title: The Cortisol Awakening Response in Patients with Poststroke Depression Is Blunted and Negatively Correlated with Depressive Mood.
abstract: It is important to reduce poststroke depression (PSD) to improve the stroke outcomes and quality of life in stroke patients, but the underlying mechanisms of PSD are not completely understood. As many studies implicate dysregulation of hypothalamic-pituitary-adrenal axis in the etiology of major depression and stroke, we compared the cortisol awakening response (CAR) of 28 admitted PSD patients with that of 23 age-matched caregiver controls. Saliva samples for cortisol measurement were collected immediately, 15, 30, and 45 min after awakening for two consecutive days. Depressive mood status in PSD patients was determined with Beck Depression Inventory and Hamilton Depression Rating Scale. Salivary cortisol levels of PSD patients did not rise significantly at any sampling time, showing a somewhat flat curve. Caregiver controls showed significantly higher CAR at 15 and 30 min after awakening compared to PSD patients even though the two groups did not differ at awakening or 45 min after awakening. Area-under-the-curve analysis revealed a significant negative correlation between the CAR and the degree of depression in PSD patients. Thus, our findings suggest that poststroke depression is closely related with dysfunctional HPA axis indicated by blunted CAR.
authors.affiliation: Hanbang Body-Fluid Research Center, Wonkwang University, Shinyong-dong, Iksan, Jeonbuk 570-749, Republic of Korea.
authors.forename: Oh Jeong
authors.initials: OJ
authors.lastname: Kwon
authors.affiliation: Department of Psychology, College of Social Sciences, Chonnam National University, Yongbong-dong 300, Buk-gu, Gwangju 500-757, Republic of Korea.
authors.forename: Munsoo
authors.initials: M
authors.lastname: Kim
authors.affiliation: Hanbang Body-Fluid Research Center, Wonkwang University, Shinyong-dong, Iksan, Jeonbuk 570-749, Republic of Korea.
authors.forename: Ho Sub
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine and Neuroscience, College of Oriental Medicine, Wonkwang University, 344-2 Shinyong-dong, Iksan, Chonbuk 570-749, Republic of Korea.
authors.forename: Kang-keyng
authors.initials: KK
authors.lastname: Sung
authors.affiliation: Hanbang Body-Fluid Research Center, Wonkwang University, Shinyong-dong, Iksan, Jeonbuk 570-749, Republic of Korea ; Department of Internal Medicine and Neuroscience, College of Oriental Medicine, Wonkwang University, 344-2 Shinyong-dong, Iksan, Chonbuk 570-749, Republic of Korea.
authors.forename: Sangkwan
authors.initials: S
authors.lastname: Lee
mesh_terms: D000339:Affect / Q000502:physiology*; D019540:Area Under Curve; D016022:Case-Control Studies; D003863:Depression / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D012463:Saliva / Q000737:chemistry; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D014851:Wakefulness
chemical_list: D006854:Hydrocortisone