Hypothalamic-Pituitary-Adrenal Axis Reactivity in Chronic Fatigue Syndrome and Health Under Psychological, Physiological, and Pharmacological Stimulation

Autor: Ulrike Ehlert, Renate Peisen, Thomas H. Schürmeyer, Dominik Hüster, Jens Gaab, Veronika Engert, Vera Heitz, Tanja Schad
Přispěvatelé: University of Zurich, Gaab, Jens
Rok vydání: 2002
Předmět:
Adult
Blood Glucose
Male
Hypothalamo-Hypophyseal System
endocrine system
medicine.medical_specialty
Time Factors
Psychometrics
Pituitary-Adrenal System
3202 Applied Psychology
2738 Psychiatry and Mental Health
Corticotropin-releasing hormone
Heart Rate
Stress
Physiological
Endocrine Glands
Internal medicine
medicine
Chronic fatigue syndrome
Humans
Insulin
Endocrine system
Applied Psychology
Social stress
Analysis of Variance
Fatigue Syndrome
Chronic
10093 Institute of Psychology
Insulin tolerance test
Stressor
Middle Aged
medicine.disease
Psychiatry and Mental health
Endocrinology
medicine.anatomical_structure
Area Under Curve
Exercise Test
Female
Analysis of variance
150 Psychology
Psychology
Stress
Psychological
hormones
hormone substitutes
and hormone antagonists
Hypothalamic–pituitary–adrenal axis
Zdroj: Psychosomatic Medicine. 64:951-962
ISSN: 1534-7796
0033-3174
DOI: 10.1097/01.psy.0000038937.67401.61
Popis: Objectives Subtle alterations of the hypothalamic-pituitary-adrenal (HPA) axis in chronic fatigue syndrome (CFS) have been proposed as a shared pathway linking numerous etiological and perpetuating processes with symptoms and observed physiological abnormalities. Because the HPA axis is involved in the adaptive responses to stress and CFS patients experience a worsening of symptoms after physical and psychological stress, we tested HPA axis functioning with three centrally acting stress tests. Methods We used two procedures mimicking real-life stressors and compared them with a standardized pharmacological neuroendocrine challenge test. CFS patients were compared with healthy control subjects regarding their cardiovascular and endocrine reactivity in a psychosocial stress test and a standardized exercise test, and their endocrine response in the insulin tolerance test (ITT). Results Controlling for possible confounding variables, we found significantly lower ACTH response levels in the psychosocial stress test and the exercise test, and significantly lower ACTH responses in the ITT, with no differences in plasma total cortisol responses. Also, salivary-free cortisol responses did not differ between the groups in the psychosocial stress test and the exercise test but were significantly higher for the CFS patients in the ITT. In all tests CFS patients had significantly reduced baseline ACTH levels. Conclusions These results suggest that CFS patients are capable of mounting a sufficient cortisol response under different types of stress but that on a central level subtle dysregulations of the HPA axis exist.
Databáze: OpenAIRE
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