Hyperstable arousal regulation in multiple sclerosis

Autor: Sebastian Olbrich, Florian Then Bergh, Klara Meyer, Maike Schlingmann, Muriel Stoppe
Rok vydání: 2018
Předmět:
Adult
Male
medicine.medical_specialty
Hypothalamo-Hypophyseal System
Corticotropin-Releasing Hormone
Endocrinology
Diabetes and Metabolism
media_common.quotation_subject
Pituitary-Adrenal System
Dexamethasone
Arousal
03 medical and health sciences
Corticotropin-releasing hormone
Young Adult
0302 clinical medicine
Endocrinology
Multiple Sclerosis
Relapsing-Remitting
Mental stress
Internal medicine
medicine
Humans
In patient
Biological Psychiatry
Fatigue
media_common
Endocrine and Autonomic Systems
business.industry
Multiple sclerosis
medicine.disease
030227 psychiatry
Psychiatry and Mental health
medicine.anatomical_structure
Case-Control Studies
Female
Pituitary-Adrenal Function Tests
business
030217 neurology & neurosurgery
Hypothalamic–pituitary–adrenal axis
Vigilance (psychology)
medicine.drug
Zdroj: Psychoneuroendocrinology. 110
ISSN: 1873-3360
Popis: Fatigue is common in multiple sclerosis (MS) patients. Exhaustion of physiological reserves and mental stress are postulated causes, the latter supported by more pronounced hypothalamic-pituitary-adrenal (HPA) axis activation in fatigued patients. Divergent dysregulation of arousal appears to play important roles in depression- (hyperstable arousal) and in cancer-related (unstable arousal) fatigue, where HPA axis is hyperactive or hypoactive, respectively.This study assessed arousal regulation in multiple sclerosis patients, explored if fatigue can be physiologically described by altered arousal regulation, and if HPA axis activity corresponds to the type(s) of arousal regulation.51 mildly-affected patients with relapsing-remitting MS (86% on disease-modifying treatment) and 20 healthy controls were analysed via Vigilance Algorithm Leipzig and combined dexamethasone/corticotropin releasing hormone test.Hyperstable arousal pattern was significantly more frequent in patients than in controls (62.7% vs. 45.0%, p = 0.011). Patients scored higher on all fatigue, but not on sleepiness scales. All patients combined showed mild activation of the hypothalamic-pituitary-adrenal axis (p 0.05 for post-CRH ACTH and AUC ACTH; cortisol n.s.). While fatigue was numerically more pronounced in both hyperstable and unstable arousal, HPA axis activity was highest in hyperstable and lowest in unstable arousal (p = 0.013 for post-CRH ACTH; p = 0.087 for AUC ACTH; cortisol n.s.).Frequency of arousal patterns are altered in MS. An association with HPA axis activity was weak, possibly because the present sample was stable on immunotherapy.
Databáze: OpenAIRE
Externí odkaz: