title: Higher levels of basal serial CSF cortisol in combat veterans with posttraumatic stress disorder.
abstract: OBJECTIVE
  Results of basal peripheral cortisol measures in posttraumatic stress disorder (PTSD) have been variable. The authors' goal was to measure CSF cortisol concentrations, which more accurately reflect brain glucocorticoid exposure, in subjects with or without PTSD.
  
  
  METHODS
  CSF was withdrawn from a subarachnoid catheter and plasma from a venous catheter, both indwelling, over a 6-hour interval to determine hourly plasma ACTH and cortisol concentrations and hourly CSF cortisol levels in eight well-characterized combat veterans with PTSD and eight matched healthy volunteers.
  
  
  RESULTS
  Mean CSF cortisol concentrations were significantly higher in the subjects with PTSD (3.18 ng/ml, SD=0.33) than in the normal volunteers (2.33 ng/ml, SD=0.50), largely due to higher CSF cortisol concentration nadirs. No group differences were observed in either plasma ACTH or peripheral (plasma or urinary free) cortisol. CSF corticotropin-releasing hormone and CSF cortisol concentrations were positively and significantly correlated.
  
  
  CONCLUSIONS
  Despite normal peripheral cortisol indexes in the veterans with PTSD, their CNS exposure to cortisol was greater than that of normal comparison subjects.
authors.affiliation: Psychiatry Service, San Diego VA Healthcare System, CA, USA. dgbaker@ucsd.edu
authors.forename: Dewleen G
authors.initials: DG
authors.lastname: Baker
authors.forename: Nosa N
authors.initials: NN
authors.lastname: Ekhator
authors.forename: John W
authors.initials: JW
authors.lastname: Kasckow
authors.forename: Boris
authors.initials: B
authors.lastname: Dashevsky
authors.forename: Paul S
authors.initials: PS
authors.lastname: Horn
authors.forename: Ludmila
authors.initials: L
authors.lastname: Bednarik
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Geracioti
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood / Q000134:cerebrospinal fluid; D000328:Adult; D002406:Catheterization, Peripheral; D002408:Catheters, Indwelling; D002940:Circadian Rhythm / Q000502:physiology*; D003130:Combat Disorders / Q000097:blood / Q000134:cerebrospinal fluid* / Q000175:diagnosis; D003346:Corticotropin-Releasing Hormone / Q000097:blood / Q000134:cerebrospinal fluid; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000134:cerebrospinal fluid*; D008297:Male; D013129:Spinal Puncture; D013313:Stress Disorders, Post-Traumatic / Q000097:blood / Q000134:cerebrospinal fluid* / Q000175:diagnosis; D013346:Subarachnoid Space; D014728:Veterans / Q000706:statistics & numerical data
chemical_list: D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone