title: Role of cortisol in mood and memory in patients with intractable temporal lobe epilepsy.
abstract: OBJECTIVE
  This study prospectively examined the relationships among late night salivary cortisol (NSC) levels and depressive symptoms, memory performance, and hippocampal volumes in patients with medically intractable temporal lobe epilepsy (TLE) and the potential mediating effects of cortisol in the relationships between these variables.
  
  
  METHODS
  Participants included 24 adults with well-characterized medically refractory TLE (right = 11; left = 12; bitemporal = 1). All patients provided saliva samples and completed measures of mood, anxiety, and memory (objective and subjective). MRI-based volumetric analyses of the hippocampi were also conducted.
  
  
  RESULTS
  As hypothesized, cortisol was found to be negatively related to several memory measures such that patients with higher cortisol levels demonstrated lower memory performance. However, unexpectedly, cortisol was not related to current symptoms of depression or anxiety, subjective memory ratings, or hippocampal volumes. Consistent with previous findings in the literature, a number of other relationships among the study variables were observed (objective memory and hippocampal volume; subjective memory and mood/anxiety). Results of mediator analyses suggested that cortisol does not mediate the relationship between depression and memory dysfunction or the relationship between depression and hippocampal atrophy.
  
  
  CONCLUSIONS
  While cortisol may play a role in memory performance in patients with TLE, it does not fully explain the relationship between depression and mesial temporal dysfunction, likely reflecting the complex and multifactorial relationships among these variables. Results confirm the relationship between memory performance and structural brain integrity and provide further support for a role of depression in subjective memory complaints.
authors.affiliation: Neurological Institute, Cleveland Clinic, OH, USA. buschr@ccf.org
authors.forename: R M
authors.initials: RM
authors.lastname: Busch
authors.forename: T
authors.initials: T
authors.lastname: Frazier
authors.forename: J S
authors.initials: JS
authors.lastname: Chapin
authors.forename: A H
authors.initials: AH
authors.lastname: Hamrahian
authors.forename: B
authors.initials: B
authors.lastname: Diehl
authors.forename: A
authors.initials: A
authors.lastname: Alexopoulos
authors.forename: K
authors.initials: K
authors.lastname: Unnwongse
authors.forename: R I
authors.initials: RI
authors.lastname: Naugle
authors.forename: C S
authors.initials: CS
authors.lastname: Kubu
authors.forename: G E
authors.initials: GE
authors.lastname: Tesar
authors.forename: I M
authors.initials: IM
authors.lastname: Najm
mesh_terms: D000328:Adult; D000339:Affect / Q000502:physiology*; D001007:Anxiety / Q000378:metabolism / Q000523:psychology; D003863:Depression / Q000378:metabolism / Q000523:psychology; D004833:Epilepsy, Temporal Lobe / Q000378:metabolism* / Q000523:psychology*; D006801:Humans; D006854:Hydrocortisone / Q000502:physiology*; D008568:Memory / Q000502:physiology*; D008569:Memory Disorders / Q000378:metabolism / Q000523:psychology; D019964:Mood Disorders / Q000378:metabolism / Q000523:psychology; D011446:Prospective Studies; D012463:Saliva / Q000502:physiology
chemical_list: D006854:Hydrocortisone