Misiak Błażej, Piotrowski Patryk, Chęć Magdalena, Samochowiec Jerzy
Department of Psychiatry, Division of Consultation Psychiatry and Neuroscience, Wroclaw Medical University, Wroclaw, Poland.
Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland.
Compr Psychoneuroendocrinol. 2021 Mar 3;6:100041. doi: 10.1016/j.cpnec.2021.100041. eCollection 2021 May.
Prolonged activation of the hypothalamic-pituitary-adrenal (HPA) axis associated with hypercortisolemia may lead to impairments of cognition in various populations. Dehydroepiandrosterone sulfate (DHEA-S) can protect the hippocampus from the detrimental effects of cortisol. However, this phenomenon has not been widely investigated in patients with schizophrenia spectrum disorders (SSD). Therefore, in this study, we aimed to assess the levels of cortisol, DHEA-S and cortisol/DHEA-S ratio in patients with SSD and healthy controls with respect to cognitive performance. Participants were 85 patients with SSD and 56 healthy controls, matched for age, sex and body-mass index. Cognitive performance was examined using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The levels of hormones were measured in fasting serum samples. The levels of morning cortisol were significantly higher in patients with SSD compared to healthy controls, even after co-varying for potential confounding factors. There were no significant between-group differences in the levels of DHEA-S and cortisol/DHEA-S ratio. Higher levels of cortisol and greater cortisol/DHEA-S ratio were related to significantly lower RBANS scores of delayed memory in patients with SSD, but not in healthy controls after controlling for the effects of age, sex, BMI, the number of education years, cigarette smoking status and the dosage of antipsychotics. Our findings imply that elevated cortisol levels may contribute to impairments of memory processes in patients with SSD. However, longitudinal studies are needed to confirm causal associations.
与高皮质醇血症相关的下丘脑 - 垂体 - 肾上腺（HPA）轴的长期激活可能导致不同人群的认知障碍。硫酸脱氢表雄酮（DHEA - S）可以保护海马免受皮质醇的有害影响。然而，这种现象在精神分裂症谱系障碍（SSD）患者中尚未得到广泛研究。因此，在本研究中，我们旨在评估SSD患者和健康对照者中皮质醇、DHEA - S水平以及皮质醇/DHEA - S比值与认知表现的关系。参与者为85名SSD患者和56名健康对照者，在年龄、性别和体重指数方面进行了匹配。使用可重复神经心理状态评估量表（RBANS）检查认知表现。在空腹血清样本中测量激素水平。即使在对潜在混杂因素进行协变量调整后，SSD患者的早晨皮质醇水平仍显著高于健康对照者。DHEA - S水平和皮质醇/DHEA - S比值在组间无显著差异。在控制年龄、性别、BMI、受教育年限、吸烟状况和抗精神病药物剂量的影响后，较高的皮质醇水平和较大的皮质醇/DHEA - S比值与SSD患者延迟记忆的RBANS评分显著降低有关，但与健康对照者无关。我们的研究结果表明，皮质醇水平升高可能导致SSD患者的记忆过程受损。然而，需要纵向研究来证实因果关系。
