Plasma cortisol level in amyotrophic lateral sclerosis.

Area of Science:

• Neuroscience
• Endocrinology
• Clinical Research

Background:

• Amyotrophic Lateral Sclerosis (ALS) is linked to significant distress and alterations in the hypothalamic-pituitary-adrenal axis.
• Previous studies suggested a loss of cortisol circadian rhythmicity in ALS patients, with recent reports indicating increased plasma cortisol levels.

Purpose of the Study:

• To measure circadian plasma cortisol levels in ALS patients.
• To investigate the relationship between cortisol levels and the clinical phenotype and disease progression rate in ALS.

Main Methods:

• 135 ALS patients and 110 controls were recruited for the study.
• Morning and evening plasma cortisol levels were measured using the Elecsys® Cortisol Immunoassay System.
• Disease progression was quantified using the ΔFS score.

Main Results:

• ALS patients exhibited higher morning plasma cortisol levels compared to controls (15.2 vs 11.4 μg/dl, p < 0.001).
• Evening cortisol levels did not significantly differ between ALS patients and controls (7.5 vs 7.9 μg/dl, p = 0.6).
• Elevated cortisol levels were observed in the spinal-onset ALS group and in patients with intermediate or rapid disease progression.

Conclusions:

• Morning plasma cortisol is elevated in ALS, especially in spinal-onset and rapidly progressing cases.
• The observed changes in plasma cortisol levels are likely too minor to be a sensitive biomarker for ALS.
• Further research may explore other biomarkers for this severe neurodegenerative disease.