Sylvie Tordjman1, George M Anderson2, Solenn Kermarrec3, Olivier Bonnot4, Marie-Maude Geoffray5, Sylvie Brailly-Tabard6, Amel Chaouch7, Isabelle Colliot7, Severine Trabado6, Guillaume Bronsard8, Nathalie Coulon9, Michel Botbol10, Henriette Charbuy11, Françoise Camus12, Yvan Touitou12. 1. Pôle Hospitalo-Universitaire de Psychiatrie de l'Enfant et de l'Adolescent de Rennes (PHUPEA), CHGR et Université de Rennes 1, Rennes, France; Laboratoire Psychologie de la Perception, Université Paris Descartes, CNRS UMR 8158, Paris, France. Electronic address: s.tordjman@yahoo.fr. 2. Child Study Center, Yale University School of Medicine, New-Haven, CT, USA. 3. Pôle Hospitalo-Universitaire de Psychiatrie de l'Enfant et de l'Adolescent de Rennes (PHUPEA), CHGR et Université de Rennes 1, Rennes, France; Laboratoire Psychologie de la Perception, Université Paris Descartes, CNRS UMR 8158, Paris, France. 4. Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Nantes, Nantes, France. 5. Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpital le Vinatier, Bron, France. 6. INSERM U 693, Université Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin-Bicêtre, France; AP-HP, CHU Bicêtre, Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Le Kremlin-Bicêtre, France. 7. AP-HP, CHU Bicêtre, Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Le Kremlin-Bicêtre, France. 8. Maison Départementale de l'Adolescent et Centre Médico-Psycho-Pédagogique, Conseil Général des Bouches-du-Rhône, France; Laboratoire de Santé Publique EA3279, Faculté de Médecine de Marseille, France. 9. Laboratoire Psychologie de la Perception, Université Paris Descartes, CNRS UMR 8158, Paris, France. 10. Service Hospitalo-Universitaire de Psychiatrie de l'Enfant et de l'Adolescent de Brest, EA4686, UBO, Brest, France. 11. Medical Biochemistry and Molecular Biology, Paris 6 School of Medicine, Paris, France. 12. Chronobiology Unit, Rothschild Foundation, Paris, France.
Abstract
BACKGROUND: Reports of higher stress responsivity, altered sleep-wake cycle and a melatonin deficit in autism have stimulated interest in the cortisol circadian rhythm in individuals with autism. METHODS: The study was conducted on 55 low-functioning children and adolescents with autism (11.3 ± 4.1 years-old) and 32 typically developing controls (11.7 ± 4.9 years-old) matched for age, sex and puberty. Behavioral assessment was performed using the Autism Diagnostic Observation Schedule (ADOS). Salivary samples for measurement of cortisol were collected during a 24-h period (at least 0800 h-Day 1, 1600 h, 0800 h-Day 2 for 46 individuals with autism and 27 controls, and 0800 h-Day 1, 1100 h, 1600 h, 2400 h, 0800 h-Day 2 for 13 individuals with autism and 20 controls). Overnight (2000 h-0800 h) urinary cortisol excretion was also measured. RESULTS: The autism group displayed significantly higher levels of salivary cortisol at all time-points, flatter daytime and nighttime slopes, higher 0800 h cortisol levels on Day 2 compared to Day 1, and greater variances of salivary and urinary cortisol. There was a significant relationship between salivary cortisol levels and impairments in social interaction and verbal language. Overnight urinary cortisol excretion was similar in the autism and control groups. CONCLUSION: Anticipation of the stressful collection procedure appears to contribute to the higher 0800 h-Day 2 versus 0800 h-Day 1 salivary cortisol levels in autism. This sensitization to stressors might be as, or even more, important clinically than exposure to novelty in autism. The similar group means for overnight urinary cortisol excretion indicate that basal HPA axis functioning is unaltered in low-functioning autism. The elevated salivary cortisol levels observed in autism over the 24-h period in a repeated stressful condition, flattened diurnal cortisol patterns and the apparent effect of anticipation are consistent with prior findings in high trait anxiety.
BACKGROUND: Reports of higher stress responsivity, altered sleep-wake cycle and a melatonin deficit in autism have stimulated interest in the cortisol circadian rhythm in individuals with autism. METHODS: The study was conducted on 55 low-functioning children and adolescents with autism (11.3 ± 4.1 years-old) and 32 typically developing controls (11.7 ± 4.9 years-old) matched for age, sex and puberty. Behavioral assessment was performed using the Autism Diagnostic Observation Schedule (ADOS). Salivary samples for measurement of cortisol were collected during a 24-h period (at least 0800 h-Day 1, 1600 h, 0800 h-Day 2 for 46 individuals with autism and 27 controls, and 0800 h-Day 1, 1100 h, 1600 h, 2400 h, 0800 h-Day 2 for 13 individuals with autism and 20 controls). Overnight (2000 h-0800 h) urinary cortisol excretion was also measured. RESULTS: The autism group displayed significantly higher levels of salivary cortisol at all time-points, flatter daytime and nighttime slopes, higher 0800 h cortisol levels on Day 2 compared to Day 1, and greater variances of salivary and urinary cortisol. There was a significant relationship between salivary cortisol levels and impairments in social interaction and verbal language. Overnight urinary cortisol excretion was similar in the autism and control groups. CONCLUSION: Anticipation of the stressful collection procedure appears to contribute to the higher 0800 h-Day 2 versus 0800 h-Day 1 salivary cortisol levels in autism. This sensitization to stressors might be as, or even more, important clinically than exposure to novelty in autism. The similar group means for overnight urinary cortisol excretion indicate that basal HPA axis functioning is unaltered in low-functioning autism. The elevated salivary cortisol levels observed in autism over the 24-h period in a repeated stressful condition, flattened diurnal cortisol patterns and the apparent effect of anticipation are consistent with prior findings in high trait anxiety.
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Authors: Sylvie Tordjman; Katherine S Davlantis; Nicolas Georgieff; Marie-Maude Geoffray; Mario Speranza; George M Anderson; Jean Xavier; Michel Botbol; Cécile Oriol; Eric Bellissant; Julie Vernay-Leconte; Claire Fougerou; Anne Hespel; Aude Tavenard; David Cohen; Solenn Kermarrec; Nathalie Coulon; Olivier Bonnot; Geraldine Dawson Journal: Front Pediatr Date: 2015-02-23 Impact factor: 3.418