Global Rare Disease Network Research
Academic Archives
The cortisol awakening response in amyotrophic lateral sclerosis is blunted and correlates with clinical status and depressive mood |
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Summary
Considerable evidence indicates that amyotrophic lateral sclerosis (ALS), a progressive neurodegenerative disease of the motor system, has an enormous impact on the patient’s
emotional and physical well-being. As previous findings indicated that particularly the rise in
cortisol levels immediately after awakening, i.e., the cortisol awakening response (CAR), is
associated with indices of physical and emotional well-being, we compared the CAR of 29 admitted
ALS patients with that of 12 age-matched caregiver controls. Saliva samples for cortisol measurement were collected immediately, 15, 30 and 45 min after awakening. The severity of ALS
progression was quantified using the ALS functional rating scale (ALSFRS) and manual muscle test
(MMT). Depressive mood status in ALS patients was determined with the Beck Depression Inventory
(BDI) and Hamilton Depression Rating Scale (HDRS). Salivary cortisol levels of ALS patients did not
differ from those of caregiver controls at awakening, 15 min or 45 min after awakening, but were
significantly lower at 30 min after awakening. Area underthe curve analysis confirmed thatthe CAR
wassignificantly smallerin ALS patientsthan in caregiver controls. A smaller CAR in ALS patients was
significantly correlated to poorer clinical status, as assessed with both the ALSFRS and MMT rating
instruments. Further, a smaller CAR significantly correlated with a more severe depressive mood
status. No correlations were observed between total cortisol output during the first 45 min postawakening and clinical or depressive status. In conclusion, our findings indicate that ALS patients
show a blunted CAR, correlated with disease and depression severity.
# 2011 Elsevier Ltd. All rights reserved. |