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J Clin Endocrinol Metab. 2009 Apr;94(4):1223-8. doi: 10.1210/jc.2008-2543. Epub 2009 Jan 27.

Increased hypothalamic-pituitary-adrenal axis activity in Huntington's disease.

Author information

  • 1Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands. N.A.Aziz@lumc.nl

Abstract

CONTEXT:

Huntington's disease (HD) is a fatal hereditary neurodegenerative disorder characterized by motor, cognitive, and behavioral disturbances. Hypothalamic-pituitary-adrenal (HPA) axis dysfunction could contribute to a number of HD signs and symptoms; however, no data are available on cortisol diurnal variations and secretory dynamics in HD patients.

OBJECTIVE:

The aim of the study was to perform a detailed analysis of HPA axis function in HD patients in relation to clinical signs and symptoms.

DESIGN, SETTING, AND PARTICIPANTS:

Twenty-four-hour cortisol secretion was studied in eight early-stage, medication-free HD patients and eight age-, sex-, and body mass index-matched controls in a clinical research laboratory. Cortisol levels were measured every 10 min.

MAIN OUTCOME MEASURES:

Multiparameter autodeconvolution and cosinor regression were applied to quantify basal, pulsatile, and total cortisol secretion rates as well as diurnal variations in cortisol levels.

RESULTS:

Total cortisol secretion rate and the amplitude of the diurnal cortisol profile were both significantly higher in HD patients compared with controls (3490 +/- 320 vs. 2500 +/- 220 nmol/liter/24 h, P = 0.023; and 111 +/- 14 vs. 64 +/- 8 nmol/liter, P = 0.012, respectively). Cortisol concentrations in patients were particularly increased in the morning and early afternoon period. In HD patients, mean 24-h cortisol levels significantly correlated with total motor score, total functional capacity, as well as body mass index.

CONCLUSIONS:

HPA axis hyperactivity is an early feature of HD and is likely to result from a disturbed central glucocorticoid feedback due to hypothalamic pathology. HPA axis dysfunction may contribute to some signs and symptoms in HD patients.

PMID:
19174491
[PubMed - indexed for MEDLINE]
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