title: Brief Report: Low-Dose Hydrocortisone Has Acute Enhancing Effects on Verbal Learning in HIV-Infected Men.
abstract: Glucocorticoids are released in response to stress and alter cognition and brain function through both rapid nongenomic and slow genomic mechanisms. Administration of glucocorticoids in the form of hydrocortisone enhances aspects of learning and memory in individuals with PTSD but impairs these abilities in healthy individuals. We examine the time-dependent effects of glucocorticoids on cognition in HIV-infected men.
  
  
  
  In a double-blind placebo-controlled crossover study, we examined the time-dependent effects of a single low dose of hydrocortisone [10 mg; low-dose hydrocortisone (LDH)] on cognition in 45 HIV-infected men. Participants were randomized to receive either LDH or placebo and one month later, were given the opposite treatment. At each intervention session, cognition was assessed 30 minutes (assessing nongenomic effects) and 4 hours (assessing genomic effects) after pill administration. Self-reported stress/anxiety and cortisol/cytokines in saliva were measured throughout each session.
  
  
  
  Compared with placebo, LDH doubled salivary cortisol levels. Cortisol returned to baseline 4 hours postadministration. At the 30-minute assessment, LDH enhanced verbal learning compared with placebo. Greater increases in cortisol were associated with greater enhancements in verbal learning. LDH did not affect subjective stress/anxiety or any other cognitive outcomes at the 30-minute or 4-hour time point.
  
  
  
  The rapid effects of LDH on verbal learning suggests a nongenomic mechanism by which glucocorticoids can enhance cognition in HIV-infected men. The nonenduring nature of this enhancement may limit its clinical utility but provides insight into mechanisms underlying the effects of acute glucocorticoids on learning.
authors.affiliation: *Department of Psychiatry, University of Illinois at Chicago, Chicago, IL; †Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA; ‡Blood Systems Research Institute, San Francisco, CA; §CORE Center, Cook County Health and Hospitals System, Hektoen Institute of Medicine, Chicago, IL; and ‖Department of Psychology, University of Illinois at Chicago, Chicago, IL.
authors.forename: Leah H
authors.initials: LH
authors.lastname: Rubin
authors.forename: K Luan
authors.initials: KL
authors.lastname: Phan
authors.forename: Sheila M
authors.initials: SM
authors.lastname: Keating
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Weber
authors.forename: Pauline M
authors.initials: PM
authors.lastname: Maki
mesh_terms: D000293:Adolescent; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology / Q000821:virology; D018592:Cross-Over Studies; D004311:Double-Blind Method; D015658:HIV Infections / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use*; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects / Q000503:physiopathology / Q000821:virology; D008297:Male; D008570:Memory, Short-Term / Q000187:drug effects; D008875:Middle Aged; D009483:Neuropsychological Tests; D011965:Receptors, Glucocorticoid / Q000187:drug effects; D012463:Saliva / Q000378:metabolism; D016896:Treatment Outcome; D014706:Verbal Learning / Q000187:drug effects*; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D011965:Receptors, Glucocorticoid; D006854:Hydrocortisone