Brain-adrenal axis hormones are altered in the CSF of infants with massive infantile spasms

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T Z Baram1, W G Mitchell, O C Snead

  • 1Department of Neurology, University of Southern California, Los Angeles.

Neurology
|June 1, 1992
PubMed

Insights

Massive infantile spasms (MIS) in infants show altered central nervous system (CNS) adrenocorticotropic hormone (ACTH) levels. This suggests a specific brain-adrenal axis dysfunction in this infant seizure disorder.

Area of Science:

  • Pediatric Neurology
  • Neuroendocrinology
  • Infant Seizure Disorders

Background:

  • Massive infantile spasms (MIS) is an infant-specific seizure disorder.
  • It's linked to immature brain responses to stressors.
  • Seizures improve with ACTH and glucocorticoids, key brain-adrenal axis hormones.

Purpose of the Study:

  • To investigate potential abnormalities in central nervous system (CNS) hormone levels in infants with MIS.
  • To compare CNS levels of CRH, ACTH, cortisol, and IL-1-beta between MIS patients and controls.

Main Methods:

  • Analysis of cerebrospinal fluid (CSF) from 14 infants with MIS and 13 age-matched controls.
  • Quantification of corticotropin-releasing hormone (CRH), ACTH, cortisol, and interleukin-1-beta.

Main Results:

  • Significantly lower ACTH levels were found in the CSF of MIS patients compared to controls.
  • Cortisol levels did not show statistically significant differences between groups.
  • CRH levels were similar in both groups and exhibited diurnal fluctuations.

Conclusions:

  • Infants with MIS exhibit alterations in specific CNS components of the brain-adrenal axis.
  • Reduced CNS ACTH levels may play a role in the pathophysiology of massive infantile spasms.

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