Unreliability of TRH test but not dexamethasone suppression test as a marker of depression in chronic vasculopathic patients.
Thirteen vasculopathic nondepressed men, admitted to the hospital 2 weeks earlier because of stroke, 10 age- and weight-matched patients with major depression, and 10 age- and weight-matched normal controls were tested with TRH and on different occasion with the dexamethasone (DEX) suppression test (DST). Patients with stroke were tested again with TRH and DST after 1 year. All subjects were euthyroid. A blunted TSH response to TRH was observed in 77% of vasculopathic patients, 64% of depressed patients, and 27% of controls. Some depressed patients showed serum GH or cortisol increments in response to TRH. Nonsuppression to DEX was observed in 45% of depressed patients and 15% of vasculopathics but not in normal controls. These data indicate that, in contrast to cortisol nonsuppression to DEX, blunted TSH response to TRH has poor diagnostic value as a marker for depression after stroke and may merely represent the expression of neuroendocrine dysfunction associated with cerebral vasculopathy.
Marchesi
C
C
Institute of Clinical Psychiatry, University of Parma, Italy.
Silvestrini
C
C
Ponari
O
O
Volpi
R
R
Chiodera
P
P
Coiro
V
V
D000368:Aged; D002544:Cerebral Infarction / Q000097:blood / Q000175:diagnosis* / Q000523:psychology; D003866:Depressive Disorder / Q000097:blood / Q000175:diagnosis* / Q000523:psychology; D003907:Dexamethasone; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D008875:Middle Aged; D019965:Neurocognitive Disorders / Q000097:blood / Q000175:diagnosis* / Q000523:psychology; D013972:Thyrotropin / Q000097:blood*; D013973:Thyrotropin-Releasing Hormone; D014057:Tomography, X-Ray Computed
D013973:Thyrotropin-Releasing Hormone; D003907:Dexamethasone; D013972:Thyrotropin; D006854:Hydrocortisone