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Altered Pituitary Gland Structure and Function in Posttraumatic Stress Disorder.
Odelia Cooper1, Vivien Bonert1, Franklin Moser2
1Pituitary Center, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California 90048.
Journal of the Endocrine Society
|December 22, 2017
Summary
Posttraumatic stress disorder (PTSD) is linked to a smaller pituitary volume and dysregulated hypothalamus-pituitary-adrenal (HPA) axis function. These findings suggest potential endocrine targets for PTSD treatment.
Area of Science:
- Neuroendocrinology
- Psychiatry
- Neuroimaging
Background:
- Posttraumatic stress disorder (PTSD) is associated with altered hypothalamus-pituitary-adrenal (HPA) axis activity.
- The relationship between HPA axis dysfunction and neuroanatomical changes in PTSD remains unclear.
Purpose of the Study:
- To investigate whether stress-induced cortisol affects pituitary corticotroph negative feedback.
- To determine the impact on pituitary volume in individuals with PTSD.
Main Methods:
- A prospective controlled study comparing 10 individuals with PTSD to 10 matched healthy controls.
- Pituitary volume was measured using MRI; HPA axis function was assessed via 24-hour urine free cortisol (UFC), morning cortisol, ACTH levels, and a dexamethasone/corticotropin-releasing hormone test.
Main Results:
- Individuals with PTSD exhibited a smaller mean pituitary volume (729.7 mm³ vs. 835.2 mm³ in controls).
- No significant difference in ACTH area under the curve (AUC) between groups.
- In PTSD subjects, pituitary volume inversely correlated with PTSD duration; in controls, pituitary volume correlated with ACTH AUC.
Conclusions:
- The HPA axis may be downregulated and dysregulated in PTSD, indicated by discordant pituitary function and volume.
- Results suggest a structural-pituitary link in PTSD, potentially guiding endocrine-targeted therapies.
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