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Enhanced cortisol suppression to dexamethasone associated with Gulf War deployment
Julia A Golier1, James Schmeidler, Juliana Legge
1Department of Psychiatry, James J Peters VA Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468, USA. julia.gotier@med.va.gov
Psychoneuroendocrinology
|October 20, 2006
Summary
Gulf War veterans showed altered pituitary-adrenal axis function, with greater cortisol suppression linked to deployment and musculoskeletal symptoms, not PTSD. This neuroendocrine change is associated with Gulf War service and subsequent health issues.
Area of Science:
- Neuroendocrinology
- Military Medicine
- Psychotraumatology
Background:
- Gulf War veterans often experience persistent, unexplained health issues post-deployment.
- The pituitary-adrenal axis (PAA) plays a crucial role in stress response and immune function.
- Dysregulation of the PAA has been implicated in various stress-related disorders.
Purpose of the Study:
- To investigate the association between post-traumatic stress disorder (PTSD) or other post-deployment health symptoms and PAA function in Gulf War veterans.
- To determine if enhanced suppression of the PAA to low-dose dexamethasone (DEX) is linked to deployment or specific symptoms.
Main Methods:
- Measured plasma cortisol and lymphocyte glucocorticoid receptor (GR) number in Gulf War veterans and non-deployed controls.
- Administered low-dose dexamethasone (DEX) and assessed subsequent cortisol suppression.
- Compared neuroendocrine responses among veterans with no psychiatric illness, PTSD only, PTSD with major depressive disorder (MDD), and healthy controls.
Main Results:
- Gulf War veterans without psychiatric illness and those with PTSD only exhibited greater cortisol suppression to DEX compared to non-deployed veterans and those with PTSD and MDD.
- Gulf War deployment, not PTSD, was significantly associated with enhanced cortisol suppression, even after controlling for confounding factors.
- Musculoskeletal symptoms and use of pyridostigmine bromide during the war were significantly linked to greater DEX-induced cortisol suppression.
Conclusions:
- Alterations in neuroendocrine function, specifically enhanced glucocorticoid responsivity, are associated with Gulf War deployment and post-deployment musculoskeletal symptoms.
- PTSD was not found to be directly associated with altered PAA suppression in this cohort.
- Further research is warranted to explore the relationship between deployment exposures, enhanced glucocorticoid sensitivity, and chronic health symptoms in veterans.
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