Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-11T09:22:54.272Z Has data issue: false hasContentIssue false

Estudio prospectivo del volumen y la función del hipocampo en sujetos humanos tratados con corticoesteroides

Published online by Cambridge University Press:  12 May 2020

Tomáš Hájek
Affiliation:
Centro Psiquiátrico de Praga y Universidad Carlos, 3a Facultad de Medicina, Praga, República Checa Departamento de Psiquiatría, Universidad Dalhousie, QEII HSC, A. J. Lane Bldg., Habitación4031, 5909 Veteran's Memorial Lane, Halifax, NS, Canadá B3H 2E2
Miloslav Kopeček
Affiliation:
Centro Psiquiátrico de Praga y Universidad Carlos, 3a Facultad de Medicina, Praga, República Checa
Marek Preiss
Affiliation:
Centro Psiquiátrico de Praga y Universidad Carlos, 3a Facultad de Medicina, Praga, República Checa
Martin Alda
Affiliation:
Centro Psiquiátrico de Praga y Universidad Carlos, 3a Facultad de Medicina, Praga, República Checa Departamento de Psiquiatría, Universidad Dalhousie, QEII HSC, A. J. Lane Bldg., Habitación4031, 5909 Veteran's Memorial Lane, Halifax, NS, Canadá B3H 2E2
Cyril Höschl
Affiliation:
Centro Psiquiátrico de Praga y Universidad Carlos, 3a Facultad de Medicina, Praga, República Checa
Get access

Resumen

Propósito.

La disminución del volumen del hipocampo comunicada en trastornos neuropsiquiátricos y endocrinos se considera resultado de un daño neuronal putativo mediado por corticoesteroides. Éste es el primer estudio prospectivo del volumen y la función del hipocampo en pacientes tratados con corticoesteroides.

Métodos.

Se sometió a 14 sujetos tratados sistémicamente con prednisona o betametasona por trastornos dermatológicos o reumáticos a pruebas neurocognitivas prospectivas (Prueba de Aprendizaje Verbal Auditivo [AVLT], Prueba del Trazo [TMT], Amplitud de dígitos [AD]) y nueve de ellos repitieron también una volumetría de resonancia magnética.

Resultados.

La duración media del tratamiento entre la primera evaluación y la segunda fue 73 ± 38 días con dosis diaria media de 37 ± 17 mg de prednisona y 193 ± 29 días, con dosis diaria media de 24 ± 15 mg de prednisona, entre la primera evaluación y la tercera. Hubo una tendencia a disminuciones en las puntuaciones totales de la AVLT y una mejoría en la TMT y la AD, pero ausencia de cambios significativos en el volumen de los hipocampos derecho o izquierdo entre las evaluaciones. La dosis de prednisona no correlacionaba con el cambio de volumen del hipocampo.

Conclusión.

Observamos una tendencia a la disminución en la memoria verbal a pesar de la mejora en la velocidad psicomotriz, la atención/memoria operativa y una ausencia de cambios del volumen macroscópico del hipocampo durante los 36-238 días de tratamiento con dosis terapéuticas de corticoesteroides.

Type
Original
Copyright
Copyright © European Psychiatric Association 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bibliografía

Bender, BG, Lerner, JA, Poland, JE. Association between corticosteroids and psychologic change in hospitalized asthmatic children. Ann Allergy 1991 ;66(5):414–9Google ScholarPubMed
Bodnoff, SR, Humphreys, AG, Lehman, JC, Diamond, DM, Rose, GM, Meaney, MJ. Enduring effects of chronic corticosterone treatment on spatial learning, synaptic plasticity, and hippocampal neuropathology in young and mid-aged rats. J Neurosci 1995;15(1 Pt l):61–9CrossRefGoogle Scholar
Bonne, O, Brandes, D, Gilboa, A, Gomon, JM, Shenton, ME, Pitman, RK, et al. Longitudinal MRI study of hippocampal volume in trauma survivors with PTSD. Am J Psychiatry 2001 ;158(8): 1248–51CrossRefGoogle ScholarPubMed
Brambilla, P, Harenski, K, Nicoletti, MA, Mallinger, AG, Frank, E, Kupfer, DJ, et al. Anatomical MRI study of basal ganglio in bipolar disorder patients. Psychiatry Res 2001;106(2):6580CrossRefGoogle Scholar
Bremner, JD, Narayan, M, Anderson, ER, Staib, LH, Miller, HL, Charney, DS. Hippocampal volume reduction in major depression. Am J Psychiatry 2000;157(1):115–8CrossRefGoogle ScholarPubMed
Brown, ES, Woolston, J, Frol, A, Bobadilla, L, Khan, DA, Hanczyc, M, et al. Hippocampal volume, spectroscopy, cognition, and mood in patients receiving corticosteroid therapy. Biol Psychiatry 2004; 55(5):538–45CrossRefGoogle ScholarPubMed
De Bellis, MD, Hall, J, Boring, AM, Frustaci, K, Montz, G. A pilot longitudinal study of hippocampal volumes in pediatric maltreatmentrelated posttraumatic stress disorder. Biol Psychiatry 2001; 50(4):305–9CrossRefGoogle ScholarPubMed
Frodl, T, Meisenzahl, EM, Zetzsche, T, Hohne, T, Banac, S, Schorr, C, et al. Hippocampal and amygdala changes in patients with major depressive disorder and healthy Controls during a 1-year follow-up. J Clin Psychiatry 2004;65(4):492–9CrossRefGoogle ScholarPubMed
Keshavan, MS, Bagwell, WW, Haas, GL, Sweeney, JA, Schooler, NR, Pettegrew, JW. Changes in caudate volume with neuroleptic treatment. Lancet 1994;344(8934):1434CrossRefGoogle ScholarPubMed
Kirschbaum, C, Wolf, OT, May, M, Wippich, W, Hellhammer, DH. Stress-and treatment-induced elevations of cortisol levels associated with impaired declarative memory in healthy adults. Life Sci 1996; 58(17):1475–83CrossRefGoogle ScholarPubMed
Lamusuo, S, Jutila, L, Ylinen, A, Kalviainen, R, Mervaala, E, Haaparanta, M, et al. 18F]FDG-PET reveais temporal hypometabolism in patients with temporal lobe epilepsy even when quantitative MRI and histopathological analysis show only mild hippocampal damage. Arch Neurol 2001;58(6):933–9CrossRefGoogle ScholarPubMed
Lezak, M. Neuropsycholog ical Assessment. 3rd ed. New York: Oxford University Press; 1995Google Scholar
Lucassen, PJ, Muller, MB, Holsboer, F, Bauer, J, Holtrop, A, Wouda, J, et al. Hippocampal apoptosis in major depression is a minor event and absent from subareas at risk for glucocorticoid overexposure. Am J Pathol 2001; 158(2):453–68CrossRefGoogle ScholarPubMed
Lupien, SJ, Gillin, CJ, Hauger, RL. Working memory is more sensitive than declarative memory to the acute effects of corticosteroids: a dose-response study in humans. Behav Neurosci 1999;113(3):420– 30CrossRefGoogle ScholarPubMed
MacQueen, GM, Campbell, S, McEwen, BS, Macdonald, K, Amano, S, Joffe, RT, et al. Course of illness, hippocampal function, and hippocampal volume in major depression. Proc Nati Acad Sci USA 2003; 100(3):1387–92CrossRefGoogle ScholarPubMed
Magarinos, AM, McEwen, BS. Stress-induced atrophy of apical dendrites of hippocampal CA3c neurons: comparison of stressors. Neuroscience 1995;69(1):83–8.CrossRefGoogle ScholarPubMed
Magarinos, AM, McEwen, BS, Flugge, G, Fuchs, E. Chronic psychosocial stress causes apical dendritic atrophy of hippocampal CA3 pyramidal neurons in subordinate tree shrews. J Neurosci 1996; 16(10):3534–40CrossRefGoogle ScholarPubMed
McEwen, BS, Magarinos, AM. Stress effects on morphology and function of the hippocampas. Ann New York Acad Sci 1997;821: 271–84CrossRefGoogle Scholar
Mizoguchi, K, Kunishita, T, Chui, DH, Tabira, T. Stress induces neuronal death in the hippocampus of castrated rats. Neurosci Lett 1992;138(1): 157–60CrossRefGoogle ScholarPubMed
Muller, MB, Lucassen, PJ, Yassouridis, A, Hoogendijk, WJ, Holsboer, F, Swaab, DF. Neither major depression nor glucocorticoid treatment affects the cellular integrity of the human hippocampus. Eur J Neurosci 2001; 14(10): 1603–12CrossRefGoogle ScholarPubMed
Ohl, F, Michaelis, T, Vollmann-Honsdorf, GK, Kirschbaum, C, Fuchs, E. Effect of chronic psychosocial stress and long-term cortisol treatment on hippocampus-mediated memory and hippocampal volume: a pilot study in tree shrews. Psychoneuroendocrinology 2000; 25(4):357–63CrossRefGoogle ScholarPubMed
Panante, CM, Miller, AH. Glucocorticoid receptors in major depression: relevance to pathophysiology and treatment. Biol Psychiatry 2001 ;49(5):391404CrossRefGoogle Scholar
Preiss, M. Pametovy test uceni pro klinickou praxi. Bratislava: Psychodiagnostika; 1999Google Scholar
Preiss, M. Trail Making Test pro deti a dospele, manual. Bratislava: Psychodiagnostika; 1997Google Scholar
Pula, G, Sand, MR, Vicini, S, Pritchett, DB, Purdy, RH, Paul, SM, et al. Neurosteroids act on recombinant human GABAA receptors. Neuron 1990;4(5):759–65Google Scholar
Raison, CL, Miller, AH. When not enough is too mach: the role of insufficient glucocorticoid signaling in the pathophysiology of stress-related disorders. Am J Psychiatry 2003;160(9):1554–65CrossRefGoogle ScholarPubMed
Rican, P, Sebek, M, Vagnerova, M. WAIS-R. Wechsleruv inteligencni test pro dospele. Bratislava: Psychodiagnostika; 1983Google Scholar
Sapolsky, RM. Glucocorticoids and hippocampal atrophy in neuropsychiatric disorders. Arch Gen Psychiatry 2000;57(10):925–35CrossRefGoogle ScholarPubMed
Sapolsky, RM, Uno, H, Rebert, CS, Finch, CE. Hippocampal damage associated with prolonged glucocorticoid exposure in primates. J Neurosci 1990;10(9):2897–902CrossRefGoogle ScholarPubMed
Starkman, MN, Gebarski, SS, Berent, S, Schteingart, DE. Hippocampal formation volume, memory dysfunction, and cortisol levels in patients with Cushing's syndrome. Biol Psychiatry 1992;32(9):756- 65CrossRefGoogle ScholarPubMed
Starkman, MN, Giordani, B, Gebarski, SS, Berent, S, Schork, MA, Schteingart, DE. Decrease in cortisol reverses human hippocampal atrophy following treatment of Cushing's disease. Biol Psychiatry 1999;46(12): 1595–602CrossRefGoogle ScholarPubMed
Sheline, YI, Sanghavi, M, Mintun, MA, Gado, MH. Depression duration but not age predicts hippocampal volume loss in medically healthy women with recurrent major depression. J Neurosci 1999; 19(12):5034–43CrossRefGoogle Scholar
Sheline, YI, Wang, PW, Gado, MH, Csernansky, JG, Vannier, MW. Hippocampal atrophy in recurrent major depression. Proc Nati Acad Sci USA 1996;93(9):3908–13CrossRefGoogle ScholarPubMed
Steffens, DC, Byrum, CE, McQuoid, DR, Greenberg, DL, Payne, ME, Blitchington, TF, et al. Hippocampal volume in geriatric depression. Biol Psychiatry 2000;48(4):301–9CrossRefGoogle ScholarPubMed
Uno, H, Tarara, R, Else, JG, Suleman, MA, Sapolsky, RM. Hippocampal damage associated with prolonged and fatal stress in primates. J Neurosci 1989;9(5): 1705–11CrossRefGoogle ScholarPubMed
Vythilingam, M, Vermetten, E, Anderson, GM, Luckenbaugh, D, Anderson, ER, Snow, J, et al. Hippocampal volume, memory, and cortisol status in major depressive disorder: effects of treatment. Biol Psychiatry 2004;56(2):101–12CrossRefGoogle ScholarPubMed
Wolkowitz, OM, Reus, VI, Weingartner, H, Thompson, K, Breier, A, Doran, A, et al. Cognitive effects of corticosteroids. Am J Psychiatry 1990; 147(10):1297–303[see comments]Google ScholarPubMed