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Circadian cortisol and fatigue severity in relapsing-remitting multiple sclerosis
Daniel J H Powell1, Rona Moss-Morris2, Christina Liossi3
1Aberdeen Health Psychology Group, Institute of Applied Health Science, University of Aberdeen, AB25 2ZD, UK; Psychology, Faculty of Social and Human Sciences, University of Southampton, SO17 1BJ, UK.
Psychoneuroendocrinology
|March 31, 2015
Summary
Cortisol awakening response was higher in people with relapsing-remitting multiple sclerosis (RRMS), but not linked to daily fatigue. Cortisol may play a role in RRMS fatigue, though causality is unproven.
Area of Science:
- Endocrinology
- Neuroimmunology
- Psychoneuroendocrinology
Background:
- Cortisol regulates immunity, metabolism, and stress.
- The role of cortisol in fatigue for relapsing-remitting multiple sclerosis (RRMS) is unclear.
Purpose of the Study:
- To investigate cortisol secretory activity in RRMS patients.
- To examine the association between cortisol and fatigue severity in RRMS, both between and within individuals.
Main Methods:
- Case-control ecological momentary assessment design.
- Saliva samples collected over 4 days to measure cortisol awakening response (CAR) and diurnal cortisol slope (DCS).
- 38 RRMS patients and 38 controls participated; fatigue measured via recalled and daily ratings.
Main Results:
- CAR output was significantly greater in RRMS participants compared to controls.
- Recalled fatigue in RRMS was linked to lower waking cortisol and a larger CAR.
- No significant day-to-day association was found between CAR and same-day fatigue levels in RRMS.
Conclusions:
- Cortisol secretory activity differs in RRMS, with altered CAR.
- Cortisol may be implicated in the fatigue experienced by individuals with RRMS.
- Further research is needed to clarify the causal relationship between cortisol and RRMS fatigue.
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