Bremner J Douglas, Vythilingam Meena, Vermetten Eric, Anderson George, Newcomer John W, Charney Dennis S
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 126 Briarcliff Road, Atlanta, GA 30306, USA.
Biol Psychiatry. 2004 Apr 15;55(8):811-5. doi: 10.1016/j.biopsych.2003.10.020.
Major depression has been associated with hypercortisolemia in a subset of patients with depression. Administration of exogenous cortisol and other glucocorticoids to healthy human subjects has been observed to result in a transient impairment in verbal declarative memory function. The purpose of this study was to assess the effects of the glucocorticoid, dexamethasone, on verbal declarative memory function in patients with untreated unipolar major depressive disorder (MDD).
Fifty two men and women with (n = 28) and without (n = 24) MDD received placebo or dexamethasone (1 mg and 2 mg on 2 successive days) in a double-blind, randomized fashion. Declarative memory was assessed with paragraph recall at baseline (day 1) and day 3.
There was a significant interaction between diagnosis and drug (dexamethasone vs. placebo) on paragraph recall. In the healthy subjects, memory improved from baseline to day 3 with placebo and was unchanged with dexamethasone, whereas in MDD patients memory function showed a pattern of decreasing with placebo and improving with dexamethasone from baseline to day 3.
These findings are consistent with an altered sensitivity of declarative memory function in MDD to regulation by glucocorticoids. Possible explanations of the findings include alterations in glucocorticoid receptors in the hippocampus or other brain regions mediating declarative memory, or differential sensitivity to dexamethasone-induced reductions in cortisol, in patients with MDD.
在部分抑郁症患者中，重度抑郁症与高皮质醇血症有关。已观察到，对健康人类受试者施用外源性皮质醇和其他糖皮质激素会导致言语陈述性记忆功能出现短暂损害。本研究的目的是评估糖皮质激素地塞米松对未经治疗的单相重度抑郁症（MDD）患者言语陈述性记忆功能的影响。
52名患有（n = 28）和未患有（n = 24）MDD的男性和女性以双盲、随机方式接受安慰剂或地塞米松（连续两天每天1毫克和2毫克）。在基线（第1天）和第3天通过段落回忆评估陈述性记忆。
在段落回忆方面，诊断和药物（地塞米松与安慰剂）之间存在显著交互作用。在健康受试者中，安慰剂组从基线到第3天记忆有所改善，地塞米松组则无变化；而在MDD患者中，记忆功能呈现出从基线到第3天安慰剂组下降、地塞米松组改善的模式。
这些发现与MDD中陈述性记忆功能对糖皮质激素调节的敏感性改变一致。这些发现的可能解释包括海马体或其他介导陈述性记忆的脑区中糖皮质激素受体的改变，或MDD患者对地塞米松诱导的皮质醇降低的不同敏感性。
