Activity of the hypothalamic–pituitary–adrenal axis in multiple sclerosis: Correlations with gadolinium-enhancing lesions and ventricular volume

Authors

  • Erina M. Schumann MD,

    1. Max Planck Institute of Psychiatry, Munich, Germany
    Current affiliation:
    1. Friedberg Hospital, Friedberg, Germany
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  • Tania Kümpfel MD,

    1. Max Planck Institute of Psychiatry, Munich, Germany
    Current affiliation:
    1. Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
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  • Florian Then Bergh MD,

    1. Max Planck Institute of Psychiatry, Munich, Germany
    Current affiliation:
    1. Laboratory of Molecular Biology, National Institute of Neurological Disease and Stroke, Bethesda, MD.
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  • Claudia Trenkwalder MD,

    1. Max Planck Institute of Psychiatry, Munich, Germany
    Current affiliation:
    1. Department of Clinical Neurophysiology, University of Göttingen, Göttingen, Germany
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  • Florian Holsboer MD, PhD,

    1. Max Planck Institute of Psychiatry, Munich, Germany
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  • Dorothee P. Auer MD

    Corresponding author
    1. Max Planck Institute of Psychiatry, Munich, Germany
    • Max Planck Institute of Psychiatry, Kraepelinstrasse 10, 80804 Munich, Germany
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Abstract

The known interaction between the immune system and the hypothalamic–pituitary–adrenal axis led us to explore the interrelation between magnetic resonance imaging findings and the hypothalamic–pituitary–adrenal axis activity in 53 multiple sclerosis patients. The cortisol release induced by the dexamethasone-corticotropin-releasing hormone test was negatively associated with the presence and number of gadolinium-enhancing lesions and positively associated with ventricular size. This finding suggests a protective effect of the hypothalamic– pituitary–adrenal drive on acute lesional inflammation in multiple sclerosis, probably by limiting immune overshoot. In contrast, the nature of the correlation between hypothalamic–pituitary–adrenal hyperdrive and brain atrophy remains to be determined.

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