Glucocorticoid receptor mediated negative feedback in chronic fatigue syndrome using the low dose (0.5 mg) dexamethasone suppression test

Papadopoulos, Andrew and Ebrecht, Marcel and Roberts, Amanda D. L. and Poon, Lucia and Rohleder, Nicolas and Cleare, Anthony J. (2009) Glucocorticoid receptor mediated negative feedback in chronic fatigue syndrome using the low dose (0.5 mg) dexamethasone suppression test. Journal of Affective Disorders, 112 (1-3). pp. 289-294. ISSN 0165-0327

Full content URL: http://dx.doi.org/10.1016/j.jad.2008.05.001

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Glucocorticoid receptor mediated negative feedback in CFS

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Abstract

Background: Chronic fatigue syndrome (CFS) is associated with hypocortisolism, but it is not yet clear the extent to which enhanced negative feedback may underlie this finding.
Methods: We undertook a low-dose dexamethasone (0.5 mg) suppression test in 18 CFS patients and 20 matched, healthy controls.We measured salivary cortisol levels at 0800 h, 1200 h, 1600 h and 2000 h before and after the administration of 0.5 mg of dexamethasone.
Results: Basal cortisol output was raised in this group of CFS patients compared to controls. Overall, the percentage suppression following dexamethasone administration was no different between CFS (mean±sem: 80.4±4.4%) and controls (76.2±4.9 %). However, the sub-group of patients with CFS and comorbid depression (n=9) showed a significant hypersuppression of salivary cortisol in response to dexamethasone (89.0±1.9%; pb0.05 v controls).
Limitations: The sub-group analysis was on small numbers and should be considered preliminary. Dexamethasone probes only glucocorticoid medicated negative feedback but does not probe mineralocorticoid feedback, the other main physiological feedback mechanism.
Conclusion: We found partial support for the hypothesis of enhanced negative feedback in CFS but only in patients with comorbid depression and also in the context of a sample of patients with elevated basal cortisol levels, which is an atypical finding in the literature.

Keywords:Chronic fatigue syndrome, HPA axis, Dexamethasone suppression test, Glucocorticoid receptor, Negative feedback, Neuroendocrinology
Subjects:A Medicine and Dentistry > A300 Clinical Medicine
C Biological Sciences > C841 Health Psychology
C Biological Sciences > C840 Clinical Psychology
Divisions:College of Social Science > School of Psychology
ID Code:15802
Deposited On:27 Oct 2014 10:05

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