Brown E Sherwood, J Woolston Dixie, Frol Alan, Bobadilla Leonardo, Khan David A, Hanczyc Margaret, Rush A John, Fleckenstein James, Babcock Evelyn, Cullum C Munro
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas 75390-8849, USA.
Biol Psychiatry. 2004 Mar 1;55(5):538-45. doi: 10.1016/j.biopsych.2003.09.010.
Hippocampal volume reduction, declarative memory deficits, and cortisol elevations are reported in persons with major depressive disorder; however, data linking cortisol elevations with hippocampal atrophy are lacking. Prescription corticosteroid-treated patients offer an opportunity to examine corticosteroid effects on hippocampal volume and biochemistry and memory in humans.
Seventeen patients on long-term prescription corticosteroid therapy and 15 controls of similar age, gender, ethnicity, education, height, and medical history were assessed with magnetic resonance imaging and proton magnetic resonance spectroscopy, the Rey Auditory Verbal Learning Test, Stroop Color Word Test and other neurocognitive measures, the Hamilton Rating Scale for Depression, Young Mania Rating Scale, and Brief Psychiatric Rating Scale.
Compared with controls, corticosteroid-treated patients had smaller hippocampal volumes and lower N-acetyl aspartate ratios, lower scores on the Rey Auditory Verbal Learning Test and Stroop Color Word Test, and higher Hamilton Rating Scale for Depression and Brief Psychiatric Rating Scale scores.
Patients receiving chronic corticosteroid therapy have smaller hippocampal volumes, lower N-acetyl aspartate ratios, and declarative memory deficits compared with controls. These findings support the idea that corticosteroid exposure appears to be associated with changes in hippocampal volume and functioning in humans.
据报道，重度抑郁症患者存在海马体体积减小、陈述性记忆缺陷和皮质醇升高的情况；然而，缺乏将皮质醇升高与海马体萎缩联系起来的数据。接受处方皮质类固醇治疗的患者为研究皮质类固醇对人类海马体体积、生物化学和记忆的影响提供了一个机会。
对17名长期接受处方皮质类固醇治疗的患者以及15名年龄、性别、种族、教育程度、身高和病史相似的对照者进行了磁共振成像和质子磁共振波谱分析、雷伊听觉词语学习测验、斯特鲁普色词测验及其他神经认知测量、汉密尔顿抑郁评定量表、杨氏躁狂评定量表和简明精神病评定量表评估。
与对照组相比，接受皮质类固醇治疗的患者海马体体积更小，N-乙酰天门冬氨酸比率更低，雷伊听觉词语学习测验和斯特鲁普色词测验得分更低，汉密尔顿抑郁评定量表和简明精神病评定量表得分更高。
与对照组相比，接受慢性皮质类固醇治疗的患者海马体体积更小，N-乙酰天门冬氨酸比率更低，且存在陈述性记忆缺陷。这些发现支持了皮质类固醇暴露似乎与人类海马体体积和功能变化有关的观点。
