Low cerebrospinal fluid corticotropin-releasing hormone concentrations in eucortisolemic depression

Hypersecretion of corticotropin-releasing hormone (CRH) and resulting hypercortisolism have been implicated in the pathogenesis of major depression. To test this CRH hypersecretion hypothesis, cerebrospinal fluid (CSF) was continuously withdrawn from 11:00 am to 5:00 pm via an indwelling subarachnoi...

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Bibliographic Details
Published in:Biological psychiatry (1969) 1997-08, Vol.42 (3), p.165-174
Main Authors: Geracioti, Thomas D., Loosen, Peter T., Orth, David N.
Format: Article
Language:English
Subjects:
Adrenocorticotropic Hormone - blood
Adult
Adult and adolescent clinical studies
Arousal - physiology
atypical depression
Biological and medical sciences
Catheters, Indwelling
cerebrospinal fluid
Circadian Rhythm - physiology
corticotropin
corticotropin-releasing factor
Corticotropin-releasing hormone
Corticotropin-Releasing Hormone - cerebrospinal fluid
cortisol
Depression
Depressive Disorder - diagnosis
Depressive Disorder - physiopathology
Depressive Disorder - psychology
eating
Fasting - physiology
Female
Humans
Hydrocortisone - blood
hypercortisolemia
Male
Medical sciences
metabolism
Middle Aged
Mood disorders
Pituitary-Adrenal System - physiopathology
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Reference Values
Smoking - physiopathology
Spinal Puncture - psychology
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Summary:Hypersecretion of corticotropin-releasing hormone (CRH) and resulting hypercortisolism have been implicated in the pathogenesis of major depression. To test this CRH hypersecretion hypothesis, cerebrospinal fluid (CSF) was continuously withdrawn from 11:00 am to 5:00 pm via an indwelling subarachnoid catheter (placed at 8:00 am), and immunoreactive CRH concentrations were determined at 10-min intervals in 10 depressed patients, the majority of whom exhibited at least one “atypical” symptom, and in 15 normal volunteers. CSF CRH was low, plasma adrenocorticotropin (ACTH) tended to be low, and plasma cortisol was normal in the depressed patients. Also, tobacco smokers had lower CSF CRH than nonsmokers. CRH increased acutely in response to lumbar puncture, had a brief half-life, showed rapid variability in concentration over time, and displayed a diurnal concentration rhythm that was preserved in fasting individuals and in most depressed patients. CSF CRH did not correlate with plasma ACTH or cortisol; this and its rapidly fluctuating levels suggest a primarily extrahypothalamic origin of lumbar CSF CRH.
ISSN:0006-3223
1873-2402
DOI:10.1016/S0006-3223(96)00312-5