Martignoni E, Petraglia F, Costa A, Bono G, Genazzani A R, Nappi G
Neurobiology Unit, Neurological Institute C. Mondino Foundation, University of Pavia, Italy.
Acta Neurol Scand. 1990 May;81(5):452-6. doi: 10.1111/j.1600-0404.1990.tb00994.x.
The activity of the hypothalamus-pituitary-adrenocortical (HPA) axis was explored in 10 patients with dementia of the Alzheimer type (DAT) and in 11 age-matched controls, by measuring 1) corticotropin-releasing factor (CRF) levels in cerebrospinal fluid (CSF), 2) the circadian changes of plasma cortisol, 3) and 4) the plasma cortisol response to dexamethasone suppression test (DST) and to CRF stimulation test. CSF CRF levels in DAT were significantly higher than in controls and inversely related to the Mini Mental State (MMS) score. The patients also displayed increased morning (0800 h) plasma cortisol values, with higher mesor and amplitude in the circadian pattern. Dexamethasone resistance was shown by 6 of the 10 DAT subjects. Plasma cortisol response to CRF administration was similar in the two groups, except for the peak values, which in DAT patients were reached earlier than in controls. The present data suggest an overactivity of HPA axis in DAT; its possible role in the evolution of the disease is discussed.
通过测量以下指标，对10例阿尔茨海默型痴呆（DAT）患者和11名年龄匹配的对照者的下丘脑 - 垂体 - 肾上腺皮质（HPA）轴活性进行了研究：1）脑脊液（CSF）中促肾上腺皮质激素释放因子（CRF）水平；2）血浆皮质醇的昼夜变化；3）和4）血浆皮质醇对地塞米松抑制试验（DST）和CRF刺激试验的反应。DAT患者的脑脊液CRF水平显著高于对照组，且与简易精神状态（MMS）评分呈负相关。患者还表现出早晨（08:00）血浆皮质醇值升高，昼夜模式中的中值和振幅更高。10例DAT受试者中有6例表现出地塞米松抵抗。两组中血浆皮质醇对CRF给药的反应相似，但峰值除外，DAT患者的峰值比对照组更早达到。目前的数据表明DAT中HPA轴活性过高；讨论了其在疾病发展中的可能作用。
