Response of the Hypothalamic-Pituitary-Adrenal Axis to Lumbar Puncture Induced Stress

Article type: Research Article

Authors: Lerner, Alan J.^{a; *} | Elston, Robert C.^b | Chen, Chien Hsiun^b | Friedland, Robert P.^{a; c}

Affiliations: [a] Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA | [b] Department of Epidemiology and Biostatistics, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA | [c] Laboratory of Neurogeriatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA

Correspondence: [*] Corresponding author: A.J. Lerner, M.D., Alzheimer Center, 12200 Fairhill Road, Cleveland, OH 44120, USA. Tel.: +1 216 8446440; Fax: +1 216 844 6369; E-mail: [email protected]

Abstract: To assess lumbar puncture (LP) stress as measured by Hypothalamic-Pituitary-Adrenal axis response, serum cortisols were measured before and after LP in Alzheimer's disease (AD) and healthy elderly individuals. There were no differences in baseline serum cortisol. AD group had significantly higher cortisols at 165 minutes post-LP. Growth curve analysis confirmed these findings and showed significant differences in cortisol levels overall. The AD males had higher cortisols at 105 minutes post-LP, but no other consistent gender differences emerged. The findings are consistent with the relative reduction in HPA negative feedback seen in AD. Overall, LP induces little change in group mean cortisol levels relative to inter-individual variation, indicating that while LP is an interesting model of neuroendocrine challenge, it needs to be tested in larger populations.

Keywords: lumbar puncture, stress, Alzheimer's disease, cortisol, hypothalamic-pituitary-adrenal axis

DOI: 10.3233/JAD-2000-23-401

Journal: Journal of Alzheimer's Disease, vol. 2, no. 3-4, pp. 193-198, 2000