Diurnal salivary cortisol concentrations in Parkinson's disease: increased total secretion and morning cortisol concentrations

O Skogar, P-A Fall, G Hallgren, J Lökk, B Bringer, M Carlsson, U Lennartsson, H Sandbjork, C-J Törnhage, O Skogar, P-A Fall, G Hallgren, J Lökk, B Bringer, M Carlsson, U Lennartsson, H Sandbjork, C-J Törnhage

Abstract

Background: Parkinson's disease (PD) is a chronic neurodegenerative disorder. There is limited knowledge about the function of the hypothalamic-pituitary-adrenal axis in PD. The primary aim of this prospective study was to analyze diurnal salivary cortisol concentrations in patients with PD and correlate these with age, gender, body mass index (BMI), duration of PD, and pain. The secondary aim was to compare the results with a healthy reference group.

Methods: Fifty-nine PD patients, 35 women and 24 men, aged 50-79 years, were recruited. The reference group comprised healthy individuals matched for age, gender, BMI, and time point for sampling. Salivary cortisol was collected at 8 am, 1 pm, and 8 pm, and 8 am the next day using cotton-based Salivette(®) tubes and analyzed using Spectria(®) Cortisol I(125). A visual analog scale was used for estimation of pain.

Results: The median cortisol concentration was 16.0 (5.8-30.2) nmol/L at 8 am, 5.8 (3.0-16.4) at 1 pm, 2.8 (1.6-8.0) at 8 pm, and 14.0 (7.5-28.7) at 8 am the next day. Total secretion and rate of cortisol secretion during the day (8 am-8 pm) and the concentration of cortisol on the next morning were lower (12.5 nmol/L) in the reference group. No significant correlations with age, gender, BMI, duration of PD, Hoehn and Yahr score, Unified Parkinson's Disease Rating Scale III score, gait, pain, or cortisol concentrations were found.

Conclusion: The neurodegenerative changes in PD does not seem to interfere with the hypothalamic-pituitary-adrenal axis. Salivary cortisol concentrations in PD patients were increased in the morning compared with the reference group, and were not influenced by motor dysfunction, duration of disease, or coexistence of chronic or acute pain.

Keywords: Parkinson’s disease; cortisol; hypothalamic-pituitary-adrenal axis.

Figures

Figure 1A
Figure 1A
Individual diurnal salivary cortisol concentrations (nmol/L) in Parkinson’s disease with and without chronic pain.
Figure 1B
Figure 1B
Diurnal salivary cortisol concentrations (nmol/L) in all 59 patients with Parkinson’s disease. Statistical analysis, between paired time points. Notes: Correlations – Spearman two-tailed test: 8 am–8 am, r = 0.44: P < 0.01; 1 pm–8 am, r = 0.39: P < 0.01. Abbreviation: ns, not significant.

References

    1. Bruguerolle B, Simon N. Biologic rhythms and Parkinson’s disease: A chronopharmacologic approach to considering fluctuations in function. Clin Neuropharmacol. 2002;25(4):194–201.
    1. Borg A, Törnhage C-J. “Parkitouch”-studien, Parkinsons sjukdom och effekten av beröringsmassage. [the study of “Parkitouch”, Parkinson’s disease and the effects of tactile touch] Parkinson Journalen. 2009;1:22–24.
    1. Beiske AG, Loge JH, Ronningen A, Svensson E. Pain in Parkinson’s disease: Prevalence and characteristics. Pain. 2009;141(1–2):173–177.
    1. Negre-Pages L, Regragui W, Rascol O, DoPaMi PSG. Chronic pain in Parkinson’s disease: The cross-sectional French DoPaMiP survey. Mov Disord. 2008;23(10):1361–1369.
    1. Ford B. Pain in Parkinson’s disease. Clin Neurosci. 1998;5(2):63–72.
    1. Buzas B, Max MB. Pain in Parkinson disease. Neurology. 2004;62(12):2156–2157.
    1. Borgman. Parkinsonenkät-98. Parkinsonjournalen. 2002
    1. Schestatsky P, Kumru H, Valls-Sole J, et al. Neurophysiologic study of central pain in patients with Parkinson disease. Neurology. 2007;69(23):2162–2169.
    1. Simuni T, Sethi K. Nonmotor manifestations of Parkinson’s disease. Ann Neurol. 2008;64(Suppl 2):S65–S80.
    1. Munhoz RP, Teive HA, Troiano AR, et al. Parkinson’s disease and thyroid dysfunction. Parkinsonism Relat Disord. 2004;10(6):381–383.
    1. Aziz NA, Pijl H, Frolich M, Roelfsema F, Roos RA. Diurnal secretion profiles of growth hormone, thyrotropin and prolactin in Parkinson’s disease. J Neuroendocrinol. 2011;23(6):519–524.
    1. McEwen BS. Re-examination of the glucocorticoid hypothesis of stress and aging. Prog Brain Res. 1992;93:365–381.
    1. Van Cauter E, Leproult R, Kupfer DJ. Effects of gender and age on the levels and circadian rhythmicity of plasma cortisol. J Clin Endocrinol Metab. 1996;81(7):2468–2473.
    1. Seeman TE, Singer B, McEwen B. Gender differences in age-related changes in HPA axis reactivity. Psychoneuroendocrinology. 2001;26(3):225–240.
    1. Laughlin GA, Barrett-Connor E. Sexual dimorphism in the influence of advanced aging on adrenal hormone levels: The Rancho Bernardo Study. J Clin Endocrinol Metab. 2000;85(10):3561–3568.
    1. Kudielka BM, Buske-Kirschbaum A, Kirschbaum C, et al. HPA axis responses to laboratory psychosocial stress in healthy elderly adults, younger adults, and children: Impact of age and gender. Psychoneuroendocrinology. 2004;29(1):83–98.
    1. Larsson CA, Gullberg B, Rastam L, Lindblad U. Salivary cortisol differs with age and sex and shows inverse associations with WHR in Swedish women: A cross-sectional study. BMC Endocr Disord. 2009;9:16.
    1. Hartmann A, Veldhuis JD, Deuschle M, Standhardt H, Heuser I. Twenty-four hour cortisol release profiles in patients with Alzheimer’s and Parkinson’s disease compared to normal controls: Ultradian secretory pulsatility and diurnal variation. Neurobiol Aging. 1997;18(3):285–289.
    1. Charlett A, Dobbs RJ, Purkiss AG, et al. Cortisol is higher in parkinsonism and associated with gait deficit. Acta Neurol Scand. 1998;97(2):77–85.
    1. Rabey JM, Scharf M, Oberman Z, Zohar M, Graff E. Cortisol, ACTH, and beta-endorphin after dexamethasone administration in Parkinson’s dementia. Biol Psychiatry. 1990;27(6):581–591.
    1. Muller T, Welnic J, Muhlack S. Acute levodopa administration reduces cortisol release in patients with Parkinson’s disease. J Neural Transm. 2007;114(3):347–350.
    1. Calne DB, Snow BJ, Lee C. Criteria for diagnosing Parkinson’s disease. Ann Neurol. 1992;32(Suppl):S125–S127.
    1. Ramaker C, Marinus J, Stiggelbout AM, Van Hilten BJ. Systematic evaluation of rating scales for impairment and disability in Parkinson’s disease. Mov Disord. 2002;17(5):867–876.
    1. Scott J, Huskisson EC. Graphic representation of pain. Pain. 1976;2(2):175–184.
    1. Jones MT, Gillham B, Campbell EA, Al-Taher AR, Chuang TT, Di Sciullo A. Pharmacology of neural pathways affecting CRH secretion. Ann N Y Acad Sci. 1987;512:162–175.
    1. Tornhage CJ, Alfven G. Diurnal salivary cortisol concentration in school-aged children: Increased morning cortisol concentration and total cortisol concentration negatively correlated to body mass index in children with recurrent abdominal pain of psychosomatic origin. J Pediatr Endocrinol Metab. 2006;19(6):843–854.
    1. Tornhage CJ. Salivary cortisol for assessment of hypothalamic-pituitary-adrenal axis function. Neuroimmunomodulation. 2009;16(5):284–289.
    1. Clements AD, Parker CR. The relationship between salivary cortisol concentrations in frozen versus mailed samples. Psychoneuroendocrinology. 1998;23(6):613–616.
    1. Tornhage CJ. Reference values for morning salivary cortisol concentrations in healthy school-aged children. J Pediatr Endocrinol Metab. 2002;15(2):197–204.
    1. Pruessner JC, Kirschbaum C, Meinlschmid G, Hellhammer DH. Two formulas for computation of the area under the curve represent measures of total hormone concentration versus time-dependent change. Psychoneuroendocrinology. 2003;28(7):916–931.
    1. Fekedulegn DB, Andrew ME, Burchfiel CM, et al. Area under the curve and other summary indicators of repeated waking cortisol measurements. Psychosom Med. 2007;69(7):651–659.
    1. Vining RF, McGinley RA, Maksvytis JJ, Ho KY. Salivary cortisol: A better measure of adrenal cortical function than serum cortisol. Ann Clin Biochem. 1983;20(Pt 6):329–335.
    1. Aardal E, Holm AC. Cortisol in saliva – reference ranges and relation to cortisol in serum. Eur J Clin Chem Clin Biochem. 1995;33(12):927–932.
    1. Weibel L. Methodological guidelines for the use of salivary cortisol as biological marker of stress. Presse Med. 2003;32(18):845–851. French.
    1. Leproult R, Van Cauter E. Role of sleep and sleep loss in hormonal release and metabolism. Endocr Dev. 2010;17:11–21.
    1. Bellomo G, Santambrogio L, Fiacconi M, Scarponi AM, Ciuffetti G. Plasma profiles of adrenocorticotropic hormone, cortisol, growth hormone and prolactin in patients with untreated Parkinson’s disease. J Neurol. 1991;238(1):19–22.
    1. Travison TG, O’Donnell AB, Araujo AB, Matsumoto AM, McKinlay JB. Cortisol levels and measures of body composition in middle-aged and older men. Clin Endocrinol (Oxf) 2007;67(1):71–77.
    1. Heim C, Ehlert U, Hellhammer DH. The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders. Psychoneuroendocrinology. 2000;25(1):1–35.

Source: PubMed

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