Central serotonin transporter levels are associated with stress hormone response and anxiety
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- Reimold, M., Knobel, A., Rapp, M.A. et al. Psychopharmacology (2011) 213: 563. doi:10.1007/s00213-010-1903-y
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Negative mood states are characterized by both stress hormone dysregulation and serotonergic dysfunction, reflected by altered thalamic serotonin transporter (5-HTT) levels. However, so far, no study examined the individual association between cortisol response and cerebral in vivo 5-HTT levels in patients suffering from negative mood states.
The objective of this cross-sectional study was to assess the interrelation of cortisol response, thalamic 5-HTT levels, and anxiety in healthy subjects and two previously published samples of patients with unipolar major depression (UMD) and obsessive–compulsive disorder (OCD), controlling for age, gender, 5-HTT genotype, smoking, and seasonality.
Regional 5-HTT levels and cortisol response to dexamethasone-corticotropin (Dex-CRH) challenge were assessed in consecutive samples of medication-free patients suffering from UMD (N = 10) and OCD (N = 10), and 20 healthy volunteers. The intervention used was combined Dex-CRH test and [11C]DASB positron emission tomography. The main outcome measures were: 5-HTT binding potential (BPND) in a predefined thalamic ROI, cortisol response defined as the maximum cortisol increase in the combined Dex-CRH-test, and state of anxiety from the state-trait-anxiety inventory.
Reduced thalamic 5-HTT BPND was associated with increased cortisol response (r = −0.35, p < 0.05; in patients: r = −0.53, p < 0.01) and with increased state anxiety (r = −0.46, p < 0.01), surviving correction for age, gender, 5-HTT genotype, smoking, and seasonality (p < 0.05). The 5-HTT genotype, on the contrary, was not significantly associated with cortisol response (p = 0.19) or negative mood (p = 0.23).
The association between stress hormone response, thalamic 5-HTT levels, and anxiety in patients suffering from negative mood states suggests an interaction between two major mechanisms implicated in negative mood states in humans.