title: Plasma cortisol and norepinephrine in Alzheimer's disease: opposite relations with recall performance and stage of progression.
abstract: OBJECTIVE
  Alzheimer's disease (AD) is characterized by effortful retrieval memory impairments, loss of hippocampal neurons and elevated plasma cortisol (CORT) concentrations. The latter could induce further memory decline. AD is also characterized by increased central and peripheral noradrenergic activity. Since noradrenergic function is involved in memory formation, this upregulated function could counteract memory decline. The aim of the present study was to test these hypotheses using plasma norepinephrine (NE) as a noradrenergic parameter, and recall of the prerecency part of neutral valence word lists as a measure of effortful retrieval.
  
  
  METHODS
  Area under the curve (AUC) of morning, midday and afternoon plasma CORT and plasma NE concentrations was related to two measures of recall performance, ie summated recall scores of the prerecency and recency parts of three word lists, and to the stage of the Clinical Dementia Rating (CDR).
  
  
  RESULTS
  Partial correlation between each hormone AUC value and prerecency recall performance, controlling for the effect of the other hormone, showed opposite relations between recall and either plasma CORT or NE. Similar stronger correlations were found with the CDR score.
  
  
  CONCLUSIONS
  Plasma CORT and NE are oppositely related with effortful retrieval and the stage of progression in AD.
authors.affiliation: 1GGZ-Leiden, Rivierduinen, Oegstgeest, The Netherlands.
authors.forename: Karel J
authors.initials: KJ
authors.lastname: Bemelmans
authors.affiliation: 2de Stichting 'Meerkanten', Harderwijk,The Netherlands.
authors.forename: Annemarie
authors.initials: A
authors.lastname: Noort
authors.affiliation: 3Division of Medical Pharmacology, University of Leiden, Leiden, The Netherlands.
authors.forename: Roel
authors.initials: R
authors.lastname: de Rijk
authors.affiliation: 5Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Huub A M
authors.initials: HA
authors.lastname: Middelkoop
authors.affiliation: 4Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Godfried M J
authors.initials: GM
authors.lastname: van Kempen
authors.affiliation: 1GGZ-Leiden, Rivierduinen, Oegstgeest, The Netherlands.
authors.forename: Jaap G
authors.initials: JG
authors.lastname: Goekoop