NDLI: Exploring the Impact of Short- and Long-Term Hydrocortisone Replacement on Cognitive Function, Quality of Life and Catecholamine Secretion: A Pilot Study

Content Provider	Springer Nature Link
Author	Harbeck, Birgit Danneberg, Sven Rahvar, Amir Hossein Haas, Christian S. Lehnert, Hendrik Kropp, Peter Mönig, Heiner
Copyright Year	2016
Abstract	Hydrocortisone (HC) substitution is essential in the treatment for patients with adrenal insufficiency (AI). Current replacement regimens however only incompletely mimic the physiological circadian rhythm of cortisol secretion, thereby resulting in subclinical temporary hypo- and hypercortisolism. Several studies point toward impairment of cognitive functions under these conditions, in part due to affected catecholamine secretion. Aim of this study was to evaluate the influence of long-term versus short-term HC replacement therapy on the adrenomedullary system and cognitive functions. Fourteen patients with primary or secondary AI were divided into two groups, depending on the duration of disease and HC replacement therapy (<15 years). All subjects underwent standardized neurocognitive testing; in addition, cortisol and catecholamine levels as well as physiological parameters and quality of life (QoL) were assessed. Patients with HC replacement therapy ≥15 years (n = 7) received significantly higher equivalent glucocorticoid doses than those with a shorter lasting therapy (n = 7; p = 0.048). Neuropsychological tests, QoL, physiological parameters, and cortisol levels did not differ significantly between both groups. Of note, norepinephrine levels were significantly lower in patients on short-term HC replacement therapy (p = 0.025). However, there were no significant differences in catecholamines with respect to the underlying pathophysiology, gender, or age. Irrespective of the duration of use, male patients scored significantly better for single aspects of QoL, whereas females performed significantly better in the attention test. Overall, we showed that duration of cortisol replacement therapy may have an impact on catecholamine release, but does not seem to affect cognitive functions and QoL.
Starting Page	341
Ending Page	347
Page Count	7
File Format	PDF
ISSN	10900586
Journal	Applied Psychophysiology and Biofeedback
Volume Number	41
Issue Number	3
e-ISSN	15733270
Language	English
Publisher	Springer US
Publisher Date	2016-05-12
Publisher Place	New York
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Adrenal insufficiency Hydrocortisone replacement Cognitive function Adrenomedullary system Psychology Health Psychology Public Health Psychotherapy and Counseling
Content Type	Text
Resource Type	Article
Subject	Neuropsychology and Physiological Psychology Applied Psychology

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