Beresford Thomas P, Arciniegas David B, Alfers Julie, Clapp Lori, Martin Brandon, Beresford Henry F, Du Yiping, Liu Dengfeng, Shen Dinggang, Davatzikos Christos, Laudenslager Mark L
Mental Health Service, Department of Veterans Affairs Medical Center, 1055 Clermont Street (116), Denver, Colorado 80220-0116, USA.
J Stud Alcohol. 2006 Nov;67(6):861-7. doi: 10.15288/jsa.2006.67.861.
The effects of hypercortisolism on hippocampal volume have not been studied in heavy drinkers. Prior work suggested increased hypothalamic-pituitary-adrenal activity in relation to lowered total hippocampus volume (THV) in heavy-drinking alcohol-dependent (AD) subjects. The present study hypothesized the following: (1) that chronic heavy-drinking subjects would demonstrate significantly higher salivary cortisol concentrations than light-drinking control subjects and (2) that data from the whole sample group would present an inverse relationship between cortisol concentration and THV.
In carefully selected test and control subject groups matched for age, gender, and ethnicity, we measured salivary cortisol samples at waking, waking + 30 minutes, noon, and 4 PM on the day of magnetic resonance imaging of the brain. We next compared mean cortisol concentrations between groups and assessed the statistical association between cortisol concentration and hippocampus volume measures.
Comparison of AD test subjects (n = 8) and non-AD control subjects (n = 8) found significantly higher cortisol concentrations at both morning sampling times (mean [SD] at waking: 0.49 [0.23] vs 0.24 [0.14] microg/dl, p = .012; at waking + 30 minutes: 0.57 [0.37] vs 0.28 [0.11] microg/dl, p = 0.043). Controlling for intracranial volume, there was a significant inverse correlation between waking cortisol concentration and THV (p = .007) in the total sample group (N = 16). However, when analyzed separately, only the control group maintained a strong, inverse association (p = .025). There was no association among the heavy drinking subjects.
These early data in a small sample support the view that chronic heavy drinking results in high salivary cortisol concentrations. What remains unclear is whether hypercortisolism exerts a selectively injurious effect that results in observed hippocampus volume loss. Further research in larger groups using more frequent, monitored sampling must address the following: (1) whether this finding can be replicated and (2) if replicated, whether the lack of an association between low hippocampal volumes and high cortisol levels may indicate an extent of injury beyond which a normal association of the two may be lost.
尚未对酗酒者中高皮质醇血症对海马体体积的影响进行研究。先前的研究表明，酗酒依赖（AD）受试者下丘脑 - 垂体 - 肾上腺活动增强，同时总海马体体积（THV）降低。本研究提出以下假设：（1）慢性酗酒受试者的唾液皮质醇浓度显著高于轻度饮酒的对照受试者；（2）整个样本组的数据将显示皮质醇浓度与THV之间呈负相关。
在精心挑选的年龄、性别和种族相匹配的测试组和对照组中，我们在脑部磁共振成像当天的清醒时、清醒后30分钟、中午和下午4点测量唾液皮质醇样本。接下来，我们比较了两组之间的平均皮质醇浓度，并评估了皮质醇浓度与海马体体积测量值之间的统计关联。
对AD测试受试者（n = 8）和非AD对照受试者（n = 8）的比较发现，在两个早晨采样时间，皮质醇浓度均显著更高（清醒时平均值[标准差]：0.49[0.23] vs 0.24[0.14]μg/dl，p = 0.012；清醒后30分钟：0.57[0.37] vs 0.28[0.11]μg/dl，p = 0.043）。在总样本组（N = 16）中，控制颅内体积后，清醒时皮质醇浓度与THV之间存在显著负相关（p = 0.007）。然而，单独分析时，只有对照组保持了强烈的负相关（p = 0.025）。酗酒受试者之间没有关联。
这个小样本中的早期数据支持慢性酗酒会导致唾液皮质醇浓度升高的观点。尚不清楚的是，高皮质醇血症是否会产生选择性损伤作用，导致观察到的海马体体积减少。使用更频繁、受监测的采样方法对更大样本组进行的进一步研究必须解决以下问题：（1）这一发现是否可以复制；（2）如果可以复制，海马体体积低与皮质醇水平高之间缺乏关联是否可能表明损伤程度已超出两者正常关联可能丧失的范围。
