Effects of mineralocorticoid receptor stimulation via fludrocortisone on memory in women with borderline personality disorder.
In a previous study, we found that in contrast to healthy controls, hydrocortisone administration had enhancing effects on memory in patients with borderline personality disorder (BPD). Because hydrocortisone acts on glucocorticoid receptors (GR) and mineralocorticoid receptors (MR), it is unclear which receptor mediated these effects. The aim of the current study was to test whether more selective MR stimulation with fludrocortisone improves memory in BPD. In a placebo-controlled, randomized, within-subject, cross-over study, 39 medication-free women with BPD and 39 healthy women received placebo or 0.4mg fludrocortisone prior to cognitive testing. We measured verbal memory, visuospatial memory, and working memory. We found a significant group by fludrocortisone interaction on verbal memory and visuospatial memory. In both tests patients with BPD, but not healthy women, had impaired memory performance after fludrocortisone compared to placebo. In contrast, working memory was improved after fludrocortisone compared to placebo in both groups. Contrary to our hypothesis, we found impairing effects of MR stimulation on hippocampus-mediated verbal memory and visuospatial memory in BPD but not in healthy controls. In contrast, working memory, which depends more on the prefrontal cortex, was improved after MR stimulation across groups. Future studies should systematically disentangle beneficial and adverse effects of MR stimulation in health and disease.
Department of Psychiatry, Charité University Berlin, Campus Benjamin Franklin, Berlin, Germany. Electronic address: katja.wingenfeld@charite.de.
Katja
K
Wingenfeld
Department of Psychiatry, Charité University Berlin, Campus Benjamin Franklin, Berlin, Germany.
Linn K
LK
Kuehl
Department of Psychiatry, Charité University Berlin, Campus Benjamin Franklin, Berlin, Germany.
Katrin
K
Janke
Department of Psychiatry, Charité University Berlin, Campus Benjamin Franklin, Berlin, Germany.
Kim
K
Hinkelmann
Department of Psychiatry, Charité University Berlin, Campus Benjamin Franklin, Berlin, Germany.
Franciska C
FC
Eckert
Department of Psychiatry, Charité University Berlin, Campus Benjamin Franklin, Berlin, Germany.
Stefan
S
Roepke
Department of Psychiatry, Charité University Berlin, Campus Benjamin Franklin, Berlin, Germany.
Christian
C
Otte
D001794:Blood Pressure / Q000187:drug effects; D001883:Borderline Personality Disorder / Q000503:physiopathology* / Q000523:psychology; D016022:Case-Control Studies; D018592:Cross-Over Studies; D005260:Female; D005438:Fludrocortisone / Q000494:pharmacology*; D006801:Humans; D008568:Memory / Q000187:drug effects / Q000502:physiology*; D008570:Memory, Short-Term / Q000187:drug effects / Q000502:physiology; D018161:Receptors, Mineralocorticoid / Q000819:agonists / Q000502:physiology*; D065852:Spatial Memory / Q000187:drug effects / Q000502:physiology; D014706:Verbal Learning / Q000187:drug effects / Q000502:physiology; D055815:Young Adult
D018161:Receptors, Mineralocorticoid; D005438:Fludrocortisone
Borderline personality disorder; Fludrocortisone; Memory; Mineralocorticoid receptor