Cognitive effects of corticosteroids

Wolkowitz, Owen M.; Reus, Victor I.; Weingartner, Herbert; Thompson, Karen; Breier, Alan; Doran, Allen R.; Rubinow, David; Pickar, David

doi:10.1176/ajp.147.10.1297

Cited by 367 publications

(29 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition, although administering hydrocortisone for four days successfully increased circulating cortisol to high physiological levels (Schoorlemmer, et al, 2009) and produced similar cognitive impairments to those reported with in other studies of exogenous or endogenous manipulation of cortisol levels (Wolkowitz, et al, 1990), endogenous alterations of cortisol accompanying increased stress are associated with other hormonal changes (e.g., ACTH) that may have independent effects on the central nervous system (McEwen, 2008). One goal of this study was to model the Shors et al animal work that examined the interactive effects of estradiol and acute stress.…”

Section: Discussionsupporting

confidence: 60%

Cognitive response to estradiol in postmenopausal women is modified by high cortisol

Baker¹,

Asthana²,

Cholerton³

et al. 2012

Neurobiology of Aging

View full text Add to dashboard Cite

Estradiol has potent favorable effects on brain function and behavior in animals while in human trials, the results are inconsistent. A number of potential mediating variables influencing response to estradiol have been proposed to account for this variability, one of which includes stress. We conducted a placebo-controlled study to examine joint and independent effects of estradiol and elevated levels of the stress hormone cortisol on cognition and biomarkers of aging and neurodegenerative disease. Thirty-nine healthy postmenopausal women (56-84 yrs) received 0.10 mg/d of transdermal 17β-estradiol (E2) or placebo for eight weeks. During the last four days of the trial, subjects also received 90 mg/d (30 mg TID) of oral hydrocortisone (CORT) to induce stress-level elevations in cortisol, or a matched placebo. The four groups thus included Placebo (placebo patch/placebo pill), CORT-alone (placebo patch/hydrocortisone), E2-alone (estradiol patch/placebo pill), and E2+CORT (estradiol patch/hydrocortisone). Eight weeks of E2 increased plasma estradiol by 167%, and four days of CORT increased plasma cortisol by 119%. Overall, E2 had favorable effects on verbal memory (p=0.03), working memory (p=0.02), and selective attention (p=0.04), and the magnitude of these effects was attenuated for E2+CORT. E2-alone and E2+CORT had opposing effects on plasma levels of the amyloid-β (Aβ) biomarker (Aβ40/42 ratio, p<0.05), with the more favorable response observed for E2-alone. CORT-induced increases in insulin-like growth factor-1 were blunted by E2 co-administration. Our findings indicate that cognitive and physiological responses to estradiol are adversely affected by elevated stress hormone levels of cortisol in healthy postmenopausal women.

show abstract

Section: Discussionsupporting

confidence: 60%

Cognitive response to estradiol in postmenopausal women is modified by high cortisol

Baker¹,

Asthana²,

Cholerton³

et al. 2012

Neurobiology of Aging

View full text Add to dashboard Cite

show abstract

“…Smaller hippocampi have been found in adults who have experienced early adversity (Wolkowitz et al, 1990; Newcomer et al, 1994; Keenan et al, 1996; Bremner et al, 1997; Perry, 2001; Heim et al, 2002; Lupien et al, 2005; Teicher et al, 2006), but not in children (Carrion et al, 2001; De Bellis, 2001; De Bellis et al, 2002; Woon and Hedges, 2008), nor in adolescents (Carrion et al, 2001; De Bellis, 2001; De Bellis et al, 2002; Woon and Hedges, 2008; Frodl et al, 2010; Rao et al, 2010). …”

Section: Introductionmentioning

confidence: 99%

Associations between Family Adversity and Brain Volume in Adolescence: Manual vs. Automated Brain Segmentation Yields Different Results

et al. 2016

View full text Add to dashboard Cite

Associations between brain structure and early adversity have been inconsistent in the literature. These inconsistencies may be partially due to methodological differences. Different methods of brain segmentation may produce different results, obscuring the relationship between early adversity and brain volume. Moreover, adolescence is a time of significant brain growth and certain brain areas have distinct rates of development, which may compromise the accuracy of automated segmentation approaches. In the current study, 23 adolescents participated in two waves of a longitudinal study. Family aggression was measured when the youths were 12 years old, and structural scans were acquired an average of 4 years later. Bilateral amygdalae and hippocampi were segmented using three different methods (manual tracing, FSL, and NeuroQuant). The segmentation estimates were compared, and linear regressions were run to assess the relationship between early family aggression exposure and all three volume segmentation estimates. Manual tracing results showed a positive relationship between family aggression and right amygdala volume, whereas FSL segmentation showed negative relationships between family aggression and both the left and right hippocampi. However, results indicate poor overlap between methods, and different associations were found between early family aggression exposure and brain volume depending on the segmentation method used.

show abstract

“…Excessive circulatory levels of corticosteroids were observed to be associated with cognitive impairment in various disease states (34). Wolkowitz et al (35) found that even a single dose (1 mg dose of dexamethasone) or short-term use of corticosteroids (80 mg dose of prednisone for 5 days) was significantly related to memory problems and raised the possible adverse effect of corticosteroids on cognitive function. This result implies that even patients with relatively low-dose glucocorticoid use may be at risk for cognitive problems.…”

Section: Discussionmentioning

confidence: 99%

The Relationship Between Cognitive Function and Physical Function in Rheumatoid Arthritis

Shin

Julián

Katz³

2013

J Rheumatol

View full text Add to dashboard Cite

Objective To explore the prevalence and possible predictors of cognitive impairment in persons with rheumatoid arthritis (RA). Methods Individuals from a longitudinal cohort study of RA participated in a study visit that included a range of physical, psychosocial, and biologic metrics. Cognitive function was assessed using a battery of 12 standardized neuropsychological measures yielding 16 indices. Subjects were classified as “impaired” if they performed 1 SD below age-based population norms on at least 4 of 16 indices. Logistic regression analyses were conducted to identify which of the following were significant predictors of cognitive impairment: sex, race, income, education, depression, disease duration, disease severity, C-reactive protein (CRP) level, glucocorticoid use, and cardiovascular disease (CVD) risk factors. Results A total of 115 subjects with a mean ± SD age of 58.6 ± 10.8 years were included; 64% were women and 81% were white. The proportion of persons who were classified as cognitively impaired was 31%. Education, income, glucocorticoid use, and CVD risk factors independently predicted cognitive impairment, controlling for sex, race, disease duration, disease severity, CRP level, and depression. Individuals with cognitive impairment were more likely to have low education (odds ratio [OR] 6.18, 95% confidence interval [95% CI] 1.6 –23.87), have low income (OR 7.12, 95% CI 1.35–37.51), use oral glucocorticoids (OR 2.92, 95% CI 1.05–8.12), and have increased CVD risk factors (OR 1.61, 95% CI 1.19–2.17 per risk factor). Conclusion The findings of this study suggest that the burden of cognitive impairment in RA is significant, and future studies identifying specific etiologic contributors to cognitive impairment are warranted.

show abstract

Cognitive effects of corticosteroids

Cited by 367 publications

References 44 publications

Cognitive response to estradiol in postmenopausal women is modified by high cortisol

Cognitive response to estradiol in postmenopausal women is modified by high cortisol

Associations between Family Adversity and Brain Volume in Adolescence: Manual vs. Automated Brain Segmentation Yields Different Results

The Relationship Between Cognitive Function and Physical Function in Rheumatoid Arthritis

Contact Info

Product

Resources

About