The Relationship Between Cumulative Exogenous Corticosteroid Exposure and Volumes of Hippocampal Subfields and Surrounding Structures
| Autor: | Alyson Nakamura, Duc M. Nguyen, E. Sherwood Brown, Alexandra Kulikova, Michael A. Yassa, Erin Van Enkevort, Jared M. Roberts, Nicholas J. Tustison, Elena I. Ivleva |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Aging hippocampus Hippocampus Physiology Hippocampal formation Medical and Health Sciences corticosteroids chemistry.chemical_compound 0302 clinical medicine Corticosterone Hippocampal Pharmacology (medical) Chronic stress Young adult Psychiatry Clinical Trials as Topic Middle Aged CA3 Region CA3 Region Hippocampal Magnetic Resonance Imaging Psychiatry and Mental health Mental Health Neurological Population study Female Glucocorticoid medicine.drug Adult Neuroimaging Basic Behavioral and Social Science Article 03 medical and health sciences Young Adult Clinical Research Behavioral and Social Science medicine Humans Glucocorticoids Aged business.industry Dentate gyrus Psychology and Cognitive Sciences Neurosciences 030227 psychiatry Brain Disorders chemistry Dentate Gyrus Prednisone business 030217 neurology & neurosurgery |
| Zdroj: | J Clin Psychopharmacol Journal of clinical psychopharmacology, vol 39, iss 6 |
| ISSN: | 1533-712X |
| Popis: | PURPOSE/BACKGROUND: Glucocorticoids are a class of hormones that include naturally occurring cortisol and corticosterone, as well as prescription drugs commonly used to manage inflammatory, autoimmune, and allergic conditions. Adverse effects, including neuropsychiatric symptoms, are common. The hippocampus appears to be especially sensitive to the effects of glucocorticoids. However, to our knowledge, no studies to date have examined hippocampal subfields in humans receiving glucocorticoids. We examined patients on chronic glucocorticoid regimens to determine relationships between dose and duration of treatment, and hippocampal subfields, and related regions volumes. METHODS/PROCEDURES: The study included adult men and women receiving at least 5 mg daily of prednisone equivalents for at least 6 months. Volumes of brain regions were measured via magnetic resonance imaging (MRI). A multivariate general linear model was used for analysis, with brain volumes as dependent variables and age, gender, and cumulative corticosteroid exposure, as predictors. FINDINGS/RESULTS: The study population consisted of 81 adult outpatients (43 male) on corticosteroids (mean dose = 7.88 mg, mean duration = 76.75 months). Cumulative glucocorticoid exposure was negatively associated with left and right hippocampal dentate gyrus/CA3 (DG/CA3) volume. In subsequent subgroup analysis, this association held true for the age group older than the median age of 46 years but not for the younger age group. IMPLICATIONS/CONCLUSIONS: This finding is consistent with previous studies showing detrimental effects of elevated glucocorticoids on the hippocampus but further suggest that the dentate gyrus and CA3 regions are particularly vulnerable to those effects, which is consistent with animal models of chronic stress but has not been previously demonstrated in humans. |
| Databáze: | OpenAIRE |
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