Leah H Rubin1,2,3, K Luan Phan1, Sheila M Keating4,5, Pauline M Maki1,6. 1. Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois. 2. Department of Neurology, Johns Hopkins School of Medicine. 3. Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland. 4. Department of Laboratory Medicine, University of California, San Francisco. 5. Blood Systems Research Institute, San Francisco, California. 6. Department of Psychology, University of Illinois at Chicago, Chicago, Illinois, USA.
Abstract
OBJECTIVE:Low-dose hydrocortisone (LDH) enhances aspects of learning and memory in select populations including patients with posttraumatic stress disorder and HIV-infected men. HIV-infected women show impairments in learning and memory, but the cognitive effects of LDH in HIV-infected women are unknown. DESIGN: Double-blind, placebo-controlled, cross-over study examining the time-dependent effects of a single low-dose administration of hydrocortisone (10 mg oral) on cognition in 36 HIV-infected women. Participants were first randomized to LDH or placebo and then received the opposite treatment one month later. METHODS:Cognitive performance was assessed 30 min and 4 h after pill administration to assess, respectively, nongenomic and genomic effects. Self-reported stress/anxiety and salivary cortisol were assessed throughout sessions. RESULTS:LDH significantly increased salivary cortisol levels versus placebo; levels returned to baseline 4-h postadministration. At the 30-min assessment, LDH enhanced verbal learning and delayed memory, working memory, behavioral inhibition, and visuospatial abilities. At the 4-h assessment, LDH enhanced verbal learning and delayed memory compared with placebo. LDH-induced cognitive benefits related to reductions in cytokines and to a lesser extent to increases in cortisol. CONCLUSION: The extended benefits from 30 min to 4 h of a single administration of LDH on learning and delayed memory suggest that targeting the hypothalamic-pituitary-adrenal axis may have potential clinical utility in HIV-infected women. These findings contrast with our findings in HIV-infected men who showed improved learning only at the 30-min assessment. Larger, longer term studies are underway to verify possible cognitive enhancing effects of LDH and the clinical significance of these effects in HIV.
RCT Entities:
OBJECTIVE: Low-dose hydrocortisone (LDH) enhances aspects of learning and memory in select populations including patients with posttraumatic stress disorder and HIV-infectedmen. HIV-infectedwomen show impairments in learning and memory, but the cognitive effects of LDH in HIV-infectedwomen are unknown. DESIGN: Double-blind, placebo-controlled, cross-over study examining the time-dependent effects of a single low-dose administration of hydrocortisone (10 mg oral) on cognition in 36 HIV-infectedwomen. Participants were first randomized to LDH or placebo and then received the opposite treatment one month later. METHODS: Cognitive performance was assessed 30 min and 4 h after pill administration to assess, respectively, nongenomic and genomic effects. Self-reported stress/anxiety and salivary cortisol were assessed throughout sessions. RESULTS:LDH significantly increased salivary cortisol levels versus placebo; levels returned to baseline 4-h postadministration. At the 30-min assessment, LDH enhanced verbal learning and delayed memory, working memory, behavioral inhibition, and visuospatial abilities. At the 4-h assessment, LDH enhanced verbal learning and delayed memory compared with placebo. LDH-induced cognitive benefits related to reductions in cytokines and to a lesser extent to increases in cortisol. CONCLUSION: The extended benefits from 30 min to 4 h of a single administration of LDH on learning and delayed memory suggest that targeting the hypothalamic-pituitary-adrenal axis may have potential clinical utility in HIV-infectedwomen. These findings contrast with our findings in HIV-infectedmen who showed improved learning only at the 30-min assessment. Larger, longer term studies are underway to verify possible cognitive enhancing effects of LDH and the clinical significance of these effects in HIV.
Authors: Julius Popp; Michael Bacher; Heike Kölsch; Carmen Noelker; Oliver Deuster; Richard Dodel; Frank Jessen Journal: J Psychiatr Res Date: 2008-11-26 Impact factor: 4.791
Authors: Maria L Alcaide; Anita Parmigiani; Suresh Pallikkuth; Margaret Roach; Riccardo Freguja; Marina Della Negra; Hector Bolivar; Margaret A Fischl; Savita Pahwa Journal: PLoS One Date: 2013-05-28 Impact factor: 3.240
Authors: Asante R Kamkwalala; Pauline M Maki; Scott A Langenecker; K Luan Phan; Kathleen M Weber; Leah H Rubin Journal: J Neurovirol Date: 2021-09-24 Impact factor: 2.643
Authors: Leah H Rubin; Deeya Bhattacharya; Joelle Fuchs; Abigail Matthews; Sarah Abdellah; Rebecca T Veenhuis; Scott A Langenecker; Kathleen M Weber; Hans P Nazarloo; Sheila M Keating; C Sue Carter; Pauline M Maki Journal: Psychosom Med Date: 2022-08-20 Impact factor: 3.864
Authors: Leah H Rubin; Scott A Langenecker; K Luan Phan; Sheila M Keating; Gretchen N Neigh; Kathleen M Weber; Pauline M Maki Journal: Psychoneuroendocrinology Date: 2020-02-07 Impact factor: 4.905
Authors: Asante R Kamkwalala; Kunbo Wang; Yanxun Xu; Leah H Rubin; Jane O'Halloran; Dionna W Williams; Raha Dastgheyb; Kathryn C Fitzgerald; Amanda B Spence; Pauline M Maki; Deborah R Gustafson; Joel Milam; Anjali Sharma; Kathleen M Weber; Adaora A Adimora; Igho Ofotokun; Anandi N Sheth; Cecile D Lahiri; Margaret A Fischl; Deborah Konkle-Parker Journal: AIDS Behav Date: 2021-01
Authors: Erin E Sundermann; Kristine M Erlandson; Caitlin N Pope; Anna Rubtsova; Jessica Montoya; Alison A Moore; Catia Marzolini; Kelly K O'Brien; Savita Pahwa; Brendan A I Payne; Leah H Rubin; Sharon Walmsley; Norman J Haughey; Monty Montano; Maile Y Karris; Joseph B Margolick; David J Moore Journal: AIDS Res Hum Retroviruses Date: 2019-09-10 Impact factor: 1.723