Cortisol Response Mediates HIV-1-Related Cognitive Deficits Among Injecting Drug Abusers

Abstract

Abstract:The cortisol response is an important measure of the endocrine activity to environmental challenges and has been related to cognitive function and mood. Previous studies have shown that the cortisol response to stress is dysregulated in persons with HIV-1 infection. Since cortisol is neurotoxic and its levels have been related to cognitive dysfunction in various disorders, it is possible that neuroendocrine dysregulation may also be related to cognitive dysfunction in individuals with HIV-1 infection. The purpose of this study was to test the hypothesis that the cortisol response to an alpha adrenergic challenge, cold pressor, is related to cognitive function in HIV-infected injecting drug abusers. We used growth curve modeling to study the relationship of cold pressor challenge stimulated cortisol response to scores on the modified HIV Dementia Scale (mHDS). To test this hypothesis, we assessed the effects of HIV-1 infection on the HDS score directly and indirectly via pattern of cortisol response. The analysis showed that HIV-1 infection was directly related to mHDS performance and that it also influenced scores on the mHDS by way of individuals' pattern of cortisol response. Cortisol response to -adrenergic challenge thus may mediate cognitive deficits in individuals with HIV-1 infection. These findings further emphasize the importance of understanding the role of stress in the cognitive problems associated with HIV-1 infection.

Tumor Necrosis Factor-alpha Levels in HIV-1 Seropositive Injecting Drug Users

“…This is likely due to the time frame in which samples were collected, which was based on interest in plasma catecholamines and cortisol in the parent study. In fact, data on the levels of catecholamines and cortisol showed a clear and robust effect of cold pressor stress that we have reported elsewhere (Ownby et al 2006). The apparent lack of effect on TNF- α is, thus, likely the result of the time course of sampling.…”

“…A relation between TNF- α and HIV-associated cognitive deficits has also been reported (Sippy et al 1995) and we have previously shown that cognitive functioning in HIV + IDUs may be affected by the neurohormonal response to stress (Ownby et al 2006). The study reported here evaluated the relation between the TNF- α mRNA and intravenous drug use and HIV infection.…”

HIV-1 Infection, Injecting Drug Use, and Neuroendocrine Response to Psychological Stress

“…Neurological complications are often especially troublesome for affected individuals and may include memory and other cognitive deficits as well as impairments in the function of the autonomic nervous system or ANS [1]. Several studies have shown that individuals with HIV-1 infection may have multiple disturbances in their response to stress, suggesting that infection is associated with disturbances in autonomic reactivity [1,2] that have implications for the effectiveness of treatment [3] as well as mood and sleep [4,5] and cognition [6].…”