Delta sleep response to metyrapone in post-traumatic stress disorder
| Autor: | Frank B. Schoenfeld, Nicholas Z. Rosenlicht, Maryanne Lenoci, Melissa L. Maglione, Charles R. Marmar, Thomas J. Metzler, Rachel Yehuda, Thomas C. Neylan, Christian Otte |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Male medicine.medical_specialty Hydrocortisone Polysomnography Cortodoxone Sleep REM Adrenocorticotropic hormone Stress Disorders Post-Traumatic Adrenocorticotropic Hormone Internal medicine medicine Humans Enzyme Inhibitors Slow-wave sleep Veterans Pharmacology Metyrapone medicine.diagnostic_test Electromyography Electroencephalography Middle Aged Sleep in non-human animals Psychiatry and Mental health Endocrinology Delta Rhythm Case-Control Studies Sleep onset Psychology medicine.drug |
| Zdroj: | Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology. 28(9) |
| ISSN: | 0893-133X |
| Popis: | Metyrapone blocks cortisol synthesis, which results in the stimulation of hypothalamic cortiocotropin-releasing factor (CRF) and a reduction in delta sleep. We examined the effect of metyrapone administration on endocrine and sleep measures in male subjects with and without chronic PTSD. We hypothesized that metyrapone would result in a decrease in delta sleep and that the magnitude of this decrease would be correlated with the endocrine response. Finally, we utilized the delta sleep response to metyrapone as an indirect measure of hypothalamic CRF activity and hypothesized that PTSD subjects would have decreased delta sleep at baseline and a greater decrease in delta sleep induced by metyrapone. Three nights of polysomnography were obtained in 24 male subjects with combat-related PTSD and 18 male combat-exposed normal controls. On day 3, metyrapone was administered during normal waking hours until habitual sleep onset preceding night 3. Endocrine responses to metyrapone were measured in plasma obtained the morning following sleep recordings, the day before and after administration. Repeated measures ANOVAs were conducted to compare the endocrine and sleep response to metyrapone in PTSD and controls. PTSD subjects had significantly less delta sleep as indexed by stages 3 and 4, and total delta integrated amplitude prior to metyrapone administration. There were no differences in premetyrapone cortisol or ACTH levels in PTSD vs controls. PTSD subjects had a significantly decreased ACTH response to metyrapone compared to controls. Metyrapone caused an increase in awakenings and a marked decrease in quantitative measures of delta sleep that was significantly greater in controls compared to PTSD. The decline in delta sleep was significantly associated with the magnitude of increase in both 11-deoxycortisol and ACTH. The results suggest that the delta sleep response to metyrapone is a measure of the brain response to increases in hypothalamic CRF. These data also suggest that the ACTH and sleep EEG response to hypothalamic CRF is decreased in PTSD. |
| Databáze: | OpenAIRE |
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