the time of retention testing are also known to have direct impairing effects on memory retrieval, it is possible that such acute hormonal influences on retrieval processes contribute to the memory deficits found with chronic glucocorticoid exposure. To investigate this issue, we examined memory functions and hippocampal volume in 24 patients with rheumatoid arthritis who were treated either chronically (5.3 +/- 1.0 years, mean +/- SE) with low to moderate doses of prednisone (7.5 +/- 0.8 mg, mean +/- SE) or without glucocorticoids. In both groups, delayed recall of words learned 24 h earlier was assessed under conditions of either elevated or basal glucocorticoid levels in a double-blind, placebo-controlled crossover design. Although the findings in this patient population did not provide evidence for harmful effects of a history of chronic prednisone treatment on memory performance or hippocampal volume per se, acute prednisone administration 1 h before retention testing to either the steroid or nonsteroid group impaired word recall. Thus, these findings indicate that memory deficits observed under chronically elevated glucocorticoid levels result, at least in part, from acute and reversible glucocorticoid effects on memory retrieval.