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The relationship between cortisol and verbal memory in the early stages of Huntington’s disease

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Abstract

Hypothalamic pituitary adrenal (HPA) axis hyperactivity has been linked to learning and memory difficulties in a range of neurodegenerative and neuropsychiatric conditions. In Huntington’s disease (HD), both declines in learning and memory and HPA axis dysfunction are present early in the disease. However, the relationship between specific learning and memory deficits and HPA axis functioning in HD has not been examined. The aim of this study was to investigate cortisol levels in relation to verbal learning and memory in pre-diagnosed (pre-HD) participants and patients at the early stages of diagnosed HD (early-HD). Cortisol concentration was assayed in saliva samples from 57 participants (17 early-HD, 20 pre-HD, and 20 controls) at four time-points across a 24-h period. Verbal memory was assessed using the California Verbal Learning Test—Second Edition (CVLT-II). We focused statistical analyses on the late evening cortisol concentration, and examined cortisol levels and verbal memory function in relation to diagnostic group (control, pre-HD, early-HD), and in a separate set of analyses combining pre-HD and early-HD (and excluding controls) we also examined cortisol and verbal memory performance in relation to the severity of HD-related motor signs. Of these two classification approaches, HD motor sign severity was more strongly associated with high evening cortisol levels and both reduced information encoding and memory retrieval. Separately, there was also a trend of higher cortisol levels in pre-HD. The findings suggest hypercortisolism and the underlying pathological changes may begin many years before a clinical diagnosis is made, but the memory decline associated with HPA axis disturbance may only become detectable once motor signs become pronounced.

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Acknowledgments

The authors thank the participants for giving generously of their time. We thank Dr. Terence Pang for contributing to the design of the study, Professor Edmond Chiu for helping with the clinical assessment of participants, and Professor Grahame Coleman for statistical advice. Finally we thank Ms. Angela Komiti for assisting with a portion of the data collection. The research was supported by a 2007 Pfizer Neuroscience Research Grant and funding from the School of Psychology and Psychiatry, Monash University. Neither of these institutions were involved in the design, conduct, or publication of this study.

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical standard

This study have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.

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Authors and Affiliations

  1. School of Psychology and Psychiatry, Monash University, Clayton Campus, Wellington Road, Clayton, Victoria, 3800, Australia

    Christopher A. Shirbin, Phyllis Chua, Andrew Churchyard, Georgia Lowndes & Julie C. Stout

  2. Huntington’s Disease Clinic, St George’s Hospital, Kew, Victoria, Australia

    Phyllis Chua & Andrew Churchyard

  3. Academic Department of Old Age Psychiatry, University of Melbourne, St George’s Hospital, Kew, Victoria, Australia

    Phyllis Chua

  4. Huntington’s Disease Service, Calvary Health Care Bethlehem, Caulfield, Victoria, Australia

    Andrew Churchyard

  5. Howard Florey Institute, Florey Neuroscience Institutes, University of Melbourne, Parkville, Victoria, Australia

    Anthony J. Hannan

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  1. Christopher A. Shirbin
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Correspondence to Julie C. Stout.

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Shirbin, C.A., Chua, P., Churchyard, A. et al. The relationship between cortisol and verbal memory in the early stages of Huntington’s disease. J Neurol 260, 891–902 (2013). https://doi.org/10.1007/s00415-012-6732-y

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  • DOI: https://doi.org/10.1007/s00415-012-6732-y

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